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RESP > LRTI > Flashcards

LRTI Flashcards

1
Q

What are the different types of pneumonia?

A
  • CAP
  • HAP
  • VAP
  • Aspiration
  • Immunocompromised
  • Viral
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2
Q

What are risk factors for pneumonia?

A
  • Age
  • COPD
  • Smoking
  • Alcoholism
  • Season
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3
Q

How is pneumonia diagnosed?

A
  • Clinical history + physical examination
  • Blood for culture, gram stain, PCR
  • Nose/throat swab for viral
  • WCC
  • Radiology: CXR
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4
Q

What are risk factors of HAP?

A
  • General anasthesia
  • Surgery
  • Immunosuppression
  • Decreased conciousness
  • VAP
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5
Q

What bacteria cause HAP/VAP?

A

GNB:
- E.coli
- Klebsiella
- Enterobacter
- Pseudomonas

Staph. aureus (MRSA)
Legionella pneumophilia

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6
Q

What viruses cause HAP/VAP?

A
  • SARS-CoV-2
  • Influenza
  • RSV
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7
Q

What bacteria cause CAP?

A
  • Strep pneumoniae (60%)
  • Mycoplasma pneumoniae (10-20%)
  • H. influenzae
  • Legionella pneumophilia
  • S. aureus
  • GNB
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8
Q

What does S. pneumoniae cause?

A
  • CAP
  • Sinusitis + otitis media
  • Meningitis + BSI
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9
Q

What diagnostic test is done for S.pneumoniae?

A
  • Sputum culture
  • Blood culture
  • Urinary antigen
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10
Q

What is seen on a culture for S. pneumoniae?

A
  • Gram positive diplococci
  • alpha-haemolytic
  • Catalase negative
  • Susceptible to optochin
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11
Q

What is the treatment for CAP?

S. pneumoniae

A
  • Benzylpenicillin IV → Amoxicillin oral
  • Ceftriaxone IV if penicillin-resistant
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12
Q

What is the diagnosis and treatment for H. influenzae?

A
  • GNB
  • Fastidious
  • Require factor X and V
  • chocolate agar

Treatment: co-amoxiclav

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13
Q

What are the organisms that cause atypical pneumoniae?

A
  • Mycoplasma
  • Legionella
  • Chlamydia
  • Coxiella

look at slides for detail on each

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14
Q

What antibiotic is given for atypical pneumoniae?

A
  • Not susceptible to B-lactams
  • Macrolides, tetracyclines, fluoroquinolones
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15
Q

What antibiotic is given for mycoplasma pneumoniae?

A
  • Clarithromycin
  • Doxycycline
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16
Q

What antibiotic is given for legionella?

A
  • Clarithromycin (macrolide)
  • Levofloxacin (fluoroquinolone)
17
Q

What antibiotic is given for chlamydia?

A
  • Clarithromycin
  • Doxycycline
18
Q

What is a common feature of Staph aureus and Klebsiella pneumoniae?

A
  • Abscess formation
  • both associated with severe CAP
19
Q

What are viral causes of CAP?

A
  • SARS-CoV-2
  • Influenza A&B
  • RSB
  • Varicella, measles, CMV as part of systemic infection
20
Q

What is CURB-65?

A
  • Assesment score used asses CAP
  • C: Confusion
  • U: Urea >7mmol/L
  • R: Respiratory rate >30/min
  • B: BP, Systolic <90 and diastolic <60
  • 65: Age > 65 years
21
Q

What treatment is given for CAP according to CURB-65?

A
  • 0-1, Mild: oral amoxicillin/clarithromycin/doxycycline
  • 2, Moderate: IV axomicillin + oral clarithromycin
  • 3-5, Severe: IV co-amoxiclav + oral clarithromycin
22
Q

What antibiotic is given for VAP?

A
  • piperacillin-tazobactam IV
  • covers gram positive and negative, and pseudomonas
23
Q

What causes aspiration pneumonia?

A
  • Loss of gag reflex
  • Organisms: Strep, S. aureus, E.coli and other GNB
24
Q

What are oppurtinistic pathogens in immunocompromised pneumonia?

A
  • Fungi: P. jiroveci, aspergillus
  • Viruses: HSV, CMV
  • Mycobacteria: NTM
25
Q

What is lung abscess?

A
  • Destruction of lung parenchyma to produce cavitation
26
Q

What bacteria cause lung abscess?

A
  • Polymicrobial: peptostreptococcus
  • Monomicrobial: S. aureus, K. pneumoniae, Strep pyogenes
27
Q

What is bronchiectasis?

A
  • chronic bronchial dilation
28
Q

What organisms cause bronchiectasis?

A
  • H. influenzae
  • S. pneumoniae
  • S. aureus
  • P. aeruginosa
29
Q

Why do Cystic Fibrosis patients get infection?

A
  • Defects on microbial clearance (excess mucous production)
  • Altered salt content in airway surface liquid: kills neutrophils
  • P.aeruginosa receptors
  • Decreased NO
  • Hyper inflammatory airway
30
Q

What do we do urinary antigen tests for?

A
  • Legionella
  • Pneumococcal antigens
31
Q

What antibiotics are used to treat coxiella burnetti?

A
  • Doxycycline (+ rifampicin if chronic)
32
Q

What specimen do we take for VAP?

A
  • Broncho-alveolar lavage (BAL)

if no sputum, done during bronchoscopy

33
Q

What antibiotics are given for pseudomonas aeruginosa?

A
  • Piperacillin-tazobactam

RESP (20 decks)

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