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Medical Studies 1 > 8.2 Pathophysiology of Pneumonia > Flashcards

8.2 Pathophysiology of Pneumonia Flashcards

1
Q

Provide a simple definition of pneumonia

A

Acute infection of the pulmonary parenchyma

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2
Q

How many hospital admissions for pneumonia per year in Australia?

A

77,000

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3
Q

Pneumonia was the ___th leading cause of death in Australia in 2019

A

9th

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4
Q

List some risk factors for pneumonia

A
  • Age > 65
  • Chronic lung disease (e.g. COPD, cystic fibrosis)
  • Immunocompromised conditions (e.g. HIV)
  • Lifestyle factors (smoking, alcohol, toxic inhalation of substances)
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5
Q

Additional important questions to ask during history of suspected TB patient

A
  • Living environment
  • Current/previous employment
  • Travel and emigration
  • Sick contacts
  • Toxic exposures
  • Vaccinations
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6
Q

Symptoms of pneumonia

A
  • Productive cough
  • Dyspnoea
  • Pleuritic chest pain
  • Lethargy
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7
Q

Signs of pneumonia

A
  • Tachypnoea
  • Fever
  • Tachycardia
  • Hypoxia
  • Dullness to percussion
  • Decreased breath sounds
  • Bronchial breathing
  • Coarse crackles
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8
Q

Describe the SMART COP mnemonic for pneumonia severity

A
  • Systolic BP <90mmHg
  • Multilobar CXR involvement
  • Albumin < 3.5 g/dL
  • Resp Rate >30
  • Tachycardia >125bpm
  • Confusion
  • O2 sats <90%
  • pH <7.35
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9
Q

Explain the CURB-65 severity scoring

A
  • Confusion
  • Urea >7 mmol/L
  • Respi rate >30
  • Blood pressure (sys <90 or dia <60)
  • Age: >65
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10
Q

List some acute complications of pneumonia

A
  • Sepsis
  • Parapneumonic effusion
  • Empyema
  • Respiratory failure
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11
Q

What is parapneumonic effusion?

A

Accumulation of fluid in pleura due to inflammatory response to pneumonia

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12
Q

What is empyema?

A

Direct infection/pus buildup in pleural space

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13
Q

How is community acquired pneumonia transmitted (mechanism of transport)?

A

Droplets/aerosols

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14
Q

Describe the pathophysiology of community acquired pneumonia (starting with transmission)

A
  • Droplets/aerosols
  • Colonise nasopharynx
  • Microaspiration -> parenchyma
  • If macrophage cannot contain, it releases cytokines
  • Systemic and local inflammatory response
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15
Q

Aetiological classifications of pneumonia

A
  • Bacterial
  • Viral
  • Aspiration
  • Atypical
  • Opportunistic
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16
Q

Acquisition-based classifications of pneumonia

A
  • Community acquired
  • Healthcare associated
  • Ventilator associated
17
Q

In order, list some common bacterial causes of community acquired pneumonia

A
  • Streptococcus pneumoniae
  • Mycoplasma pneumoniae
  • Haemophilus influenzaae
18
Q

In order, list some common viral causes of community acquired pneumonia

A
  • Influenza A/B
  • Picronaviruses
  • Adenovirus
19
Q

In order, list some common causative organisms of healthcare associated pneumonia

A
  • Streptococcus pneumoniae
  • Escherichia coli
  • Klebsiella pneumoniae
  • MRSA
20
Q

Lobar vs bronchopneumonia

A

Lobar: one or more lobes
Bronchopneumonia: patches all throughout lungs

21
Q

Why is an EUC important in suspected cases of pneumonia

A
  • Measures renal function
  • Important before giving antibiotics
22
Q

What would be expected in an FBC of a pneumonia patient?

A

Raised white blood cells

23
Q

Would inflammatory markers be expected to be raised or lowered in pneumonia

A

Raised

24
Q

What is the purpose of sputum microscopy and culturing in suspected pneumonia patients?

A

To see if any bacteria or fungi are present

25
Q

What could be seen on a CXR of a pneumonia patient?

A
  • Consolidation
  • Effusions (parapneumonic effusion vs empyema)
26
Q

What organisms would make you suspicious of opportunistic pneumonia?

A
  • Cryptococcus
  • Pneumocystis
27
Q

When is bronchoscopy used in suspected cases of pneumonia?

A
  • Immunosuppressed patient with high rsk of fungal pneumonia
  • Severe pneumonia, no identified organism, not responding to normal therapy
  • Concern for endobronchial obstruction casuing pneumonia
  • Concern of non-infective pneumonia
28
Q

What are the three main aspects of pneumonia management?

A
  • Antiobiotic therapy
  • Supportive therapy
  • Assess reversibility of risk factors
29
Q

Describe some non-antibiotic therapies for pneumonia patients

A
  • Oxygen as required (usually above 92%; CO2 retainers: 88-92%)
  • Allied health—mukltidisciplinary approach
  • Rehab
  • DVT prophylaxis
  • Adequate nutrition
30
Q

Class 1 pneumonia treatment

A
  • Amoxicillin
  • Doxycycline
  • Can probably go home
31
Q

Class 2 Pneumonia treatment

A
  • IV amoxicillin
  • Azithromycin
  • Gentamicin (if high risk)
32
Q

Class 3 pneumonia treatment

A
  • Amoxicillin
  • Azithromycin
  • Gentamicin
  • May or may not need other support
33
Q

If there is dense consolidation of CT, patient may need repeat CT in 3 months. Why?

A
  • Ensure resolution
  • Ensure no underlying lesion
34
Q

Effect of pneumonia on vocal resonance?

A

Increase+

Medical Studies 1 (90 decks)

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