120 - Pneumonia Flashcards
What is pneumonia?
LRTI
Inflammation and consolidation of the lung tissue due to an infectious agent
What is CAP?
Community acquired pneumonia
What puts you at risk of pneumonia?
Institutions Low nutrition Smoking Alcoholism specific drugs - mucociliary drugs (atropine), sedatives - reduce cough, steroids - reduce phagocytosis
What investigations might you do in pneumonia? What is the acronym?
SUBEX
Sputum - Acid fast bacilli, general culture, gram stain, legionella antigen Urine Blood - Cultures, WBC, urea, serology ECG Xray
What is the prognosis of pneumonia?
6th leading cause of death
Most common cause of death due to infectious disease
What is the ‘risk screening’ acronym used in pneumonia to see if you should admit the patient?
CURB65
Confusion High urea (>7) High rest rate (>30) Low BP (90/60) Age 65+
If they have 2 points, admit
What are the historical types of pneumonia?
Typical - abupt onset, high fever, purulent sputum, focal consolidation
Atypical - Gradual onset, dry cough, myalgias, headaches
What is lobar and bronchopneumonia?
Lobar - continuous area affected, eg. a lobe
Bronchopneumonia - affects brochioles, so mulitple lobe foci
How could you treat uncomplicated pneumonia?
oral amoxycillin + clarithromycin
or
oral cephlasporin
How could you treat complicated pneumonia?
IV cefuroxime + oral clarithromycin
or
IV augmentin + oral clarythromycin
How could you treat atypical pneumonia?
IV Rifampicin + tetracycline
How could you treat cavitation or aspiration in pneumonia?
IV CEF + MET
Cefuroxime + metronidazole
or
Flucloxacillin
If someone with pneumonia has rust coloured sputum, what infectious cause would you suspect?
Streptococcus Pneumonia
If someone had a viral infection, then developed pneumonia, that had sepsis, cavitation, empyema and absesses, what would you think is the cause?
Staphylococcus Aureus
If someone had an URTI, develops a pneumonia that grumbles along, they feel weak, what might be the cause?
Haemiohilus influzena
A patient with COPD develops a pneumonia, that is distributed as a bronchopneumonia, what may be the cause?
Haemophilus Influenza
An alcoholic presents with redcurrent jelly like sputum, what might be the cause?
Klebsiella
Someone who has many comorbidities and often chokes on food and regurgetates food develops pneumonia, what might be the cause?
E-coli
Someone is chronically ill with a pneumonia that never fully clears, they have green sputum, what may cause this?
Pseudomonas Aerinonsa
After travelling abroad, someone develops gradual shortness of breath, weight loss, and has a bright green sputum - what may cause this?
TB - Mycobacterium Turberculosis
Someone develops pneumonia after staying in an apartment with old air con, they also stop passing urine and start developing hepatosplenomegaly - what is the cause?
Legionella Pneumophilia
In a nursing home there is an outbreak of an URTI followed by pneumonia. People thought it might be glandular fever at first. What might cause this?
Mycoplasma Pneumoniae
A pigeon fancier develops pneumonia, and starts to feel depressed. What might cause this?
Chlamydia Psittacci
An immunocompromised patient develops pneumonia, what 3 causes may you suspect?
PCP - pneumocystis Carinii
Aspergillus
Cryptococcus