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535514
Respiratory Infections
Description
Mind Map on Respiratory Infections, created by fiona.medic on 02/08/2014.
Mind Map by
fiona.medic
, updated more than 1 year ago
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Created by
fiona.medic
about 11 years ago
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Resource summary
Respiratory Infections
upper respiratory tract
adults
sore throat + tonsillitis
common viral cause
majority due to viruses
antibiotics usually unnecessary
enteroviruses
Epstein-Barr
adenoviruses
common bacterial cause
strep pyogenes
management
probs nothing
if severe/persistant
oral penicillan V
investigations
blood/serology tests
nasal swab
viral culture
throat swab
gram stain
common cold
Rhinoviruses
adenoviruses
coronaviruses
infectious mononucleosis
effects adolescents + young adults
causes
HIV infection
toxoplasmosis
cytomegalo virus
Epstein-Barr virus
glandular fever
investigations
blood film
serology
raised IgM
IgG in previous infection
IM test/ monospot
treatment
aspirin gargles
avoid penicillin esters eg ampicillin
children
tonsillitis/pharyngitis
viral or bacterial
treatment
nothing or 10 days penicillin
throat swab
infective agents
bacterial
H influenzae
Moxarella catterhalis
mycoplasma
staph aureus
beta haemolytic
strep pyogenes
non-haemolytic
strep pneumoniae
streptococci
viral
Rhinovirus
RSV
paraflu 1+3
influenza A + B
adenovirus
croup/epiglottitis
bacterial
rare
intubation + antibiotics
can swell to obstruct trachea
stridor due to narrowing of airways
oral steroids
otitus media
antibiotic treatment usually doesn't help
ear infection
secondary infection
pneumococcus
haemococcus influenzae
spontaneous rupture of ear drum
Rhinitis
self limiting
limits own growth by its actions
prodome to other illnesses
pneumonia
bronchiolitis
meningitis
septicaemia
lower respiratory tract
pneumonia
CURB 65
Confusion
Urea
Respiratory Rate
diastolic BP
over age 65
severity scale
affects lung parenchyma
solid alveoli
symptoms
pleuritic chest pain
breathlessness
cough
shadowing on chest X-ray
infected sputum
signs
reduced chest expansion
dull percussion note
bronchial breathe sounds
increased vocal resonance
crackles
classification
community acquired
hospital acquired
recurrent
aspiration
in immunocompromised
bacterial
common
staph aureus
strep pneumoniae
uncommon
legionella pneumophilia
treatment
pneumococcus
IV benzyl penicillin
oral ampi/amoxycillin
staphylocoocal
IV flucloxacillan, gentamicin, vancomycin
mycoplasma
tetracycline or clarithromycin
chlamydial
tetracycline, erythromycin, larithromycin
bronchiectasis
dilation of bronchi produces chronic sepsis in chest
caused by
severe childhood measles
prolonged whooping cough
immunoglobulin deficiencies
CF
severe pneumonia or TB
symptoms
daily cough
sputum production
chest infections
signs
lung crackles on inspiration + expiration
finger clubbing
treatment
occasionally prophylactic antibiotics
daily autogenic drainage by physios
can't be cured
in children
viral causes
respiratory syncytial virus
parainfluenzae 3
influenza A + B
adenovirus
bronchiolitis
infection of bronchioles
in infants, peaks at 3 months
usually caused by RSV
symptoms
crackles +/- wheeze
nasal stuffiness
tachypnoea
shortness of breathe
poor feeding
management
maximal observation, minimal intervention
commnity acquired pneumonia
not treated if symptoms mild
if vomiting
oral amoxycillin or macrolide
empyaema
complication of pneumonia
symptoms
chest pain
unwell
extension of infection into pleural space
treatment
drainage
Enter text here
microbiological diagnosis of chest infections
diagnostic tehniques
microscopy + culture of sputum + blood
antigen detection methods
detect specific antigen immunologically
agglutination
latex particles coated with monoclonal antibodies (single clone of plasma cells), clumping visible
changes in colour if enzyme present
virus detected innasopharyngeal secretions
legionella + pneumoncoccal antigen can be detected in urine
immunofluorescence
ezyme immunoassay
enzyme-labelled antigens + antibodies to detect biological molecules
TB
ZN or aranine phenol stain
AAFB
extended culture for mycobateria
bronchio-alveolar lavage
lower airway samples collected by bronchoscopy
more accurate diagnosis as less liable to contamination
used for diagnosis of ventilator associated pneumonia
many patients have bacteraemia (bacteria in blood)
PCR
primers bind to target DNA sequence
multiple copies of target sequence produced
amplified copies of DNA dectected
organisms not easily cultured
coxiella burnetti
legionella pneumophilia
chlamydia psittaci
mycoplasma pneumoniae
pathology of pulmonary infection
lung infections are multifactorial
microorganism pathogenicity
opportunistic
immunocompromised patients
primary
facultative
capacity to resist infection
age of patient
state of host defence mechanisms
decreases with age
population at risk
exposure
acute epiglottitis
haemophilus influenzae type B
rarely caused by parainfluenza virus type 4
inflammation + infection can rapidly block airwway
viral infection
can damage respiratory epthelium
can be completely lost
no clearance of fluids or microorganisms from lungs
recurrent lung infection
local bronchial obstruction
local pulmonary damage
generalised lung disease
non-respiratory disease
alveolar hypoventilation
increases PACO2
leads to increase in PaCO2
insufficient amount of air moved in + out of lungs
decrease in PAO2
decrease in PaO2
corrected by raising FIO2
outcome/complications of pneumonia
most resolve
pleurisy
inflammation
pleural effusion
fluid collected in pleural space
pleural empyema
pus in pleural space
fibrous wall develops around it
mass lesion
fibrous tissue
cryptogenic organising pneumonia
chronic bronchiolitis obliterans
lung abscess
tissue destruction
accumulation of inflammatory exudate
obstructed bronchus
staph aureus
metastatic pyaemia
necrotic lung
infection arrives via bloodstream
Klebsiella
pneumococcus
bronchiectasis
dilatation of bronchi
lung parenchymal destruction
severe infective episode
recurrent infection
proximal bronchial obstruction
patterns of pneumonia
aspiration
vomiting,oesophageal lesions
obstrutive
endogenous lipid
segmental
hypotatic
underlying/pulmonary CV disease
build up of fluid
lobar
Enter text here
host defences in lower respiratory tract
alveolar macrophages
mucociliary escalator
cough reflex
deposition on terminal bronchioles/proximal alveoli
clearance by alveolar macrophage phagocytosis
interstitial pathway via lymph to lymph nodes
exit lung to bloodstream
deposition on conducting airways
clearance via mucociliary escalator
mucous carried out of lungs with macrophages in it
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