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YFRM 300 > Bacterial pneumonia > Flashcards

Bacterial pneumonia Flashcards

1
Q

Pneumonia

A

is an acute infection of lung parenchyma, usually caused by bacteria.

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2
Q

Pneumonia is classified into:

A
  • CAP: community-acquired
    pneumonia
  • HAP: hospital-acquired
    pneumonia
  • VAP: ventilator-associated
    pneumonia
  • Aspiration pneumonia
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3
Q

predisposing condition for pneumonia

A
  • Very young or old age
  • Other concomitant disease
  • Malnutrition
  • HIV infection
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4
Q

management guided by?

A

Age
* Co-morbidities
* Severity of pneumonia

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5
Q

symptoms of pneumonia

A

Fever
chest pain
coughing
Dyspnea
malaise
severe: shock nd respiratory failure

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6
Q

signs of pneumonia when examaning a patient ?

A

fever> than 38 degrees
crackles sound
tachypnoea
bronchial breath sounds

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7
Q

most commmon pneumonic pathogens causing Community aquired pneumonia

A

S. pneumoniae
S. aureus
Atypicals
(Legionella
pneumoniae, Mycoplasma
pneumoniae, Chlamydia
pneumoniae)
H. influenzae

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8
Q

most common pneumonic pathogens causing hospital acquired pneumonia

A

Staphylococcus
aureus
G- enterics
(Klebsiella
pneumoniae)
G- nonenterics
(P. aeruginosa,
H. influenzae
M. catarrhalis

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9
Q

most common pneumonic pathogens causing ventilated acquired pneumonia

A

S. pneumoniae
S. aureus
Haemophilus
influenzae

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10
Q

Aspiration P

A

B. Melaninogenicus
Fusobacteria
anaerobic streptococci
Polymicrobial infections
with
S. aureus,
S. pneumoniae
gram-negative bacilli

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11
Q

CAP treatment considerations

A

for less than 65 years:
amoxicillin
ampicillin
Co-amoxiclav or cefuroxime

above the age 65:
co-amoxiclav

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12
Q

An alternative drug for CAP treatment?

A

Moxifloxacin

or luvoflaxacin

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13
Q

Adjuvant treatment of severe CAP requiring ICU

A

Addition of macrolide (azithromycin)
Systemic corticosteroids

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14
Q

IN CAP what bacteria’s mostly causes severe pneumonia in children?

A

Bacterial * Non-typical H. influenza & S. aureus leading bacterial causes of
severe pneumonia in children

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15
Q

respiratory viruses causing severe pneumonia in children - CAP

A

Resp. syncytial virus

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16
Q

for severe pneumonia plus chest indrawing.

A

Give ceftriaxone.

17
Q

HAP (Hospital Acquired Pneumonia) pathogens causing it ?

A

Gram Positive staphylococci * S. aureus
Gram Negative enterics
* K. pneumoniae
Gram Negative nonenterics
* P. aeruginosa
* H. influenzae
* M. catarrhalis

18
Q

what are risk factors Of HAP

A

Hospitalized > 5 days
* Hospitalized > 2 days in past 3 months
* Immunocompromised with poor functional status
* Developed pneumonia after admission to ICU
* Mechanical ventilation

19
Q

What is HAP normally diagnosed on?

A

New infiltrate on CXR
* Fever * Worsening respiratory status
* Thick secretions (neutrophil-containing

20
Q

VAP (Ventilator- associated pneumonia)

A
  • S. pneumoniae
  • S. aureus
  • H. influenzae
21
Q

Standard treatment and medicine for VAP

A

Piperacillin/tazobactam, IV
Amikacin, IV
Cefepime

22
Q

Carbapenem with activity against Pseudomonas.-DRUG?

A

imipenem-IV
(Except CNS infections or known epileptics)

23
Q

Aspiration pneumonia

A

inhalation or abnormal entry of large inoculum of exogenous substance or endogenous secretions into the lower airways. causes inflammation leading to pneumonia.

24
Q

Anaerobic bacteria

A
  • B. melaninogenicus, Fusobacteria, and anaerobic streptococci.
25
Q

Consider treatment with aspiration pneumonitis and persistent with

A

amoxicillin/ clavulanate

cephalosporin- cefazolin and cefepime and ceftriaxone

26
Q

Antimicrobial stewardship principles

A

empiric treatment
obtain cultures
use a narrow treatment

stable vitals
free of fever
conscious.

27
Q

Pneumonia Preventive Strategies

A

Pneumococcal vaccines;
23 valent polysaccharide
13 valent pneumococcal conjugate

28
Q

Pneumococcal polysaccharide vaccine (PPSV)23.

A
  • 19-64 underlying comorbid conditions, smoke, immunocompromised
  • All persons 65 + years of age
29
Q

Pneumococcal conjugate vaccine (PCV)13

A

Single dose > 18 years
* High risk: sickle cell disease and HIV
* Trivalent Influenza Vaccin

30
Q

who should receive the influenza vaccine?

A

Pregnant women
HIV-infected adults
Healthcare workers
High-risk for influenza
Old-age home and chronic care/rehabilitation
residents
Age > 65

31
Q

Pneumocystis pneumonia

A

is caused by pneumocystis jiroveci.

32
Q

who is at risk of having it

A

person with advanced HIV

33
Q

symptoms of Pneumocystis pneumonia.

A

SOB, dry cough

34
Q
A

YFRM 300 (18 decks)

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