Pneumonia Flashcards
What is pneumonia?
Inflammatory condition affecting the alveoli of the lungs
In the majority of cases it is secondary to a bacterial infection.
What is pneumonia usually due to?
Secondary to a bacterial infection
What is the most common cause of bacterial acquired pneumonia?
Streptococcus pneumonia
What are the other possible causes of community acquired pneumonia?
- Haemophilus influenzae
- Staphylococcus aureus
- Klebsiella pneumoniae
When are people normally affected by staphylococcus aureus pneumonia?
After a an influenza virus
Who is commonly affected by klebsiella pneumonia?
Alcoholics
What are the main presentations of pneumonia?
- cough
- sputum
- dyspnoea
- chest pain: may be pleuritic
- fever
How might the chest pain be described with pneumonia?
Pleuritic chest pain
What are possible signs of pneumonai?
Fever
Tachycardia and tachypnoea
Hypotesnion
Reduced oxygen saturations
Bronchial breathing and reduced breath sounds
What might you hear on auscultation of someone with pneumonia?
Bronchial breathing and reduced breath sounds
What are the characteristic features of pneumococcal pneumonia?
- rapid onset
- high fever
- pleuritic chest pain
- herpes labialis (cold sores)
What is the initial investigation for pneumonia?
Chest x-ray
What would you see on a chest x-ray of someone with pneumonia?
Consolidation
What investigations might you do on an intermediate-high risk patient?
Blood and sputum cultures
Pneumococcal and legionella urinary antigen tests
Why might you check the CRP in someone with pneumonia?
To help determine response to treatment
What is used for the assessment of someone with pneumonia?
CURB-65 score
What does CURB-65 score?
- C-Confusion (abbreviated mental test score <= 8/10)
*U-Urea > 7mmol/l - R- Respiration rate >= 30/min
- B- Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
- 65- Aged >= 65 years
When does hospital acquired pneumonia occur?
48 hours after admission to hospital
What is the main cause of hospital acquired pneumonia?
Pseudomonas aeruginosa
What are the other causes of hospital acquired pneumonia?
- Staphylococcal aureus
* Enterobacteria.
What is the causative agent of pneumonia that results in hyponatraemia?
Legionella pneumonia
What is first line management for community acquired pneumonia and CURB score 0?
Amoxicillin
What is an alternative to amoxicillin?
Macrolide and tetracycline
How long are antibiotics given for low severity community acquired pneumonia?
5 days
What is the management of moderate to high severity community acquired pneumonia?
Dual antibiotic therapy- Amoxicillin and a macrolide
How long is medication given for moderate to high severity community acquired pneumonia?
7-10 days
What additional management can be given for pneumonia?
- Oxygen-keep O2 saturations above 94%
- Fluid management
- Analgesia- pleuritic chest pain
What is the management of pleuritic chest pain?
Paracetamol 1g/6 hours (Max. 4g 24hours)
When needs to be done in 6 weeks after clinical resolution and why?
Repeat chest x-ray
Ensures that the consolidation has resolved and there is no underlying secondary abnormalities
What would 3-5 on a CURB65 score indicate?
Hospital admission alongside consideration for ITU referral.
How can consolidation appear on a chest x-ray?
As shadowing
What signs can present in someone with pneumonia?
Signs of systemic infection
What signs of systemic infection can present in someone with pneumonia?
High temperature
Tachycardia
Hypotension
Confusion
Tachypnoea
What can be heard on auscultation of someone with pneumonia?
Reduced breath sounds
bronchial breathing
Crepitations and crackles
What is pneumonia?
Inflammation and infection of teh lung tissue
Sputum fills the airways and alveoli
When is pneumonia classified as aspiration pneumonia?
Pneumonia whoch results from aspiration of forgein material or food
