Respiratory Tract Infections Flashcards Preview

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Flashcards in Respiratory Tract Infections Deck (30):
1

What are the common upper respiratory tract infections?

- Rhinitis
- Sinusitis
- Pharyngitis
- Epiglottitis

2

What is the cause of most rhinitis?

Viral

3

What are the causes of sinusitis?

Many are viral, some bacterial (S pneumonia, H flu, moraxella and oral anaerobes)

4

Why is pharyngitis often treated?

Treatment prevents complications (rheumatic fever, post strep GN)

5

What are the signs of epiglottitis?

– High fever, systemic toxicity, drooling, blood cultures positive in 65% of kids, 30% adults

6

What are the causes of epiglottitis?

H flu, group A strep, H parainfluenza

7

What are the cause of acute bronchitis?

• Majority are viral (influenza, parainfluenza, RSV, coronavirus, adenovirus, rhinovirus)
• Bacteria include mycoplasma, strep pneumoniae, H flu, chlamydophila, B pertussis

8

What are some risk factors for pneumonia?

• Old age
• Pulmonary disease
• Smoking
• Recent viral illness
• Diabetes
• Chronic renal disease
• Immunodeficiency

9

What are some signs of pneumonia?

• Cough, sputum, fever, shortness of breath
• Signs of consolidation

10

What is seen in typical CAP?

Acute onset of symptoms (cough, sputum, fever, shaking chills), lobar infiltrate, gram stain with PMNs and organisms

11

What is the most common cause of typical CAP?

Streptococcus pneumoniae

12

What is seen in atypical CAP?

Subacute onset of symptoms, prodrome, milder symptoms (“walking pneumonia”), negative gram stain

13

What are the common causes of atypical CAP?

Mycoplasma, Chlamydia, Legionella, viruses

14

What are the typical signs of influenza?

Fever, cough, headache, sore throat, myalgias.

15

What are the signs of CAP in pediatric patients?

• Tachypnea, fever, cough, dyspnea

16

What are the major organisms causing CAP in the 3 pediatric age ranges (under 2/5-10/10-16)?

• Under 2: Viral (RSV, rhinovirus)
• 5‐10 years old: Mycoplasma
• 10‐16: S. pneumoniae, Chlamydophila

17

What is the outpatient treatment for CAP?

Macrolide or doxycycline

18

What is the in-patient treatment for CAP?

– Respiratory fluoroquinolone
– 􏰝Lactam + macrolide

19

What are the possibilities if CAP is not responding to therapy?

‐ Inadequate dosing
‐ Host factors (slower response in elderly, patients with other chronic illnesses, alcoholics)

20

What are the typical organisms of HAP?

Klebsiella, E coli, Enterobacter, Proteus, Serratia, Pseudomonas, Acinetobacter

21

What is the treatment for HAP?

Early, broad empiric therapy that is narrowed down with the culture results

22

What are some organisms involved in chronic pneumonia?

• Mycobacterium (TB or atypical)
• Nocardia
• Actinomyces
• Endemic fungi (histo, blasto, cocci)
• Coxiella
• Tularemia
• Anatomic problem

23

What are organisms commonly involved in lung abscess?

Commonly isolated organisms include anaerobic mouth organisms (bacteroides, fusobacterium, peptostreptococcus), aerobic and anaerobic streptococcus, GNRs

24

What organisms is someone with neutrophil deficiency susceptible to?

Gram negative rods (Pseudomonas and H flu), Staph, Aspergillus, Candida

25

What organisms is someone with T cell deficiency susceptible to?

– Fungi (candida, aspergillus, cryptococcus)
– Viral (CMV, HSV)
– Pneumocystis, Mycobacteria, Listeria

26

What organisms is someone with B cell deficiency susceptible to?

Encapsulated organisms: S pneumoniae, H flu, Neisseria, Klebsiella, E coli, Giardia

27

What is CMV pneumonia?

Rare in immunocompetent but is seen in those with T cell deficiency and involves multiple organ systems

28

What can cause neutrophil deficiency?

Chemotherapy, leukemia, chronic granulomatous disease

29

What can cause T cell deficiency?

AIDS, T cell lymphoma, Transplant, DiGeorge’s syndrome

30

What can cause B cell deficiency?

Splenectomy, chronic lymphocytic lymphoma, Non Hodgkin’s Lymphoma, Myeloma, gamma globulin deficiencies

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