chest infections Flashcards
what is the most common bacteria in community acquired pneumonia
strep pneumonia
diff btwn community and hosp acquired pneumonia in terms of time
hospital: infection that develops 48hrs or more after hospital admission
community aquired: infection acquired outside a healthcare setting or diagnosed within 48 hrs of admission.
hosp aquired bacteria
gram neg (E.coli + pseudomonas)
staph aures
sympyoms of Pneumonia
cough, fever, sputum, L U N G S
letharhy
unusual breath sounds
night sweats
green or rust colored sputum
Shortness of breath
severity score for pneumonia
CURB-65 (1 pt each)
confusion
urea> 7
RR> 30
BP <90 sys/60 dias
age>65
what type of bacteria causes rusted color sputum, fever , chest pain , 90% polymorphic leukocytosis , associated w herpes labialis
strep pneumonia
what type of bacteria where x ray does not correlate with symptoms = symptoms are mild whereas x ray looks bad
mycoplasma
serology shows high igM and WBC usually normal
mycoplasma
a young male who smokes inhaled water mist and presented witg headache and neurological symptoms with investigations showed hyponatremia, hypoalbunemia.
legionella
a pt came in very ill with fever and increased neutrophils, malaise, weight loss, and clubbing. on x ray pus in pleural cavity from ruptured lung abscess
empyema
what is localized suppuration of lung associated w cavity formatiom , often w an air-fluid lvl on CXR
lung abscess
what do pts w lung abscess present with
persistent or worsening pneumonia
copious foul smelling sputum
finger clubbing
what are two types of pneumonia
community and hospital
what are causes of lung abscess
secondary to aspiration pneumonia and bacterial
bronchial obstruction
in pleural effusion what is exudate
leaky vessels inflam pulmonary capillaries due to damaged pleura loss of tissue fluid and protein and impaired lymphtic drainage
causes of exudate pleural effussion
anythimg related to lungs
IM PEACEFUL
I: Infection (e.g., pneumonia, tuberculosis, empyema)
M: Malignancy (e.g., lung cancer, metastatic disease)
P: Pulmonary embolism (often exudative)
E: Esophageal rupture
A: Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
C: Chylothorax (lymphatic obstruction)
E: Empyema
F: Fungal infections
U: Uremia (renal failure)
L: Lymphatic obstruction
difference in fluid apperance of exudate and transudate
exudate = pale yellow, cloudy (more proteins)
transudate = clear, water, pale yellow
causes of transudate
anything not lung related other organs
CHiP
congestive heart failure
hypoalbunemia( nephrotic syndrome , liver cirhossis ) low proteins
Pulmonary Embolism
what is lights criteria
helps distiguish btwn exudate and transudate
- fluid is an exudate if one or more of these criteria are met :
1) pleural fluid protein> 0.5 serum protein
2) pleural fluid LDH > 0.6 serum LDH
3) pleural fluid LDH>2/3 upper normal serum limit
what is resp failure
impaired gas exchange causes hypoxemia w or wout hypercapnia (pa02<60 or Pco2>55)
how to differ btwn hemithorax and hemorrhagic pleural effusion w pleural: serum hct=
> 50 hemothorax
< 50 hemorrhagic pleural effusion
what is pneumothorax
air in pleural space —> partial /complete lung collapse
causes of pneumothorax
trauma
underlying disease COPD or infection
rupture of subpleural apical blebs (youmg thin men)
symptoms of pneumothorax
P-THORAX
pleuritic pain
Tracheal deviation
Hyperresonance
onset-sudden
Reduced breath sounds and breathing
Absent fremitus
X-Ray shows collapse and presence of visceral pleural line
