Respiratory tract infections Flashcards
(49 cards)
What is the other name for a common cold?
Coryza
What is coryza?
An acute viral infection of nasal passages, often accompanied by a sore throat and a mild fever.
How is the common cold spread?
Spread by droplets and fomites (intermediate objects)
What are the typical infectious organisms associated with coryza?
Adenovirus
Rhinovirus
Respiratory Syncytial Virus
What is acute sinusitis?
short-term inflammation of nasal membranes and surrounding sinuses -> purulent nasal discharge.
Some symptoms of acute sinusitis?
Frontal headaches
maxillary sinus pain
toothache
discharge
Is acute sinusitis bacterial or viral aetiology?
viral but a bacterial infection can be acquired before the viral infection clears which prolongs duration
What is the proper name for the cold which ‘goes to chest’?
Acute bronchitis
What are the clinical features of acute bronchitis?
Productive cough - increased mucus production
Fever
Normal chest exam
Normal CXR
May have transient wheeze - inflamed bronchial wall
Treatment of acute bronchitis?
antibiotics NOT indicated
Usually self limiting
If person already has a chronic lung disease it can become serious
3 main features of COPD?
Chronic sputum production
Bronchoconstriction
Inflammation of airways
What are the clinical features of an acute exacerbation of COPD?
(Usually preceded by URTI)
Increased sputum production and purulence (more pus/green colour)
More wheezy
SOB
What would you find on examination of a COPD patient having an exacerbation?
Respiratory distress Wheeze Coarse crackles May be cyanosed Ankle oedema (if advanced)
Which antibiotic would you give for an exacerbation of COPD?
Amoxicillin / Doxycycline
How would you manage a COPD exacerbation in primary care?
Antibiotic - amoxicillin / doxycycline
Bronchodilator inhaler
Potentially short course of steroids
What are the indications for antibiotics in an exacerbation of COPD? (antibiotic man)
Give if increased sputum purulence.
No antibiotics if no increased purulence UNLESS consolidation on CXR or signs of pneumonia
What is the treatment for COPD exacerbation in hospital?
Same as in primary but also check ABGs, CXR (for other diseases), and give O2 if in respiratory failure.
What would you find on a chest exam of a patient with pneumonia?
Chest expansion reduced Percussion note dull Breath sounds bronchial Added sounds crackles Vocal resonance increased
What investigations would you do if you suspect pneumonia?
FBC blood culture serology ABG U&E LFT CXR
What is the UK definition of pneumonia?
Signs and symptoms of a lower respiratory tract infection, with a new infiltrate on a CXR.
What is the score used to determine treatment of community acquired pneumonia?
CURB65
What is the criteria for the Community Acquired Pneumonia score?
C - confusion U - urea > 7 R - resp rate > 30 B - BP: systolic <90 or diastolic <61 65 - age 65+
How is a patient with a CURB score of 0-2 treated?
As an outpatient: Amoxicillin 1g IV/PO 5 days; Doxycycline if allergic to penicillin or Clarithromycin if NBM
How is a patient with a CURB score of 3-5 treated?
Co-amoxiclav IV + Doxycycline PO
Levofloxacin IV if allergic to penicillin
ICU or NBM:
Co-amoxiclav IV + Clarithromycin IV (Levofloxacin)
