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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
Q

What is present on percussion in pneumonia

A

Dull to percussion

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26
Q

What are symptoms of an atypical pneumonia

A
  • Dyspnoea
  • Dry cough
  • Low-grade fever
  • Malaise, Headache
  • Auscultation is unremarkable
27
Q

What is lobar pneumonia

A

Pneumonia of an entire lobe

28
Q

In primary care how is pneumonia assessed

A

CRB65 and CRP

29
Q

When is CRP performed in primary care in suspected pneumonia

A

CRP is performed if individual has a LRTI, but is not diagnosed with pneumonia based on clinical assessment

30
Q

What CRP are antibiotics offered

A

> 100

31
Q

If an individual has CRP 20-100 what is done

A

Consider delayed antibiotics (eg. I’ll give you antibiotics now but don’t use them for a few days)

32
Q

If an individual has CRP less than 20 what is done

A

Do not give Abx

33
Q

What does CRB65 stand for

A

Confusion
RR
BP
65

34
Q

What defines confusion on CRB65

A

AMTS less than 8.

New onset disorientation in time, place or person

35
Q

What defines RR in CRB65

A

> 30

36
Q

What defines BP in CRB65

A

Systolic BP <90

Diastolic BP <60

37
Q

What defines age in CRB65

A

> 65 years-old

38
Q

If CRB65 is 0 what is done

A

Manage at home

39
Q

If CRB65 is 1 what is done

A

Consider hospital assessment

40
Q

If CRB65 is 2 what is done

A

Hospital assessment

41
Q

What criteria is used in hospital to assess pneumonia

A

CURB65

42
Q

What does the U of CURB65 mean

A

Urea >7

43
Q

In hospital if someone scores 0-1, how are they managed

A

Home based care

44
Q

In hospital if someone scores 2 how are they managed

A

Ward-based care

45
Q

In hospital if someone scores 3 how are they managed

A

ITU

46
Q

What imaging is ordered in pneumonia

A

CXR

47
Q

How will lobar pneumonia present

A

Consolidation of a single lobe

48
Q

How will bronchopneumonia present

A

Patchy infiltrates scattered throughout the lung

49
Q

What is ordered 6 weeks later in pneumonia and why

A

CXR - exclude lung cancer

50
Q

If patients have a moderate-high severity CAP, what investigations should be ordered

A
  • Sputum MC+S
  • Blood Culture
  • Legionella and pneumococcal urinary antigen test
51
Q

Explain CRP in hospital

A

CRP should be measured in all inpatients to assess response to treatment

52
Q

How is low severity pneumonia managed

A

Amoxicillin (5d)

53
Q

What is offered to patients allergic to penicillin

A

Clarithromycin (5d)

54
Q

What is offered to medium severity pneumonia (CRB 1/2)

A

Amoxicillin and clarithromycin 7-10d

55
Q

What is offered for severe pneumonia (CRB 3/4)

A

Co-amoxiclav and clarithromycin 7-10d

56
Q

What is given to prevent pneumonia

A

Pneumococcal vaccine

Influenza vaccine

57
Q

What time frame would you expect fever to resolve in pneumonia

A

1 Week

58
Q

What time frame would you expect chest pain and fever to resolve in pneumonia

A

4 Weeks

59
Q

What time frame would you expect cough and breathlessness to resolve on pneumonia

A

6 Weeks

60
Q

What time frame would you expect symptoms to have resolved in pneumonia

A

3-months

61
Q

What may be present at 3-months in pneumonia

A

Fatigue

62
Q

When should individuals feel back to themselves

A

6 months

63
Q

What are 5 complications of pneumonia

A
  • Pleural effusion
  • Empyema
  • Lung abscess
  • Resp Failure
  • Septicaemia

Respiratory (19 decks)

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