Other Pneumonias Flashcards
what criteria must be met to diagnose a patient with HAP?
> 48 hrs in hospital in past 90 days
what criteria must be met to diagnose a patient with VAP?
endotracheal intubation > 48 hours
what is the most common HAP organism?
staph aureus
what are 3 common VAP organism? (SAP)
Steno malto
Acine species
Pseudomonas a.
what clinical findings are present to diagnose HAP and VAP?
opacities on xray
fever
leukocytosis
purulent sputum
what would be seen in a blood gas for HAP or VAP
hypoxemia
hypercapnia
what 3 diagnostics should be ordered for HAP and VAP?
blood culture
sputum culture
chest xray or CT
what 2 labs should be ordered for HAP and VAP?
CBC
chemistry
what is the treatment for HAP and VAP?
IV vancomycin + piperacillin OR cefepime
aspiration of gastric contents or oral/dental bacteria leads to what?
anaerobic pneumonia
lung abscesses
where in the lungs does aspiration lead to pneumonia?
gravity dependent areas
a patient presents with fever, weight loss, malaise, poor dentition, cough with foul-smelling purulent sputum. what are they experiencing?
anaerobic pneumonia
lung abscess
what would a lung abscess look like on chest Xray or CT?
thick-walled cavity surrounded by consolidation
what would a necrotizing pneumonia look like on chest xray or CT?
multiple areas of cavitation inside consolidation
what are 3 first line treatments for anaerobic pneumonia and lung abscesses?
augmentin
amoxicillin + metronidazole
clindamycin
where is viral pneumonia located?
inside the alveoli
a patient presents with fever, myalgias, fatigue, URI symptoms, increased RR, diffuse rales and wheezes, non-productive cough +/- pink frothy sputum, +/- tender trachea, and cervical lymphadenopathy. what are they experiencing?
viral pneumonia
what will viral pneumonia look like on chest xray if it doesn’t look normal? (3)
diffuse consolidation
bronchial wall thickening
small pleural effusions
what will viral pneumonia look like on a chest CT?
ground-glass opacity
what is the general treatment for viral pneumonia? (3)
antivirals
NSAIDs
cough suppressants
what are 2 NSAIDs that can be used for vial pneumonia?
ibuprofen
naproxen
what are 2 cough suppressants that can be used for viral pneumonia?
dextromethorphan
benzonatate
what is the most common organism in fungal pneumonia?
pneumocystis jirovecii
a patient presents with abrupt onset of fever, tachypnea, SOB, dry cough, and +/- bibasilar crackles. what are they experiencing?
pneumocystis jirovecii
what would pneumocystis jirovecii look like in a chest xray? (bat wings)
perihilar interstitial infiltrations - ground glass type
what would blood gas of pneumocystis jirovecii look like?
hypoxemia
hypercapnia
what is the first line treatment for pneumocystis jirovecii?
trime-sulfa
what class of medication can be used in pneumocystis jirovecii if PaO2 is less than 70, A-a gradient is more than 35, or resting room OSat is less than 92?
corticosteroids
small oval bodies that reach the terminal bronchioles and alveoli?
mycelia
what kind of infection occurs when mycelia transform into yeasts that are found inside macrophages?
histoplasmosis (fungal pneumonia)
what are some risk factors for histoplasmosis? (4)
excavation
going into caves
remodeling old buildings
cutting dead trees
a patient presents with flu-like symptoms + cough, dyspnea, and chest pain. what are they likely experiencing?
histoplasmosis
when do symptoms of histoplasmosis typically occur?
1-4 weeks after exposure
what would histoplasmosis look like on a chest xray?
hilar/mediastinal adenopathy
pulmonary infiltrates
what 2 labs should we run for histoplasmosis?
antigen test of bronchial fluid or serum
cytology of bronchial fluid
what kind of patients may have chronic cavitary histoplasmosis?
smokers who have COPD
what is the treatment for histoplasmosis?
amphotericin B + itraconazole
