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Pneumonia * Flashcards

1
Q

What is pneumonia

A

Fluid exudate in alveoli = Inflammation of the lungs caused by infection

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2
Q

What are the most common causes of CAP pneumonia

A

Strep pneumonia
H.Influenzae
Mycoplasma Pneumonia (Atypical)

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3
Q

What is the pathology of Pneumonia

A 
Typical = bacteria invades and exudate forms inside alveoli LUMEN causing SPUTUM
Atypical = Bacteria invades and exudate forms inside Alveoli INTERSTITIUM causing DRY COUGH
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4
Q

What causes Community acquired pneumonia

A

Strep Pneumonia
H Influenzae
Mycoplasma Pneumoniae

H.influenzae

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5
Q

What are the presentations of Pneumonia

A

Typical =Productive cough w/ rust sputum
Atypical = Dry cough w/ low fever

Pleuritic chest pain; worse w/ breathing
Tachypnoea and Tachycardia and Hypotension
Pyrexia
No URTI Sx

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6
Q

What are the auscultation signs of pneumonia

A 
Bronchial breathing
Dull percussion
Pleural rub
Coarse crackles 
Wheeze
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7
Q

What are the causes of Hospital Acquired Pneumonia (Gram Negative Bacilli)

A

Pseudomonas Aureginosa
E coli
Kiebsella
Staph Aureus

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8
Q

What are the causes of Atypical Pneumonia

A

Legionella Pneumoniae
Mycoplasma Pneumoniae
C. psitacci
Chlamydia Pneumoniae

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9
Q

What is HAP

A

Hospital acquired

  • > 48 hrs after admission
  • Lower respiratory tract infection
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10
Q

What is Staph Aureus Pneumonia

A

Common with IV drug users, elderly and IC patients
Use macrolide as B Lactam resistant

Presents with Bilateral Bronchopneumonia

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11
Q

What organism causes upper resp tract infection with red currant sputum

A

Klebsiella (Gram negative rod)

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12
Q

What are the features of Mycoplasma pneumonia

A

Flu, myalgia, dry cough and headache
Caused by cold? autoimmune haemolytic anaemia
Can lead to GBS

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13
Q

What is the typical pneumonia caused by poor hotel air conditioning

A

Legionella pneumonia
presents with flue and dyspnoea with dry cough
-check for hyponatraemia and abnormal LFT
-Tx = Clarythromycin

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14
Q

What are the investigations for Pneumonia

A

CURB-65
1st-CXR = Consolidation, effusion, abscess and empyema
Sputum and Culture

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15
Q

What is the Mortality scoring for Pneumonia

A 
CURB 65
C - Confusion
U - Urea >7mmol/L
R - Resp rate >30
B - BP <90/60
65 - Patient over 65
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16
Q

With what CURB65 score should they be discharged and treated with amoxicillin/macrolide

A

0-1

macrolide if penicillin allergies

17
Q

With what score should the patient be admitted and treated with both Amoxicillin and macrolide

A

2

18
Q

When should a patient be considered for ITU and treatment with IV Co-amoxiclav and macrolide

A

3-5

19
Q

What is the general management of Pneumonia

A

Oxygen 94-98 (88-92 if w/COPD)
Antibiotics (Amoxicillin, macrolide and Co-Amoxiclav)
Anagesia for chest pain
Fluids

20
Q

How can Pneumonia be prevented

A

Pneumococcal vaccine against strep pneumonia

21
Q

Why are HAP causatives more severe than CAP

A

Mostly Drug resistant

22
Q

How can Pneumonia be contracted

A

Inhaled pathogens and Aspiration

23
Q

What are the RF for Pneumonia

A

Immunocompromised
IVDU
Hx of resp disease
Age extremities

24
Q

What is the difference between typical and atypical pneumonia pathology

A 
Typical = exudate in lumen w/ sputum
Atypical = exudate in interstitium w/ dry cough
25
Q

What causatives of pneumonia show multilobar lesions CXR

A

S Pneumonia
S Aureus
Legionella

26
Q

What causatives of Pneumonia show Multiple abscesses on CXR

A

S Aurues

27
Q

What Causatives of Pneumonia show Upper lobe lesions on CXR

A

Klebsiella
EXCLUDE TB

-Rule out TB w/ Ziehl Neelson first

28
Q

Which Pneumonia is AIDS defining

A

Polycystitic Pneumonia from P Jurovecci

29
Q

In CAP, when should amoxicillin be used

A

CURB 0-2

30
Q

In CAP, when should Co-amoxicalv and Clarithromycin be used

A

CURB 3-5

31
Q

What CAP exception requires Clarithromycin as first line regardless of CURB Score

A

Legionella
-PHE Notifiable disease

32
Q

What is the main presentation difference between typical and atypical pneumonia

A

Typical = Prurlent cough
Atypical = Dry cough w/ low fever

33
Q

In what patients is aspiration pneumonia seen in

A

Stroke
Bulbar palsy
Myaesthenia gravis
-Mycoplasma pneumoniae
-Gastric contents aspirated into the lung = destruction

34
Q

What is the diagnostic sign see in CXR for pneumonia

A

Consolidation
Air bronchogram
-Fluid filled bronchi surrounding Alveoli

35
Q

When is CAP typicaly contracted

A

in the community or <48hrs in hospital

Resp (14 decks)

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