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2. Pulmonology > 25.26. Pneumonia > Flashcards

25.26. Pneumonia Flashcards

1
Q

What is pneumonia?

A

Inflammation of the distal small airways, alveoli, and the interstitium associated with exudate accumulation in the alveolar space.

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2
Q

What is pneumonitis?

A

Pneumonia induced by irradiation or chemical agents.

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3
Q

What is interstitial pneumonia?

A

Inflammation affecting primarily the interstitium.

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4
Q

What is community-acquired pneumonia (CAP)?

A

A type of pneumonia that is acquired outside of a hospital or healthcare setting.

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5
Q

What are the typical pathogens that cause typical pneumonia?

A

Streptococcus pneumoniae, Hemophilus influenzae, and Staphylococcus aureus.

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6
Q

What are the atypical pathogens that cause atypical pneumonia?

A

Mycoplasma pneumoniae, Chlamydophila pneumoniae, and viruses.

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7
Q

What is hospital-acquired pneumonia (HAP)?

A

A type of pneumonia that is acquired in a hospital or healthcare setting.

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8
Q

What is ventilator-associated pneumonia (VAP)?

A

Pneumonia occurring in patients on mechanical ventilation breathing machines in hospitals, typically in the ICU.

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9
Q

What are the gram-negative pathogens that cause HAP?

A

Pseudomonas aeruginosa, Enterobacteriaceae (E.coli), and Acinetobacter spp.

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10
Q

What are the symptoms and clinical signs of pneumonia?

A

-Symptoms : Fever, cough, sputum, dyspnea, chest pain,
- Clinical signs : shortened sound with percussion, fine crepitation, rales, X-ray shadow.

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11
Q

What are the laboratory test results in pneumonia?

A
  • Increased CRP, neutrophil granulocytes, ESR, LDH, GOT,
  • increased procalcitonin in severe sepsis (may increase in lung cancer),
  • decreased renal function.
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12
Q

What are the blood gas test results in pneumonia?

A

Hypoxemia, hypocapnia, and respiratory alkalosis.

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13
Q

What is the ECG finding in pneumonia?

A

Sinus tachycardia (fever).

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14
Q

What are the diagnostic methods for pneumonia?

A

-Clinical diagnosis based on history, physical examination, laboratory findings, and CXR finding.
- Consider microbiological studies and advanced diagnostics based on patient history, comorbidities, severity, and entity of pneumonia.

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15
Q

What are the methods to collect sputum from lower airways?

A
  • Bronchofibroscopy,
  • protected brush specimen,
  • bronchoalveolar lavage.
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16
Q

Why do we need to do a urine test for pneumonia?

A

For streptococcus pneumoniae and Legionella pneumophila antigen detection.

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17
Q

What are the different findings observed in chest X-ray for different types of pneumonia?

A
  • Lobar pneumonia shows opacity of one or more lobes with air bronchograms,
  • bronchopneumonia shows poorly defined patchy infiltrates,
  • atypical/interstitial pneumonia shows diffuse reticular opacity.
18
Q

What are the different findings observed in chest CT for pneumonia?

A

Localized areas of consolidation (hyperdense), air bronchograms, and ground-glass opacities

19
Q

What is the PORT score?

A

The PORT (pneumonia outcome research team) score is a clinical prediction rule used to calculate the probability of morbidity and mortality among patients with community-acquired pneumonia.

20
Q

What is the classification of the PORT score?

A

The PORT score is classified into four categories:
- PORT I (at home, per os ABs),
- PORT II-III (at home, per os ABs, some will later need hospitalization),
- PORT III-IV (i.v. AB, hospitalization),
- PORT IV-V (i.v. AB, respirator).

21
Q

Which viruses cause viral pneumonia in adults?

A

Influenza virus, COVID.

22
Q

Which virus causes viral pneumonia in children?

A

Respiratory syncytial virus (RSV).

23
Q

What are the typical manifestations of viral pneumonia?

A

Fever, dyspnea, cough.

24
Q

What is influenza?

A

A highly contagious viral infection that typically occurs during winter months.

25
Q

What causes influenza?

A

Influenza A, B, and C viruses.

26
Q

What are the two proteins found on the surface of the influenza virus?

A

Hemagglutinin (H) and neuraminidase (N).

27
Q

What is the usual presentation of symptomatic patients with influenza?

A
  • Sudden onset of high fever,
  • nonproductive cough (atypical pneumonia!!)
  • headache,
  • malaise.
28
Q

What are the usual levels of inflammatory markers in patients with influenza?

A

They are usually normal or slightly elevated.

29
Q

What is the diagnostic test used to confirm the diagnosis of influenza?

A

PCR testing.

30
Q

What is the recommended management for patients with early or severe influenza?

A

Antiviral therapy with neuraminidase inhibitors such as oseltamivir or zanamivir.

31
Q

What is primary influenza pneumonia?

A

It is caused by direct infection of the lung parenchyma by the influenza virus and is less common than pneumonia or secondary bacterial bronchitis.

32
Q

What are some of the symptoms of primary influenza pneumonia?

A

Dyspnea, hypoxemia, cyanosis, and acute deterioration 2-5 days after onset of flu-like symptoms.

33
Q

What are some of the blood test and radiographic findings in patients with primary influenza pneumonia?

A

Blood tests may show leukocytosis or leukopenia, and CXR may show perihilar congestion with diffuse/multifocal infiltrates.

34
Q

What is the recommended management for primary influenza pneumonia?

A

Antiviral therapy for influenza with oseltamivir or zanamivir.

35
Q

What is COVID-19?

A

COVID-19 is an infectious disease caused by the coronavirus SARS-CoV2.

36
Q

What is the mechanism of entry of SARS-CoV2 into host cells?

A

The Spike protein of SARS-CoV2 facilitates entry by attaching to the ACE2 receptor of the host cell.

37
Q

How is SARS-CoV2 transmitted?

A

SARS-CoV2 is transmitted via inhalation of droplets, aerosol particles, or mucous membrane contact with respiratory particles.

38
Q

What are the clinical features of COVID-19?

A

Fever, cough, dyspnea, fatigue, loss of smell/taste, sore throat.

39
Q

What are the diagnostic tests for COVID-19?

A

PCR test or antigen testing.

40
Q

What is the mechanism of action of Ritonavir-boosted Nirmatrelvir?

A

Ritonavir inhibits packaging and assembly of viruses, while Nirmatrelvir inhibits the activity of protease.

41
Q

What is the mechanism of action of Remdesivir?

A

It is a nucleotide analog that inhibits RNA synthesis.

42
Q

What is the recommended route of administration for Ritonavir-boosted Nirmatrelvir?

A

Oral.

2. Pulmonology (22 decks)

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