Pneumonia Flashcards
What is pneumonia?
An infection in the lungs leading to fluid and blood cells leaking into the alveoli.
Causes inflammation and sputum.
What is the pathophysiology of pneumonia?
Blood cells and fluid leak into the alveoli
This consolidates and causes reduced ventilation and gas exchange.
What is an infection of pneumonia outside of the hospital called?
Community acquired pneumonia (CAP).
what is an infection of pneumonia called if it develops more than 48hrs after hospital admission?
Hospital acquired pneumonia (HAP).
What is pneumonia called if it happens after inhaling food or fluid?
Aspiration pneumonia.
What is the presentation of pneumonia?
SOB Cough (productive) Sputum - brown or green fever haemoptysis Pleuritic chest pain (worse on inspiration) delirium sepsis
What is the presentation in the IMMUNOCOMPROMISED?
SOB on exertion
Cough - WITHOUT sputum
hight sweats
What are the chest signs seen on an X-ray?
Consolidation of lung fields.
What chest signs are heard?
Bronchial breathing Dull percussion (consolidation) Coarse crackles (fluid)
What are the signs which might indicate sepsis?
Tachycardia Tachypnoea Hypotension (shock) fever (or cold) Hypoxia Confusion
What is the assessment done to indicate severity and mortality?
CURB 65 C-onfusion U-rea >7 R-espiratory rate >30 B-lood pressure, systolic <90, diastolic <60 65 = over 65 yrs.
1 point for each.
What do the different curb scores mean for where the person is treated?
0/1 = treated at home.
2 or more = hospital treatment
3 or more = ICU or HDU
What do the different curb scores mean for mortality?
1 = <5% 3 = 15% 4/5 = >25%
What are the main organisms causing pneumonia?
Streptococcus pneumonia 50%
Haemophilus influenza 20%
What organisms are CF patients likely to develop pneumonia from?
Staph aureus
Pseudomonas argenosa
What prophylaxis is offered to CF patients?
Flucloxacillin.
What is fungal pneumonia called?
Pneumocystis jiroveci
Who develops pneumocystis jiroveci?
Immunocompromised patients.
What hospital investigations are there for pneumonia?
Chest x ray
FBC
U and E
CRP
Severe:
Sputum cultures
blood cultures
legionella and pneumococcal urinary antigens
Why is WBCs and CRP good for pneumonia?
They are raised in relation to how bad the infection is - can measure after giving antibiotics, if they have decreased, antibiotics is working.
Who is given IV antibiotics?
Moderate/severe pneumonia
sepsis
What is the treatment for mild community acquired pneumonia?
5 days of amoxicillin OR macrolide
what is the treatment for moderate to severe community acquired pneumonia?
7-10 days DUAL antibiotics - amoxicillin + macrolide.
What are the main complications of pneumonia?
sepsis pleural effusion empyema lung abscess death
