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Principles: Pathology > Community Acquired Pneumonia > Flashcards

Community Acquired Pneumonia Flashcards

1
Q

What is the incidence of CAP?

A

3rd Leading cause of death worldwide

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2
Q

What are the major risk factors for pneumonia?

A
  • Smoking – damages epithelium, inhibits cilliary function
  • Low BMI – very low antibody levels as failure to synthesise proteins
  • Chronic illnesses (heart failure, diabetes, chronic liver disease, untreated HIV)
  • Respiratory diseases (COPD, asthma)
  • Influenza and other respiratory tract infections – primary flu pneumonia, more likely secondary bacterial infection (e.g. staph aureus)
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3
Q

What are risk factors for aspiration pneumonia?

A
  • Epilepsy (LOC)
  • Stroke
  • Chronic neurological diseases e.g MS
  • Alcohol abuse (aspiration of vomit, etc)
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4
Q

What drug treatments increase the risk of pneumonia?

A
  • Inhaled corticosteroids
  • Oral steroids (immunosuppression)
  • Proton pump inhibitors
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5
Q

What drug treatments decrease the risk of pneumonia?

A
  • Influenza vaccination
  • Pneumococcal vaccination
  • Statins
  • ACE-I in Asian patients
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6
Q

What is the aetiology of pneumonia?

A
  • Bacteria
  • Viruses
  • Fungi
  • Eosinophilic pneumonia
  • Autoimmunity
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7
Q

What is eosinophilic pneumonia?

A

Alveoli become filled with eosinophils and neutrophils - it is NOT an infection

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8
Q

What are symptoms of pneumonia?

A
  • Malaise, Anorexia, sweating, rigors, myalgia, arthralgia and headache
  • Breathlessness
  • Cough and sputum (often green)
  • Haemoptysis (rusty coloured in pneumococcal pneumonia)
  • Pleuritic chest pain
  • Confusion (esp Legionella pneumonia)
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9
Q

Why is pneumonia usually lobar?

A

Doesn’t normally cross fissures

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10
Q

What are signs of pneumonia on examination?

A
  • Dull to percussion
  • Bronchial breathing
  • Crackles
  • Pleural rub
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11
Q

What investigations would be carried out for pneumonia?

A
  • Bloods (WCC, CRP)
  • Sputum and blood cultures
  • Atypical serology (Mycoplasma IgM, Legionella urinary antigen, respiratory viruses, chlamydia serology)
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12
Q

What is CURB65 score used for?

A

To predict mortality of pneumonia on admission

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13
Q

Explain CURB65

A 
C - confusion
U - urea >7mmol/l
R - resp rate >30 breaths/min
B - blood pressure <90mmHg systolic or <60mmHg diastolic 
65 - Over 65

For each letter, score 1 point

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14
Q

What do the different CURB65 scores mean?

A
  • 0-1: outpatient treatment
  • 2: short inpatient stay
  • 3: Admit
  • 4: consider for HDU/ITU
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15
Q

Why is ciprofloxacin not given as a treatment for pneumonia?

A

Strep.pneumoniae is resistant

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16
Q

What are complications of pneumonia?

A
  • Parapneumonic effusion
  • Empyema
  • Lung abscess/cavitation
  • Metastatic infection/abscesses
  • ARDS/Multiorgan failure
  • Death
17
Q

What pneumonias can lead to lung abscesses?

A
  • Staphylococcus
  • Klebsiella
  • Anaerobes
18
Q

What is the treatment for lung abscesses caused by pneumonia?

A
  • Flucloxacillin
  • Augmentin
  • Metronidazole
  • Drainage
19
Q

What pneumonias can lead to empyema?

A
  • Strep.Milleri
  • Strep.pneumoniae
  • Klebsiella
  • Anaerobes
20
Q

What is the treatment for empyema?

A
  • Gentamicin
  • Metronidazole
  • Amoxicillin
  • Drainage
21
Q

What pneumonia is likely to be present in a Glaswegian alcoholic?

A
  • Aspiration pneumonia

* Klebsiella (weakened immune system so more likely to get unusual things)

22
Q

What pneumonia is likely to be present in an IV drug user?

A

Staph aureus

23
Q

What pneumonia is likely to be present in a sex worker?

A

Strep pneumoniae

24
Q

What pneumonia is likely to be present in a pigeon farmer?

A

Chlamydia psittaci

25
Q

What pneumonia is likely to be present in a young person?

A

Mycoplasma

26
Q

What pneumonia is likely to be present in an individual with COPD?

A

Haemophillus (common in COPD)

27
Q

What pneumonia is likely to be present in an individual with achalasia?

A

Gram -ve enterobacteria

28
Q

What pneumonia-causing microorganism are children likely to carry?

A

Haemophillus influenzae

29
Q

What microorganisms can cause cavitation in the lung?

A
  • Mycobacteria tuberculosis
  • Klebsiella
  • Eneterobacteria
30
Q

When can TB suffers be detained?

A

If they are smear positive

31
Q

What is the treatment for TB?

A

4 RIPE

Rifampicin, Isoniazid, pyrazinamide, and ethambutol

32
Q

When does pneumocystis pneumonia (PCP) occur?

A

When immune system completely wiped out (CD4 <200)

33
Q

What is the effect of pneumocystis pneumonia?

A

Sufferers become extremely hypoxic

34
Q

What is the treatment for pneumocystis pneumonia (PCP)?

A

High dose septrin (1.2g 4 times a day)

Principles: Pathology (4 decks)

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