Goroll Ch 52- Bronchitis and Pneumonia Flashcards
What does “classic” CAP present like?
sudden chill followed by fever, pleuritic pain, productive cough
What does atypical pneumonia typically present as?
sore throat and HA then nonproductive cough and dyspnea
Are there infiltrate or signs of consolidation in an acute bronchitis x-ray?
NO
What is the most common cause of pneumonia?
Strep peneumoniae
What are classic clinical features of pneumococcal pneumonia?
abrupt onset of fever w/ single rigor, cough with rusty sputum, pleuritic chest pain
Lobar consolidation on x-ray
What is the most common complication of pneumococcal pneumonia?
bacteremia
What is the distinctive feature of pneumonia from S. aureus?
multiple small lung abscesses
How does pneumonia from GAS present?
begins abruptly with fever, cough, and severe debility
CP is prominent in most patietns
What is the distinctive lcinical feature of GAS pneumonia?
rapid spread in the lung with resultant early empyema formation
What population is prone to Klebsiella pneumonia?
alcoholics
What does the sputum from Klebsiella pneumonia look like?
dark red and mucoid (“currant jelly” sputum)
what are risk factors for moraxella catarrhalis pneumonia?
Diabetes, alcoholism, malignancy, and steroid use
What are the 3 stages of pertussis?
- catarrhal phase (URI, rhinorrhea, low-grade fever, mild congestion x1-2 weeks)
- Paroxysmal phase (last 2-4 weeks; severe nonproductive coughing, posttussive syncope and vomiting; whoop sound)
- convalescent phase (symptoms resolve over 1-3 months)
How does Legionnaires’ Disease present? (type of CAP caused by Legionella pneumophilia)
acutely high fever, nonproductive cough, dyspnea; sometimes pleuritic chest pain
What is atypical pneumonia syndrome?
fever, dry cough, nonspecific infiltrate on chest film
What is the prodrome for mycoplasma pneumonia?
HA, sore throat, malaise
What is the most common cause of acute bronchitis?
viral
What is the cause of SARS?
novel coronavirus
How does SARS present?
fever, myalgias, cough and progresses to worsening respiratory distress
Multilobar infiltrates on chest x-ray
How does someone contract Q fever?
spread through inhalation of infected dust particles
Farm animal contact
What are the typical symptoms of pneumonia?
productive cough, chills, pleurisy
What are the atypical symptoms of pneumonia?
nonproductive cough with a prodrome of HA and sore throat
What problem is associated with birds?
Psittacosis
What is used to treat pertussis?
erythromycin
What is the preferred empiric treatment for CAP in healthy young adults?
macrolide
What is the preferred empiric treatment for acute exacerbation of chronic bronchitis?
2nd generation cephalosporin
What is the preferred empiric treatment for CAP in elderly or comorbid disease?
second generation macrolid plus beta-lactam
What is the preferred empiric treatment for CAP in hospitalized patient?
3rd generation cephalosporing plus second generation macrolide
What are methods of scoring pneumonia severity?
Pneumonia Severity Index (PSI)
PORT study
CURB-65
