Respiratory Tract Infections Flashcards
(32 cards)
Conditions of URT?
Common cold - AKA coryza (nose is less effective at filtering out pathogens in cold weather so viruses can multiply)
Sore throat - pharyngitis
Sinusitis
Epiglottitis
Conditions of LRT?
Acute bronchitis
Acute exacerbation of chronic bronchitis
Pneumonia
Influenza
What is the common cold, spread and symptoms?
Acute viral infection of nasal passages and is often accompanied by a sore throat and a mild fever; no treatment and is self-limiting
Spread by droplets and fomites
Complication - sinusitis, acute bronchitis
Causes of common cold?
Adenovirus
Rhinovirus
Respiratory Syncytial Virus
Describe acute sinusitis
Preceded by a common cold and produces purulent nasal discharge (mostly viral aetiology)
Usually self-limited and resolve in 10 days but some need antibiotics
What is quinsy?
AKA peritonsillar abscesss
A serious complication of acute tonsillitis
What is diphtheria?
Life threatening due to toxin production
CHARACTERISTIC PSEUDO-MEMBRANE that can suffocate people
What is acute epiglottitis?
In children, life threatening due to obstruction and can be caused by Haemophilus influenza B (do not use laryngoscope as it can irritate epiglottis further)
What is acute bronchitis and features?
Cold which "goes to the chest" and is preceded by a common cold Clinical features: Productive cough Fever - minority of cases Normal chest examination Normal CXR May have a transient wheeze
Treatment of acute bronchitis?
Usually self-limiting and antibiotics are not indicated in most people
But can lead to significant morbidity in patients with chronic lung disease
Intubation times for URTIs?
Rhinoviruses - 1-5 sayd
Group A streptococci - 1-5 days
Influenza and parainfluenza viruses - 1-4 days
RSV - 7 days
Pertussis (whooping cough) - 7-21 days
Diphtheria - 1-10 days
Epstein-Barr virus (glandular fever) - 4-6 weeks
Characteristics and clinical features of COPD?
Bronchoconstriction, inflammation of airways and chronic sputum production Clinical features: Usually preceded by URT infection Increased sputum production Increased sputum purulence More wheezy Breathless
COPD examination finds?
Respiratory distress Wheeze Coarse crackles May be cyanosed In advanced disease - ankle oedema
Management of acute COPD exacerbations in primary care and referrals?
Primary care:
Antibiotics, e.g: Doxycycline or Amoxicillin
Bronchodilatory inhalers
Short steroid course sometimes
Refer to hospital if:
Evidence of respiratory failure
Not coping at home - AKA acopia
Managing acute COPD exacerbations in hospital?
Same as in primary care and measure ABGs (to determine if they have Type I or II respiratory failure), CXR to look for other disease, give O2 if they have respiratory failure
Pneumonia definition?
Signs and symptoms of LRT infection with a new infiltrate on a CXR
Pneumonia clinical features?
Consolidation on CXR
Red hepatisation - lung may begin to resemble liver tissue, due to release of rbcs
Pneumonia symptoms?
Malaisa Anorexia Sweats Rigors Myalgia - muscle pain Arthralgia - joint pain Headache Confusion Cough Pleurisy - visceral pain have no pain receptors so must reach parietal pleura Haemoptysis Dyspnoea Preceding URTI Abdominal pain Diarrhoea Herpes labialis Tachypneoa Rub Crackles Hypotension - oral herpes due to reactivation of herpes simplex virus
Pneumonia presentation on examination?
Chest expansion - reduced Percussion note - dull Breath sounds - bronchial Added sounds - crackles Vocal resonance - increased
Pneumonia investigations?
Blood culture Serology Arterial gases Full blood count Urea Liver function CXR
Severity score for CAP determination?
CURB65 - only works if patient has pneumonia C - new onset of Confusion U - Urea >7 R - Respiratory Rate >30/min B - Blood pressure; systolic
COPD effect on CURB65?
Each score increases in mortality by 10%
Markers of severity in pneumonia?
Temp 40
Cyanosis - PaO2 30
Multi-lobar involvement
Main cause of pneumonia?
Strep. pneumoniae
