Resp Infections - 2nd half

what causes the whooping cough?

bordetella pertussis

how is the whooping cough transmitted?

airborne droplets

what is the incubation period for the whooping cough?

7-21 days

what are the 3 phases for the whooping cough?

catarrhal, paroxysmal, convalescent

what part of the respiratory tract is impacted in the catarrhal phase for whooping cough?

upper

what part of the respiratory tract is impacted in the paroxysmal phase for whooping cough?

lower

what are the s/s that are present during the catarrhal phase for whooping cough?

runny nose, sore throat, malaise, low grade fever

what are the s/s that are present during the paroxysmal phase for whooping cough?

violent repeated paroxysmal cough that is followed by deep whooping noise

how long does the convalescent phase last for with the whooping cough?

2-3 weeks

what is the name of the recovery phase for whooping cough?

convalescent

what areas are infected in someone who has croup?

larynx, trachea and bronchi

croup is also know as what?

LTB

what are the s/s for croup?

coughing, wheezing, seal like/ bark like cough, cold symptoms, loss of voice, use of accessory muscles

what s/s of croup occurs mainly in adults?

loss of voice

if there is influenza in the name of a disease, what area of the resp. tract does it have tropism for?

lower

what viruses cause croup?

parainfluenza viruses types 1 and 2

what ages are most at risk for croup?

6months - 5yrs

what 2 methods could be used to confirm a diagnosis of croup?

PCR, or chest x-ray

in a chest x-ray, what is the tell tale sign of croup?

steeple sign in the airway

are bacteria or viruses the most common cause of upper respiratory infections?

viruses

what is pneumonia?

inflammation of the alveoli

is bacterial or viral pneumonia more common?

bacterial

what are the 3 ways bacteria can enter the lungs and cause pneumonia?

inhalation, aspiration, hematogenous

what is the most common method for bacteria to enter the lungs?

inhalation

what condition is the leading cause of sepsis?

pneumonia

what are the 3 different anatomical classifications of pneumonia?

bronco pneumonia, lobar pneumonia and interstitial pneumonia

out of the 3 different anatomical classification of pneumonia, what one would be caused by a virus?

interstitial

T/F fungi can cause pneumonia

true

who is more likely to get fungal pneumonia?

immunocompromised patients

what are 2 fungi that commonly cause pneumonia

pneumocystis jiroveci and cryptococcus

what bacteria is the most common cause of pneumonia?

strep. pneumoniae

what bacteria (2) can cause nosocomial pneumonia?

pseudomonas aeruginosa and MRSA

what is it called when pneumonia came from the hospital

nosocomial pneumonia

when do s/s start to show with community acquired pneumonia after hospitalization?

<48 hours after hospitalization

when do s/s start to show with hospital acquired pneumonia after hospitalization?

>48hrs after hospitalization

when do s/s start to show with ventilator associated pneumonia?

>48hrs after endotracheal intubation

what causes aspiration pneumonia?

aspiration of colonized upper respiratory tract secretions

who is at greater risk for aspiration pneumonia?

elderly and stroke patients

no organisms are identified in ___% of hospitalized patients

75%

no organisms are identified in __% of ambulatory patients?

90%

can viruses or bacteria spread better ?

viruses can spread better than bacteria

why is it so important to recognize the flu within 48-72 hrs?

because the flu can become pneumonia

what is used to determine the location of pneumonia?

chest x-rays

what are 3 that indicate impaired lung defenses?

poor gag reflex, impaired mucociliary transport, immunosuppression

what are the 3 typical features or s/s for pneumonia

cough, high fever, changes in chest x-ray

what s/s for pneumonia are different in the elderly population?

they don’t normally have a fever, but have altered LOC instead

Do you want people with pneumonia to be in the hospital?

No- this way you prevent people from getting hospitalized pneumonia

What are the 3 scores that are used to assess pneumonia?

PSI, CURB-65, IDSA-ATS

What is PSI used to indicate?

The severity of the pneumonia

What classes in PSI should a patient be hospitalized?

Classes 4-5

What classes of PSI does the patient not need to hospitalized

1-2

Where should a patient with PSI class 3 be put?

The patient could be either in or out of hospital. It depends on the nurses/doctors clinical judgement

What is IDSA-ATS used for?

Used to determine if the patient needs to be moved from the floor to the ICU

What are the 5 things that CURB-65 assesses?

Confusion, urea, RR, BP, age

What are the 5 ways a CURB65 score will be increased?

C- altered; u- greater than 7mmol/l; r- greater than 30; b- systolic less than 90 or diastolic less than 60; older than 65

A CURB-65 score of 0-1 has what mortality rate?

Less than 5%

A CURB-65 score of 2-3 has what mortality rate?

5-15%

A CURB-65 score of 4-5 has what mortality rate?

15-30%

What CURB-65 scores should a person be considered for hospitalization

2-3

What CURB-65 scores are the patients in hospital and are considered for the ICU

4-5

What are examples of molecular testing?

PCR and antigen testing

what is used to treat non severe and severe CAP and people with a history of peudomonas aeruginosa?

beta lactam

what is used in the treatment regimen for severe CAP?

beta-lactam and atypical coverage

what is used to treat MRSA?

vancomycin

what is used for the treatment regimen for a patient with a hx of P. aeruginosa?

beta-lactam and atypical coverage

what are the 2 most common hospitalized bacteria to cause pneumonia

MRSA and pseudomonas aeruginosa

what often causes atypical pneumonia?

influenza (viral infections)

neuroaminidase inhibitors (oselamivir) is used to treat what?

atypical pnemonia