Cases- Pneumonia (3)-Leah Flashcards
Virus that causes severe pneumonia and 30k annual US deaths?
Influenza
“Hyporesonance at the base of the lung” is characteristic of?
What action should you take if this is heard in the presence of pneumonia?
Pleural effusion
–drain any effusion of 1cm or greater via thoracentesis
Walking pneumonia:
Classic bug? (2)
Treatment needed? (2)
Mycoplasma; chlamydia
Organisms lack a CELL WALL = NO penicillins
Can use macrolides, doxycycline
Respiratory infection most likely to lead to serious complications?
Pneumonia
Flu assc bacterial pneumonias (2)
Strep aureus; Strep pneumo also.
Before running cultures and CXR on a patient with suspected pneumonia you should always?
Stabilize the patient!
(This is kind of a no brainer but just in case….. If the patient has super low BP/O2 sat- fix those problems before trying to diagnose an underlying condition!!)
Pneumonia assc with
-alcoholism, abscesses, aspiration
KlebsiellAAAA
(Anaerobe)
(As are for alcoholics, aspiration, abscesses, anaerobes)
Gram - rod; urease +; lactose fermenting, grows on MacKonKEES agar.
(KEES = klebsiella, E. coli, enterococcus, serratia)
Standard treatment for community acquired pneumonia/strep pneumo (2)
Ceftriaxone
Azithromycin (macrolide)
Biggest risk factor for resistant bacterial pneumonia
Hospital stay >48 hours
Wheezing + prolonged expiration are characteristic of?
Obstructive disease!!!
Cold + runny nose + sore throat are most suggestive of what type of illness?
Viral
To what do obstructive diseases respond? (2)
Steroids and bronchodilators
No wheezing in pneumonia indicates?
Significant, severe disease
Most common pneumonia in immunosupressed patients?
COMMON THINGS ARE STILL COMMON!!!
Strep pneumo, etc.
“Rust colored sputum” is a buzzword for?
Strep pneumo pneumonia
What should you ask foreigners/ travelers about?
Vaccination
People in “close quarters” should get the vaccine for:
Meningococcus
“Crackles at the base of the lung” is a classic presentation for?
Chronic CHF
“Constantly coughing until you vomit” should be a red flag for?
Pertussis
What is a high WBC count? What is a SERIOUSLY high WBC count?
Anything 10+ is high; 20+ is indicative of severe illness
What two things do neutrophils in sputum suggest?
- good sample
- bacterial infection
In the absence of wheezing, you can usually rule out?
Asthma exacerbation
Scattered patchy infiltrates on CXR and red bullpen on the tympanic membrane is suggestive of?
Atypical pneumonia; mycoplasma
Antibiotic treatment of hospital acquired pneumonia should cover what bugs?
Common things +
Gram negatives like space bugs
Staph aureus
Legionella
