Lobar Pneumonia Flashcards

1
Q

Definition

A

• Acute infective disease of lungs, characterized by homologous consolidation of one or more lobes

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2
Q

CAUSES

A
  • Pneumococcus / Diplococcus pneumonia
  • Streptococcus / staphylococcus – less frequently

 Frequent in winter and spring.

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3
Q

RISK FACTORS

A
  • Vial respiratory infections ( influenza virus )
  • COPD, chronic heart failure
  • Immunosuppression
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4
Q

CLINICAL FEATURES

A
Onset
	Begins suddenly with rigor and fever ( 39-40)
Consolidation
	Inflammation progress
	Febrile symptoms and tachypnea continue
Resolution
	Patient improves.
	No dyspnea
	Lung begins to function
	Fever decrease as crisis.
	Collapse occurs during crisis
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5
Q

COMPLAINS

A
Onset
•	Pleuritic pain- worsen by deep breathing / cough
•	Dyspnea
•	Cough
•	Fever
•	Severe weakness
•	Fatigue
•	Headache
Consolidation
•	Cough w/ sharp pain in affected side
•	Sputum – rusty red , mucous-purulent
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6
Q

PHYSICAL EXAMINATION

A
Onset
•	State – severe
•	Cyanotic lips
•	Tachypnea
•	Dusky flushed face
•	Tactile fremitus increased
•	Herpetic lesions on lips, neck , ears.
•	Pleural friction rub
•	Forced position – lie on affected side
Consolidation•	Still severe
•	Diffuse cyanosis
•	Tachypnea ( 35- 40/min)
•	Tactile fremitus increased
•	Diminished repiratory excursion.
•	Pleural friction rub
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7
Q

PERCUSSION

A

Onset
• Decreased resonance
Consolidation
• Dull – affected side

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8
Q

AUSCULTATION

A
Onset
•	Decreased vesicular breath sound
•	Crackles.
•	Pleural rub
Consolidation
•	Bronchial character
•	Pleural rub
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9
Q

CVS

A
Onset
•	Accelerated pulse
Consolidation
•	Pulse rate (120-140)
•	Arryhthmia
•	Low bp
•	Diminished heart sounds
	Other systems;
	Hepatitis
	Nephritis
	Meningitis
	Slight jaundice
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10
Q

BLOOD TEST

A
  • Neutrophil leukocytosis ( to20-30x10^9/l)
  • Increased ESR
  • Positive blood culture
  • Hypoxemia – poor aeration
  • Alkalosis – hyperventilation
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11
Q

SPUTUM ANALYSIS

A
  • Early – rusty red
  • Later – mucous-prulent
  • Blood, pus corpuscle
  • Haematoidin crystals
  • Gram stain – positive
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12
Q

XRAY

A
  • Pulmonary tissue infiltration

* Dense consolidation

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13
Q

TREATMENT

A

• Antibiotic therapy ;
 Anti-pneumococcal antibiotics
 Beta-lactam antibiotics

•	Supportive measures;
	Analgesia and antipyretics
	Chest physiotherapy
	Oxygen supplement
	Respiratory therapy – bronchodilators
	Intravenous fluids
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14
Q

COMPLICATIONS

A
  • Pleurisy
  • Myocarditis
  • Acute respiratory failure
  • Collapse, shock
  • death
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