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Yr3 RESP > Condition- pneumonia > Flashcards

Condition- pneumonia Flashcards

1
Q

What is Pneumonia?

A

An acute Lower Respiratory Tract Infection

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2
Q

What are the different categories to classify pneumonia aetiologically?

A
  1. Community acquired
  2. Hospital acquired (developed >48hrs after admission)
  3. Aspiration Pneumonia
  4. Immunocompromised
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3
Q

List the three main causative agents of Community acquired Pneumonia

A
  • Streptococcus Pneumoniae
  • Haemophilius Influenza
  • Moraxella Catarrhalis
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4
Q

List the three main causative agents if Hospital- acquired pneumonia…

A
  1. Gram -ve enterobacter:
    • Klebsiella
    • Pseudomonas aeroginosa
  2. Staphylococcus Areus
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5
Q

List the main causative agent of aspiration pneumonia

A

Streptococcus Pneumoniae

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6
Q

List the 3 (+2) main causative agents of immunocompromised pneumonia…

A
  1. Streptococcus pneumoniae
  2. Haemophilius Influenza
  3. Staphylococcus Aureus
  4. Moraxxella catarrhalis (COPD)
  5. Mycoplasma pneumoniae
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7
Q

List some of the presenting symptoms of pneumonia…

A
  • Fever
  • SOB
  • Cough- green sputum
  • Pleuritic Chest pain
  • Malaise
  • Weight loss
  • Sweats
  • Rigors
  • haemoptysis
  • Confusion
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8
Q

List some of the signs of pneumonia on physical examination…

A
  • Low oxygen saturation, pyrexia, tachycardia, tachyopnoea, hyoptension
  • Confusion (AMT), hypothermia
  • Percuss: dullness
  • Palpate: reduced expansion
  • Auscultate:
    • Increased tactile fremitus/ vocal resonance
    • Bronchial breathing
    • Coarse crackles
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9
Q

What are the different types of pneumonia you can see on an x-ray?

A
  • Bronchopneumonia: Patchy shadowing
  • Lobar/ multilobar
  • Consolidation: Pleural effusion/ cavitation
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10
Q

List the different investigations you would perform on someone with suspected Pneumonia

A
  • Bedside: pulse ox, BP, sputum sample, urine dip
  • Bloods: FBC (elevated WCC), LFTs (in case its HPS), U+Es (urea), CRP, ABG (to check for resp failure)
  • Imaging: CXR, bronchoscopy
  • Special: Bronchoalveolar lavage, sputum and pleural fluid (MC+S)
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11
Q

Which scoring system can be used to assess the severity of pneumonia? What are the criteria?

A

CURB-65

  • Confusion (AMTS<8)
  • Urea >7mmol/L
  • Resp rate >30
  • BP <90 SBP or 60 DBP
  • >65yrs
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12
Q

What do you interpret the CURB-65 score?

A
  • 0-1: can treat at home
  • 2: Short hospital admission reqiured
  • 3: Severe, ITU may be required
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13
Q

What are the steps to be taken in the management of pneumonia?

A
  1. CURB-65
  2. ABC:
    • Supplemental Oxygen
    • Treat hypotension/ shock: IV fluids
    • Analgesia if pleurisy
    • CPAP if necessary
  3. Surgical drainiage (if abscess/ empyema)
  4. Antibiotics
  5. Vaccination
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14
Q

Which antibiotics are given to a patient with community acquired pneumonia with a CURB-65 score of:

  • 0-1
  • 2
  • >3
A
  1. 0-1: oral amoxicillin or clarithromycin
  2. 2: oral amoxicillin AND clarithromycin
  3. >3: IV co-amoxiclav/ cephalosporin AND IV clarithromycin
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15
Q

Which antibiotics are given to a patient with hospital acquired pneumonia?

A
  • IV aminoglycoside
  • AND IV pseudomonal penicillin/cephalosporin
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16
Q

Which antibiotics are given to patient with aspiration pneumonia?

A
  • IV cephalosporin + IV metronidazole
17
Q

Which antibiotics are given to patients with pneumonia caused by atypical bacteria?

A
  • Clarithromycin
18
Q

Which antibiotic is given to patients pneumonia caused by Staph A (2)

A
  • If staph: Flucloxacillin + gentamycin
  • If MRSA: Vancomycin
19
Q

Which pathogen often causes pneumonia in alcoholics?

A

Klebsiella

20
Q

Which pathogen commonly causes pneumonia in COPD patients?

A

Haemophilus Influenza B

21
Q

List some potential complications of Pneumonia…

A
  • Spread of infection:
    • Sepsis
    • Lung abscess
    • Empyema
    • Pleural effusion
    • myopericarditis
  • Damage to structure:
    • ARDS
    • Bronchiectasis
    • Pneumothorax
22
Q

Which vaccinations protect against strains of pneumonia causing agents and which subset of the population are allowed the vaccines?

A
  • HIB and pneumococcus vaccine
  • GROUPS:
    • >65
    • Chronic heart, liver or renal disease
    • Immunocompromised
    • DM
23
Q

Which pathogen is likely to infect a pt who has recently had a new AC fit in? and describe its presentation

A

Legionella (hypoNa + lymphopenia)

24
Q

Which pathogen is likely to infect a pt with pneumonia who has dogs and cats?

A

Chlamydia psittaci

25
Q

Which two pathogens can cause cavitating lesions in pts with Pneumonia?

A

Staph aureus

Klebsiella (cause lung abscess and empyema in alcoholics)

26
Q

Which pathogen commonly causes pneumonia in elderly patients who have recently been infected by the influenza virus?

A

Staph aureus

27
Q

List some symptoms of an atypical presentation of pneumonia

A
  • Dry cough
  • headache
  • Diarrhoea
  • Myalgia
  • Hepatitis
28
Q

List 4 pathogens which cause an atypical presentation of pneumonia

A
  • Mycoplasma pneumonia (causes dry cough + AIHA + erythema multiforme)
  • Legionella pneumophila (from A/C causes hypoNa + lymphopenia)
  • Clamydhia psittaci (from pet birds)
  • Clamydia pneumoinae
29
Q

Which groups of the population is pneumocytis jiroveci common in? and how does it present?

A

In HIV and TB patients

Dry cough and SOBOE

Yr3 RESP (16 decks)

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