Bacterial RTIs

Question 1

What allows bacteria to enter the lungs?

Answer 1

• host defense defect
• large innolculum of bacteria
• increased virulence

Question 2

What are the typical causes of community acquired pneumonia?

Answer 2

• S. pneumoniae
• H. Influenzae
• M. Catharralis

Question 3

What are the atypical causes of community acquired pneumonia?

Answer 3

• mycoplasma pneumoniae
• legionella pneumoniae
• chlamydophila pneumoniae
• chlamydophila psittaci

Question 4

What are the risk factors for S. pneumoniae infection?

Answer 4

• alcohol
• smoking
• infection eg. HIV
• chronic lung disease
• cancer

Question 5

What is the treatment for S. pneumoniae infection?

Answer 5

• penicillin
• if allergy = macrolides eg. Clarithromycin, tetracyclines eg. Doxycicline

Question 6

Who are more at risk of H. Influenzae infections?

Answer 6

• elderly
• underlying lung disease

Question 7

What is the treatment of H. Influenzae and its risk?

Answer 7

• co-amoxiclav
• macrolides eg. Clarithromycin
• tetracyclines eg. Doxycicline
• risk of beta lactamase production

Question 8

What is the most common cause of infective exacerbation of COPD?

Answer 8

Moxarella catarrhalis

Question 9

What is the treatment of moraxella catarrhalis infection and its risk?

Answer 9

• co-amoxiclav
• macrolides
• tetracyclines
• risk of beta-lactamase production

Question 10

What are the main symptoms of M.pneumoniae?

Answer 10

• fever
• fatigue
• chest symptoms

Question 11

What are the possible atypical features of M. Pneumoniae?

Answer 11

• haemolysis
• Guillain-Barre (nerve syndrome)
• erythema multiforme
• cardiac problems

Question 12

What is the method of diagnosing M. Pneumoniae?

Answer 12

• PCR (sputum/throat swab) - BEST
• serology

Question 13

What is the treatment for M. Pneumoniae?

Answer 13

** organism contains no cell wall so beta lactams wouldn’t work
- macrolides
- tetracyclines
- quinolones

Question 14

How can legionella pneumophilia be transmitted?

Answer 14

• contaminated soil/water
• hospital acquired

Question 15

What are the methods of diagnosing L. Pneumophilia?

Answer 15

• culture
• serology
• urinary antigen test (only recognises 2 types of pneumophilia)

Question 16

What are the treatment options for L. Pneumophilia

Answer 16

** intracellular so beta lactams would not work
- macrolides
- quinolones
- tetracyclines

Question 17

What are the common causes of hospital acquired pneumonia?

Answer 17

• enterobacterales (klebsiella, ecoli, enterobacter)
• pseudomonas aeruginosa
• S. aureus
• acinetobacter
• stenotrophomonas

Question 18

How is hospital acquired pneumonia diagnosed?

Answer 18

• culture (oxidase positive/negative)

Question 19

What is the symptoms of HAP?

Answer 19

• fever
• cough/sputum
• chest pain
• can be insidious/abrupt
• non-respiratory symptoms

Question 20

What groups are more at risk of HAP?

Answer 20

• underlying lung disease
• immunosuppressed

Question 21

What are the signs of HAP?

Answer 21

• dull percussion
• coarse crepitations
• increased vocal resonance

Question 22

How is HAP clinically assessed?

Answer 22

• multilobar consolidation on CXR +/- hypoxia on room air
  And/or
• CURB65 score >1
  (Confusion, Urea >7, Resp rate >30, BP D<60 S<90, Over 65 years old)

Question 23

What is the clinical management of RTIs in primary care?

Answer 23

5 day treatment with amoxicillin

Question 24

Learn empirical antibiotic guidelines

Answer 24

Look at lecture notes