Respiratory Infections

Description

Mind Map on Respiratory Infections, created by fiona.medic on 02/08/2014.
fiona.medic
Mind Map by fiona.medic, updated more than 1 year ago
fiona.medic
Created by fiona.medic about 11 years ago
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Resource summary

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