Infections Flashcards
Risk factors for CAP
low BMI Smoking Chronic Disease Resp. Disease - COPD/Asthma Aspiration (epilepsy, smoke, neurological disease, alcohol abuse)
Which treatments increase risk of CAP?
Steroids (ICS, Oral)
Proton pump inhibitors
Which treatments decrease risk of CAP?
Flu vaccine
Pneumococcal vaccine
Statins
ACE Inhibitors
Most common causative organism in CAP
strep. pneumonia
Common causative organism of CAP in younger patients
Mycoplasma
Legionella is a common cause of CAP in…
patients who have been on holiday to a dodgy hotel/area (air conditioning systems)
24% of CAP is caused by?
viruses
Symptoms of CAP
breathless, cough, wheeze, chest pain, fever, pleuritic pain, sometimes haemoptysis
Non-specific symptoms of CAP
malaise, myalgia, rigors, sweats, arythalgia, anorexia, headache
Where is confusion common in CAP?
Sepsis or older patients
In CAP, percussion would be resonant - TRUE OR FALSE
FALSE - percussion would be dull
Investigations that may be carried out in CAP?
CXR Blood culture FBC --> increased neutrophils and WCC U&E Throat swab LFTs Sputum Atypical serology
The CURB 65 score is an indicator of…
mortality on admission
C of CURB 65
Confusion (new onset)
U of CURB65
Urea > 7mmol/l
R of CURB 65
resp rate >30
B of CURB65
BP systolic <90mmHg or diastolic <60mmHg
65 of CURB65
> =65 years of age
Antibiotic which puts patient at risk of C.difficile
Ciprofloxin
In common and atypical pneumonia the first treatments are…
amoxicillin 250mg daily 5 days
doxcycline 200mg day 1, 100mg TD2-5
In severe CAP treatment is…
IV co-amoxiclav and clarithromycin
In penicillin allergic patients with severe CAP, you treat with…
IV levofloxin
What may clarithromycin be replaced with in severe CAP?
oral doxycycline
What might be suspect if patient does not start to get better with CAP treatment?
resistance, pleural effusion (empyema), Abscess or cavitation, metastatic infection, ARDS, death
Common causative organisms in empyema?
strep. milleri, strep in general, klebsiella
Common causative organisms of lung abscesses?
staph, klebsiella, anaerobes
treatment for lung abscesses?
flucloxacillin, augmentin, metronidazole
Common patient presentation of atypical chlamydia pneumonia
40 yr old pigeon fancier
common patient presentation of atypical klebsiella pneumonia
alcoholic or TB
common patient presentation of atypical staph aureus pneumonia
IV drug user
common patient presentation of atypical H.influenzae pneumonia
COPD
If you suspect someone might have TB, do you treat straight away?
Yes, detain and treat until you have an answer, if its not TB no harm done
