Who should get the annual flu vaccine
- Over 65
- Asthmatics
- Immunocompromised
- Pregnant women
- Chronic respi disease, heart disease, renal failure, cancer, diabetes
What is the criteria for differentiating viral and bacterial tonsillitis called
Centor criteria
5 components of modified centor criteria (including age)
- Absence of cough
- Tonsillar exudates
- History of fever
- Tender anterior cervical adenopathy
- Add 1 point for age under 15
- Subtract 1 point for age over 44
Causes of typical community-acquired pneumonia
Strep pneumonia
Hib
Klebsiella
Staph aureus
Causes of atypical community-acquired pneumonia
Legionella, Mycoplasma, Chlamydia pneumonia/psittaci
Risk factors for pneumonia
smoking, chronic lung disease, men, middle life, immunocompromised
What can cause pleural effusion in pneumonia
Empyema: bacterial invasion of pleural space
What is the ECG change in a pulmonary embolism called?
What does it consist of
S1Q3T3
S1: prominent S wave in lead 1
Q3: Q wave inversion in lead 3
T3: T wave inversion in lead 3
Components of CURB-65 score
What is it used for
Used for pneumonia
- Confusion
- Urea >7
- Respi rate >30
- Blood pressure s<90 or d<60
- Age >65
Components of DECAF score
What is it used for
Used for infective exacerbation of COPD
- Dyspnoea
- Eosinophils
- Consolidation on CXR
- Acidosis in blood
- A Fib
What would be classed as hospital-acquired pneumonia
Pneumonia with symptoms starting >48h after admission
Typical vs atypical pneumonia: symptoms
TYPICAL vs ATYPICAL
- high vs moderate fever
- productive painful cough vs late non-productive cough
- tachycardia vs relative bradycardia
- pleuritic chest pain vs none
Which type of pneumoniae are more likely to cause deranged LFTs
Atypical
Consolidation would cause what changes on chest exam
- percussion
- breath sounds
- vocal resonance
- other lung sounds
dull percussion
reduced breath sounds
increased vocal resonance
coarse crackles
What a/b are used for pneumonia
amoxicillin +/- clarithromycin
If sepsis, Tazocin + clarithromycin
What is bronchiectasis
Widening of airways + excessive mucus production
Signs of bronchiectasis on CXR
-atelectasis (lung collapse)
What is empyema
Pus in the pleural space
Symptoms of lung abscess
- chronic cough
- foul sputum
- low fever
- weight loss
Signs of lung abscess
- clubbing
- anaemia
What is empyema
Pus in the pleural space
Usually secondary to pneumonia
Risk factors for reactivation TB
- HIV
- diabetes
- lymphoma
- end stage CKD
- corticosteroid use
- TNF inhibitor use
- increased age
Investigations for active TB
- Mantoux test
- culture
- sputum smear microscopy (ZN stain)
- nucleotide antigen amplification test
Investigation for latent TB
- Mantoux test
- IFN gamma release assay
