Lower Respiratory Tract Infection in Adults Flashcards Preview

Respiratory System > Lower Respiratory Tract Infection in Adults > Flashcards

Flashcards in Lower Respiratory Tract Infection in Adults Deck (54)
Loading flashcards...
1
Q

What is the UK incidence of pneumonia?

A

5-11/1000 adult population

2
Q

What percentage of community acquired pneumonia requires hospitalisation?

A

Between 22 and 42%

3
Q

What is the mortality of hospitalised patients with pneumonia?

A

6-12%

4
Q

What are some symptoms of pneumonia?

A

Malaise

Myalgia

Fever

Chest pain

Cough

Purulent sputum

Dyspnoea

5
Q

What are some signs of pneumonia?

A

Pyrexia

Tachypnoea

Central cyanosis

Dullness on percussion of affected lobe

Bronchial breath sounds

Inspiratory crepitations

Increased vocal resonance

6
Q

What investigations are done for pneumonia?

A

Serum biochemistry, full blood count and C-reactive protein (CRP) test

Chest X-ray

Blood cultures

Throat swab

Urinary legionella antigen

Sputum microscopy and culture

HIV test

7
Q

What microrganisms are the 3 three for causing pneumonia?

A

1) Strep pneumoniae (39%)
2) Chlamydophilia pneumoniae (13.1%)
3) All viruses (13.1%)

8
Q

What is the severity of pneumonia measured by?

A

CURB 65

9
Q

What does CURB 65 stand up for?

A

C confusion

U blood urea > 7

R respiratory rate > 30

B diastolic blood pressure < 60

10
Q

What is each aspect of CURB 65 given a score of?

A

0 (low risk and could be treated in the community)

1-2 (hospital treatment usually required)

3 (high risk of death and need for ITU)

11
Q

What is the treatment for a CURB score of 0-1?

A

Amoxycillin or clarithromycin/deoxycycline

12
Q

What is the treatment for a CURB 65 score of 2?

A

Amoxycillin and clarithromycin or levoflaxacin

13
Q

What is the treatment for a CURB 65 score of 3-5?

A

Co-amoxiclav and clarithromycin or levoflaxacin (if penicillin alergic)

14
Q

What are some things that come before pneumonia?

A

Aspiration pneumonia

Haematological malignancy

Legionnaires disease

Influenza

Staph pneumonia including PVL toxin

MRSA

HIV

15
Q

What treatment should be used for pneumonia caused by MRSA?

A

Vancomycin or linezolid

16
Q

What are treatment for pneumonia other than antibiotics?

A

Oxygen

IV fluids

CPAP (continuous positive airway pressure, keeps airways open)

Intubation and ventilation

17
Q

What does CPAP stand up for?

A

Continuous positive airway pressure

18
Q

What are some possible complications of pneumonia treatment?

A

Septicaemia

Acute kidney injury

Empyema

Lung abscess

Metastatic infection

ARDS (acute respiratory distress syndrome)

19
Q

What does ARDS stand up for?

A

Acute respiratory distress syndrome

20
Q

What is acute respiratory distress syndrome?

A

Widespread inflammation of the lungs

21
Q

What is differential diagnosis?

A

Process of differentiation between two or more conditions which share similar signs or symptoms

22
Q

What is the process of differentiating between two or more conditions that share similar symptoms called?

A

Differential diagnosis

23
Q

What does differential diagnosis of pneumonia exclude?

A

TB

Lung cancer

Pulmonary embolism

Pulmonary oedema

Pulmonary vasculitis

24
Q

What is empyema?

A

Collection of pus in the pleural cavity caused by microorganisms

25
Q

What is a collection of pus in the pleura cavity caused by microorganisms called?

A

Empyema

26
Q

What may follow pneumonia?

A

Empyema

Lung abscess

Bronchiestasis

27
Q

What are the top 3 organisms that cause empyema?

A

Steptococcus (52%)

Anarobes (20%)

Staph aureus (11%)

28
Q

What is the prominant feature of empyema?

A

Chest pain

29
Q

What symptoms is absent with empyema?

A

Cough

30
Q

What is used to investigate empyema?

A

CT thorax and ultrasound

31
Q

What is empyema diagnosed by?

A

Pleural aspiration (pH < 7.2)

32
Q

What is the treatment for empyema?

A

Chest drain and IV antibiotics

Surgery for patients who do not improve

33
Q

What is a lung abscess?

A

Necrosis of lung tissue leading to the formation of cavities containing necrotic debris or fluid caused by microbial infection

34
Q

What is necrosis of lung tissue leading to the formation of cavities containing necrotic debris called?

A

Lung abscess

35
Q

What are organisms that are more likely to cause lung abscess than others?

A

Staph aureus

Pseudonomas

Anaerobes

36
Q

What can the symptoms of lung abscess be?

A

Nonspecific such as lethargy, weight loss and high swing fever

37
Q

What is lethargy?

A

Lack of energy

38
Q

What is a lack of energy called?

A

Lathargy

39
Q

What is lung abscess investigated by?

A

CT thorax

Sputum culture

40
Q

What is the treatment of lung abscess?

A

Prolonged antibiotics

41
Q

How is drainage for a lung abscess done?

A

Via the bronchial tree, occasionally percutaneous draining

42
Q

What is bronchiectasis?

A

Airways of the lung become abnormally widened, leading to excessive build up of mucus that can make the lungs more vulnerable to infection

43
Q

What does bronchiectasis cause in the lungs?

A

Build up of mucus making them more vulnerable to infection

44
Q

What is it called when the airways of the lungs become abnormally widened?

A

Bronchiectasis

45
Q

What are some of the causes of bronchiectasis?

A

Idiopathic

Immotile cilia syndrome

Cystic fibrosis

Childhood infections such as measles

Hypogammaglobulinemia

Allergic bronchopulmonary aspergillus

46
Q

What is immotile cilia syndrome?

A

Genetic disorder that causes defects in cilia

47
Q

What is a genetic disorder that causes defects in cilia?

A

Immotile cilia syndrome

48
Q

What is hypogammaglobulinemia?

A

Reduction in all types of gamma globulins

49
Q

What is a reduction in all types of gamma globulins called?

A

Hypogammaglobulinemia

50
Q

What does ABPA stand up for?

A

Allergic bronchopulmonary aspergillosis

51
Q

What are the symptoms of bronchiectasis?

A

Chronic cough

Daily sputum production

Sometimes:

Wheeze

Dyspnoea

Tiredness

Flitting chest pains

Haemoptysis

52
Q

What are signs of bronchiectasis?

A

Finger clubbing

Course onspiratory crepitation (auscultation)

53
Q

What investigations are done for bronchiectasis?

A

High resolution CT thorax

Sputum culture

Serum immunoglobulins

Total IgE and aspergillus precipitins

CF genotyping

54
Q

What is the treatment for bronchiectasis?

A

Chest physiotherapy

Prompt treatment of infections with antibiotics

May require inhaled therapy including B2 agonist and corticosteroid