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Respiratory System > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

Symptoms of Pneumonia (7)

A 
Malaise
Myalgia
Fever
Chest pain (pleuritic)
Purulent sputum
Maybe be rusty sputum (haemoptysis)
Dyspnoea
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2
Q

Signs of Pneumonia (7)

A 
Pyrexia
Tachypnoea
Central cyanosis
Dullness on percussion of affected lobe
Bronchial breath sounds
Inspiratory crepitations
Increased vocal resonance
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3
Q

Investigations for Pneumonia (7)

A 
Serum biochemistry, CRP (produced by liver in response to inflammation) and FBC
CXR
Blood cultures
Throat swab (atypical pathogens)
Urinary legionella antigen
Sputum microscopy and culture
HIV test
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4
Q

Microbiology of Pneumonia (9)

A 
Strep. Pneumoniae- CAP
H. influenzae
Legionella
S. Aureus- HAP (MRSA)
Moraxella Catarrhalis
Mycoplasma pneumoniae
Chlamydophyla pneumoniae 
Chlamydophyla psittaci
Coxiella burnetii
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5
Q

Pneumonia Severity Scoring

A

CURB 65

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6
Q

C (CURB)

A

Confusion

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7
Q

U (CURB)

A

Blood urea >7

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8
Q

R (CURB)

A

Respiratory rate >30

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9
Q

B (CURB)

A

diastolic blood pressure <60

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10
Q

65 (CURB)

A

age>65

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11
Q

A score of 0 (CURB)

A

low risk and could be treated in the community

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12
Q

A score or 1-2 (CURB)

A

hospital treatment usually required

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13
Q

A score of 3-5 (CURB)

A

High risk of death and need for ITU

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14
Q

Treatment for (CURB) 0-1

A

Amoxycillin or Clarithromycin/doxycycline

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15
Q

Treatment for (CURB) 2

A

Amoxycillin and Clarithromycin or levofloxacin

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16
Q

Treatment for (CURB) 3-5

A

Co-amoxiclav and Clarithromycin or Levofloxacin (if penicillin allergic)

17
Q

Treatment for aspiration pneumonia and why

A

Anaerobes likely

Metronidazole and amoxycillin

18
Q

Haematological malignancy/neutropenia treatment

A

Broad spectrum antibiotics, consider anti-fungals if immunosuppressed

19
Q

Legionnaires disease treatment

A

Consider involvement with public health to check water systems

20
Q

MRSA pneumonia treatment

A

Vancomycin or linezolid

21
Q

What type of pneumonia would be seen in HIV (immunosuppressed)

A

Pneumocystis jiroveci pneumonia

22
Q

General treatment for pneumonia (4)

A

Oxygen- hypoxic
IV fluids- AKI/ dehydration
Continuous positive airway pressure- for type 1 respiratory failure
Intubation and ventilation

23
Q

Complications of pneumonia (6)

A 
Septicaemia
AKI- dehydration
Empyema
Lung abscess
Metastatic infection
Acute Respiratory Distress Disorder
24
Q

Differential diagnosis for pneumonia (5)

A 
TB
Lung cancer
Pulmonary embolism
Pulmonary Oedema
Pulmonary vasculitis (Wegner's granulomatosis)
25
Q

Cause of Empyema (3)

A

Streptococcus
S. aureus
Anaerobes

26
Q

Investigation of Empyema

A

High swinging fever
CT thorax
Pleural ultrasound
Pleural aspiration (pH<7.2)

27
Q

Treatment of Empyema (2)

A

Chest drain and IV antibiotics

Intrapleural t-PA/DNase required to breakdown thick fluid if it wont drain

28
Q

Features of Lung Abscess (3)

A

Similar to empyema
May or may not follow pneumonia
S.aures, Pseudomonas may lead to cavitating pneumonia

29
Q

Symptoms of Lung Abscess (3)

A

Lethargy
Weight loss
High swinging fever

30
Q

Investigation for lung abscess (3)

A

CT thorax
Sputum culture
CXR

31
Q

Treatment of Lung abscess (2)

A

Prolonged antibiotics

Drainage via bronchial tree

32
Q

What is Bronchiectasis

A

Widening of bronchi which leads to accumulation of mucous

33
Q

Causes of Bronchiectasis (6)

A 
Idiopathic
Immotile Cilia Syndrome
Cystic fibrosis
Childhood infections (measles, whooping cough)
Hypogammaglobulinemia
Allergic bronchopulmonary aspergillosis
34
Q

Symptoms of Bronchiectasis (7)

A 
Chronic cough
Daily sputum
Wheeze
Dyspnoea 
Tiredness
Fitting chest pains
Haemoptysis
35
Q

Signs of Bronchiectasis (2)

A

Finger clubbing

Coarse inspiratory crepitations

36
Q

Investigations for Bronchiectasis (5)

A 
High resonance CT of the thorax
Sputum culture: S. aureus, P. aeruginosa, H. Influenzae
Serum immunoglobulins
Total IgE and aspergillus precipitins
CF genotyping
37
Q

Treatment for Bronchiectasis

A

Chest physiotherapy to clear the sputum
Appropriate antibiotics
Inhaled beta 2 agonists and inhaled corticosteroids

Respiratory System (30 decks)

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