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Finals - CardioResp > Lower respiratory tract infections incl pneumonias > Flashcards

Lower respiratory tract infections incl pneumonias Flashcards

1
Q

What is Pneumonia?

A

Infection causing inflammation of the lung tissue and sputum filling the airways and alveoli

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2
Q

How does Pneumonia appear on a chest x-ray?

A

Consolidation.

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3
Q

How is pneumonia classified?

A
  1. Community acquired
  2. Hospital acquired (> 48h after hospital admission)
  3. Aspiration pneumonia
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4
Q

How does pneumonia present?

A
  • Shortness of breath
  • Fever
  • Productive cough
  • Haemoptysis
  • Pleuritic chest pain
  • Delirium
  • Sepsis
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5
Q

What is pleuritic chest pain?

A

Sharp chest pain worse on inspiration

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6
Q

List 3 characteristic signs of pneumonia?

A
  1. Bronchial breath sounds
  2. Focal coarse crackles
  3. Dullness to percussion
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7
Q

What scoring system assesses severity of pneumonia?

Explain

A

CURB-65

  • Confusion
  • Urea > 7
  • RR ≥ 30
  • BP < 90 systolic or ≤ 60 diastolic.
  • Age ≥ 65
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8
Q

Interpret the various scores of CRUB-65

A
  • 0/1: Consider treatment at home
  • ≥ 2: Consider hospital admission
  • ≥ 3: Consider intensive care assessment
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9
Q

List the 4 most common bacteria causing CAP

A
  1. Streptococcus pneumoniae
  2. Haemophilus Influenzae
  3. Klebsiella pneumoniae
  4. Moraxella cattarhalis
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10
Q

List the 4 most common bacteria causing HAP

A
  1. Staphylococcus Aureus
  2. Pseudomonas
  3. MRSA
  4. Gram negative enteric bacteria
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11
Q

List 3 risk factors for Psuedomonas.

A
  1. Bronchiectasis
  2. COPD exacerbations leading to frequent steroid or Abx use
  3. HCAP
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12
Q

List 4 risk factors for CAP

A
  1. Altered Mental Status
  2. Smoking
  3. Alcohol
  4. Malnutrition
  5. Immunosuppression
  6. Underlying lung disease
  7. Age ≥65 years
  8. Specific exposure
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13
Q

What is Atypical pneumonia?

A

Caused by an organism that cannot be cultured normally or detected with gram stain

Does NOT respond to penicillins

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14
Q

List the 5 atypical pneumonia

(“Legions of psittaci MCQs”)

A
  1. Legionella pneumophila (Legionnaires’ disease)
  2. Chlamydia psittaci
  3. Mycoplasma pneumoniae
  4. Chlamydophila pneumoniae
  5. Coxiella burnetii (Q fever”)
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15
Q

How is Legionella pneumophila typically contracted?

A

Infected water supplies or air conditioning units

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16
Q

What does Legionella typically cause?

A

SIADH causing hyponatremia

(typical exam patient has recently had a cheap hotel holiday and presents with hyponatraemia)

17
Q

How is Legionella and pneumococcal diagnosed?

A

Urinary antigens

18
Q

How is Legionnaires disease treated?

A

macrolides/quinolones +/- rifampicin

19
Q

How is Chlamydia pneumoniae and Chlamydia psittaci diagnosed?

A

Serology

20
Q

How is Chlamydia psittaci contracted?

A

Contact with infected birds (bird poop)

21
Q

Example of a Fungal Pneumonia?

In which group of patients does this most commonly affect?

A

Pneumocystis jiroveci (PCP)

Occurs in patients that are immunocompromised (ie. HIV )

22
Q

How does Pneumocystis jiroveci present?

A
  1. Dry cough without sputum
  2. Shortness of breath on exertion
  3. Night sweats
23
Q

How is PCP treated?

A

Co-trimoxazole (trimethoprim/sulfamethoxazole)

24
Q

List 4 investigations for pneumonia

A
  • Chest xray
  • FBC
  • U&Es
  • CRP
  • Sputum cultures
  • Blood cultures
25
Q

Compare the treatment course of mild, moderate and severe CAP

A

Mild: 5 day course of oral antibiotics (amoxicillin or macrolide)

Moderate- severe: 7-10 day course of dual antibiotics (amoxicillin and macrolide)

26
Q

List 4 complications of pneumonia

A
  • Sepsis
  • Pleural effusion
  • Empyema
  • Lung abscess
  • Death
27
Q

What does the pneumococcal vaccine protect against?

A

Streptococcus pneumoniae

28
Q

To whom is the pneumococcal vaccine offered?

A
  1. 3 injections at 2, 4 and 12-13 months
  2. ≥ 65 years
  3. At-risk groups ie. chronic heart, liver or renal conditions.
29
Q

In which 2 groups of people is Klebsiella most common?

A

Diabetics and alcoholics

Finals - CardioResp (18 decks)

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