Pneumonia Flashcards
What is Pneumonia
Infection that causes inflammation of lung tissue and sputum filling airways and alveoli
How is pneumonia seen on a chest Xray
Consolidation
List the three types of pneumonia and their differences
1- Community acquired pneumonia : develops out of hospital
2- Hospital acquired pneumonia : develops >48hrs after hospital admission
3- Aspiration pneumonia : develops after inhaling foreign material
What is the presentation of pneumonia ( Hint : 7)
1- SOB 2- Cough with sputum 3- Fever 4- Haemoptysis 5- Pleuritic chest pain 6- Delirium 7- sepsis
What signs can indicate sepsis secondary to pneumonia ( Hint : 6)
1- Tachypnoea 2- Tachycardia 3- Hypoxia 4- Hypotension 5- Fever 6- Confusion
List the three chest signs of pneumonia
1- Bronchial breath sounds
2- Focal coarse crackles
3- Dullness to percussion
Describe bronchial breath sounds and their cause
Harsh breath sounds equally loud on inspiration and expiration.
Cause: consolidation of lung tissue around airway
What causes focal coarse crackles
Air passing through sputum
What causes dullness to percussion
Lung tissue collapse or consolidation
What is the CURB-65 scoring system and list what is assessed.
The system used for severity assessment to predict mortality. C: confusion U: ureas> 7 R: respiratory rate >= 30 B: Blood pressure < 90s <=60d 65: Age >= 65
A CURB-65 score of 0-1 means what
consider treatment at home
A CURB-65 score of 2 or more means what
consider hospital admission
A CURB-65 score of 3+ means what
consider intensive care assessment
What are the common causes of pneumonia ( Hint: 2 )
1- Streptococcus pneumonia
2- Haemophilus influenzae
What can cause pneumonia in immunocompromised patients or those with chronic pulmonary disease
Moraxella catarrhalis
What can cause pneumonia in patients with cystic fibrosis or bronchiectasis
Pseudomonas aeruginosa
What can cause pneumonia in patients with cystic fibrosis
Staphylococcus aureus
What is atypical pneumonia
Pneumonia caused by an organism that can’t be cultured or detected using gram stain. Can’t be treated with penicillins.
List possible treatments for atypical pneumonia ( hint: 3 )
1- Macrolides : clarithomycin
2- Fluoroquinolones : levofloxacin
3- Tetracyclines : doxycycline
What is Legionella pneumophila
Disease caused by infected water supply or air conditioning. Causes hyponatraemia.
How would a typical patient present with legionella pneumophila ( legionnaires’ disease )
Recently had a cheap hotel holiday and presents with hyponatraemia
Explain Mycoplasma pneumoniae
Organism that causes milder pneumonia and a rash known as erythema multiforme, and neurological symptoms ( in young patients ).
What is erythema multiforme
Rash that has varying sized target lesions that have pink rings and pale centres
How does clamydophila pneumoniae present
School aged child with mild to moderate chronic pneumonia and wheeze
What is linked with Coxiella burnetii ( Q fever )
exposure to animals and their bodily fluids
What would be a typical patient with Coxiella burnetii present as
A farmer with flu like illness
How is chlamydia psittacosaurus interacted and what would a typical patient present as
Contracted from contact with infected birds.
Typical patient will be a parrot owner.
What are the 5 causes of atypical pneumonia
1- Legionnaires' disease 2- Mycoplasma pneumoniae 3- Chlamydydophila pneumoniae 4- Q fever 5- Chalmydia psittaci
What is pneumocystis jiroveci ( PCP )
Organism that causes fungal pneumonia in immunocompromised patients.
How does PCP present
1- dry cough
2- SOB on exertion
3- Night sweats
How is PCP treated
1- co-trimaxazole ( septrin )
2- prophylactic oral co-trimoxazole if patient has low CD4 count
What minimum investigations are done for pneumonia
1- Chest xray
2- FBC
3- U&E
4- CRP
What investigations are done for moderate or severe pneumonia
1- Sputum cultures
2- Blood cultures
3- Legionella and pneumococcal urinary antigens
What tests are used to monitor progress of patient
WBC and CRP levels
What are the possible complication of pneumonia
1- Sepsis 2- Pleural effusion 3- Empyema 4- Lung abscess 5- Death
What’s the Mild CAP antibiotics for pneumonia
5 day course of oral antibiotics amoxicillin or macrolide
What’s the Moderate to severe CAP antibiotics for pneumonia
7-10 day course of dual antibiotics amoxicillin and macrolide
