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Respiratory > 1: Pneumonia > Flashcards

1: Pneumonia Flashcards

1
Q

Define pneumonia

A

LRTI - causing inflammation of alveoli and lung parenchyma

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2
Q

How is pneumonia divided

A

Depending on where it is acquired into:

  • Hospital acquired
  • Community acquired
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3
Q

What is primary community acquired pneumonia

A

Acquired in the community in individuals with no underlying respiratory illness

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4
Q

What is the most common cause of CAP

A

S. Pneumonia

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5
Q

Explain features of S.Pneumonia involvement

A
  • Rapid onset
  • High fever
  • Associated with herpes labialis (HSV1)
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6
Q

Aside from S. Pneumonia, what are two other common organisms to cause CAP

A
  • H.Influenza

- Morexalla Catarrhalis

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7
Q

What are the 5 atypical organisms causing CAP

A
  • Klebsiella
  • Legionalla
  • Mycoplasma
  • Chalmydia
  • S. Aureus
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8
Q

What are the features of mycoplasma pneumonia

A
  • Dry cough and abnormal CXR
  • Erythema multiform
  • Autoimmune haemolytic anaemias
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9
Q

When does S. aureus usually present as a cause of pneumonia

A

Following influenza infection

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10
Q

What are the two distinctive features of legionella pneumonia

A

Hyponatraemia

Lymphopenia

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11
Q

Where is legionalla pneumonia contracted from

A

Air-conditioning units

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12
Q

What is chalmydia psiattci associated with

A

Birds (Parrots)

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13
Q

What is secondary community acquired pneumonia

A

Pneumonia that occurs in individual with underlying lung disease - such as asthma, COPD, CF

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14
Q

What is most common organism to cause pneumonia in COPD patients

A

H.Influenza

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15
Q

Define hospital acquired pneumonia

A

Onset symptoms pneumonia 48h following admission

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16
Q

What usually causes hospital acquired pneumonia

A

Gram negative bacteria or S.aureus

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17
Q

What organism is associated with alcoholics

A

Klebseilla

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18
Q

What causes aspiration pneumonia

A

Oropharyngeal anaerobes

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19
Q

What causes pneumonia in HIV patients

A

Pneumocystitis Jirovecci

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20
Q

What are the features of PCP in HIV patients

A
  • Dry Cough
  • Exercise-Induced desaturations
  • Absent chest signs
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21
Q

What are 4 risk factors for pneumonia

A
  • Old age
  • Smoker
  • Immobile
  • Immunocompromised
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22
Q

What are risk factors for aspiration pneumonia

A
  • CN palsy
  • MND
  • Intoxication
  • Myasthenia Gravis
  • Stroke
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23
Q

What are symptoms of pneumonia

A
  • Productive cough
  • Pleuritic chest pain
  • Fever
  • Dyspnoea
  • Malaise
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24
Q

What is heard on auscultation in pneumonia

A
  • Decreased air entry

- Bronchial breathing

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25
What is present on percussion in pneumonia
Dull to percussion
26
What are symptoms of an atypical pneumonia
- Dyspnoea - Dry cough - Low-grade fever - Malaise, Headache - Auscultation is unremarkable
27
What is lobar pneumonia
Pneumonia of an entire lobe
28
In primary care how is pneumonia assessed
CRB65 and CRP
29
When is CRP performed in primary care in suspected pneumonia
CRP is performed if individual has a LRTI, but is not diagnosed with pneumonia based on clinical assessment
30
What CRP are antibiotics offered
>100
31
If an individual has CRP 20-100 what is done
Consider delayed antibiotics (eg. I'll give you antibiotics now but don't use them for a few days)
32
If an individual has CRP less than 20 what is done
Do not give Abx
33
What does CRB65 stand for
Confusion RR BP 65
34
What defines confusion on CRB65
AMTS less than 8. | New onset disorientation in time, place or person
35
What defines RR in CRB65
>30
36
What defines BP in CRB65
Systolic BP <90 | Diastolic BP <60
37
What defines age in CRB65
>65 years-old
38
If CRB65 is 0 what is done
Manage at home
39
If CRB65 is 1 what is done
Consider hospital assessment
40
If CRB65 is 2 what is done
Hospital assessment
41
What criteria is used in hospital to assess pneumonia
CURB65
42
What does the U of CURB65 mean
Urea >7
43
In hospital if someone scores 0-1, how are they managed
Home based care
44
In hospital if someone scores 2 how are they managed
Ward-based care
45
In hospital if someone scores 3 how are they managed
ITU
46
What imaging is ordered in pneumonia
CXR
47
How will lobar pneumonia present
Consolidation of a single lobe
48
How will bronchopneumonia present
Patchy infiltrates scattered throughout the lung
49
What is ordered 6 weeks later in pneumonia and why
CXR - exclude lung cancer
50
If patients have a moderate-high severity CAP, what investigations should be ordered
- Sputum MC+S - Blood Culture - Legionella and pneumococcal urinary antigen test
51
Explain CRP in hospital
CRP should be measured in all inpatients to assess response to treatment
52
How is low severity pneumonia managed
Amoxicillin (5d)
53
What is offered to patients allergic to penicillin
Clarithromycin (5d)
54
What is offered to medium severity pneumonia (CRB 1/2)
Amoxicillin and clarithromycin 7-10d
55
What is offered for severe pneumonia (CRB 3/4)
Co-amoxiclav and clarithromycin 7-10d
56
What is given to prevent pneumonia
Pneumococcal vaccine | Influenza vaccine
57
What time frame would you expect fever to resolve in pneumonia
1 Week
58
What time frame would you expect chest pain and fever to resolve in pneumonia
4 Weeks
59
What time frame would you expect cough and breathlessness to resolve on pneumonia
6 Weeks
60
What time frame would you expect symptoms to have resolved in pneumonia
3-months
61
What may be present at 3-months in pneumonia
Fatigue
62
When should individuals feel back to themselves
6 months
63
What are 5 complications of pneumonia
- Pleural effusion - Empyema - Lung abscess - Resp Failure - Septicaemia

Respiratory (19 decks)

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