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YEAR 3 Manchester Medicine > 12 - Pneumonia > Flashcards

12 - Pneumonia Flashcards

1
Q

What is CAP

A

Community Aquired Pneumonia - signs of lower respiratory tract infection (fever/cough/phlegm/crepitations or bronchial breathing) + CXR changes.

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2
Q

What is CURB-65 used for?

A
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3
Q

Assessing severity of CAP

A
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4
Q

What criteria does CURB-65 include?

A

Confusion

Ureas > 7mmol/L

RR > 30

BP < 90/60

> 65 years

=> 0-1 - low, 2- moderate >3 servere risk of death.

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5
Q

What conditions are included in URTI?

A

Common cold

Sinusited

Pharyngitis

Laryngitis

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6
Q

What conditions are included in LRTI?

A

Acute bronchiectasis

Pneumonia

COPD exacerbation

Bronchiectasis exacerbation

Lung absess

Empyema

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7
Q

Are UTRI mostly bacterial or viral?

A

Viral

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8
Q

Are LRTI mostly bacterial or viral?

A

Bacterial

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9
Q

Which LRTI condition is mainly viral?

A

Acute bronchiectasis

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10
Q

What types of COPD exacerbations are there?

A

Simpe - no changes on CXR

Pnumonia - Changes on CXR

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11
Q

Which bacteria cause COPD exacerbations?

A

H. influenza

S. pneumonia

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12
Q

What is the pathology of bronchiectasis exacerbations?

A

Bronchioles have wall damaged leading dilatations causing bronchipneumonia.

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13
Q

What quilifies someone as having Hospital aquired pneumonia (HAP)?

A

Developed within 48 hours of hosptial

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14
Q

What complications can occur from pneumonia?

A

Effusion

Empyema

PE

AF

Antibiotic rash and phlebitis

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15
Q

What does neutrophilia indicate?

A

Indicates bacterial infection

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16
Q

What does neutropenia indicate?

A

Viral infection

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17
Q

What does an increase white cell count indicate?

A

Acute infection

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18
Q

What does lymphopenia indicate?

A

Severe infection

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19
Q

What does Raised CRP indicate?

A

Indicates infection (more prominnat with bacteria), a lower increase indicates a inflammatory condition or malignancy.

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20
Q

What is Rigor?

A

Symptom which describes a sudden feeling of cold with shivering but an increase in body temperature

21
Q

What is the Window peroid od HIV?

A

Time where blood test shows the person to be HIV negative however is infected and infectious. Antibodies are developed during this time.

Around 4 weeks

22
Q

How many days after hospital admission is late onset HAP?

A

5 days

23
Q

Bacteria causing CAP?

A

80% are Streptococcus pneumoniae

24
Q

Bacteria involved in late onset HAP?

A

Enterobacteria

MRSA

Pseudomonas

25
Q

Which lobe is aspiration pneumonia most likely tobe in?

A

Lower right as the bonchus is more in line with the right main bronchiole

26
Q

Which organisms cause TB?

A

Myobacterium tuberculosis

Myobacterium bovis

27
Q

Descirbe the phases of TB?

A

Primary phase - no or minor symtpoms localised to lungs and may leaves domant myobacterium in macrophages

Secondary phase - reactivation of persisting myobacterium leading to immunorepsonce and therefore symptoms

28
Q

What are the symptoms of TB?

A

Cough

Weight loss

Night sweats

Fever

Malaise

Specific symptoms to the organ that TB has spread to…

29
Q

Investigations for TB

A

CXR

ESR and CRP

HIV test

LFT

Sputum and blood cultures

30
Q

What does CPE stand for?

A

Carbapenemase

Carbapenemase-producing Enterobacteriaceae

31
Q

What are the features of myobacteria?

A

AAFB -alcohol and acid fast bacilli

Spread through droplets in the air

32
Q

What is Miliary TB?

A

TB spread to the lungs from othr areas of the body leading to comolidations the size of miliary seeds. These are scene on CXR.

33
Q

What is the standard Inital treatment for TB?

A

Isoniazide

Rifampicin

Pyrazinamide

Ethambutol

For 2 months

34
Q

What happens after the intial phase for TB treatment?

A

Isoniazide

Rifampicin

Ethambutol and Pyrazinamide are dropped.

35
Q

Which antibiotic in TB therapy has the side effect of turining body fliuds orange?

A

Rifampicin

36
Q

Is TB a notifiable disease?

A

Yes, Local health authority has to be notified.

37
Q

?What are the complications of TB?

A

Death

Antibiotic SE (neuropathy from Isoniazide)

Amyloidosis

Site specific:

Lungs - avities, pleural thickening, bronchiectasis

Spine - paraplegia

Brian - cranial nerve pulse, hemiparesis

38
Q

What and when should be done in follow up for TB?

A

CXR at 6 weeks

39
Q

What the features of consolidations which allow it to be differentiated from effusions on CXR.

A

Margines are not well defined
Costo-phrenic angles are preserved

There are air bronchiograms

40
Q

What are the features of effusion which alow it to be differentiated from consolidation on CXR?

A

No lung markings

No air bronchiograms

Costodiaphragmatic angles are lost

41
Q

What does the tuberculosis skin test and Interferon gamma release essay show?

A

Assesing previous exposer to TB

Same in latent and active disease

42
Q

Who gets the pneumoccal vaccine?

A

>65 years

Chronic liver/heart and lung disease

DM not controlled by diet

Immunosupresseed (chemo, hyposplenic etc.)

43
Q

What harbours legionella pneumophilia?

A

Water tanks kept below 60°C

44
Q

What type of organism most comonly causes pneumonia in the immunosupressed?

A

Pneumocystis Jirovecci

45
Q

What type of organism most comonly causes pneumonia in bronchiectasis and cystic fibrosis?

A

Psuedomonas

46
Q

What type of organism most comonly causes pneumonia in IVDU?

A

Staphylococcus

47
Q

What the pathology behind bronchiectasis?

A

Inflammation leading to permanent dilatiotion of bronchioles

48
Q

What type of organism most comonly causes pneumonia for alcoholics?

A

Klebsiella pneumoniea

49
Q
A

YEAR 3 Manchester Medicine (34 decks)

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