Pneumonia Flashcards
What is pneumonia?
Acute lower respiratory tract infection which causes inflammation of the lung tissue and sputum filling the airways and alveoli
Classification (1)
1) What are the 4 major categories of pneumonia?
2) What is the commonest cause of community acquired pneumonia?
3) Name another cause
4) How is hospital acquired pneumonia classified?
5) What is the commonest cause of hospital acquired pneumonia (2)?
6) Name another cause
1) Community acquired, hospital acquired, aspiration pneumonia and pneumonia in immunocompromised patients
2) Streptococcus pneumoniae
3) Haemophilus influenzae, moraxella catarrhalis. Atypical mycoplasma pneumoniae, legionella species, chlamydia
4) Pneumonia >48hrs after hospital admission
5) Gram negative enterobacteria or staph aureus
6) Pseudomonas, klebsiella, clostridia
Classification (2)
1) What is aspiration pneumonia
2) What is the commonest organism cause of aspiration pneumonia?
3) Name a risk for developing aspiration pneumonia
4) Name 2 causes of pneumonia in immunocompromised patients
1) Pneumonia caused by inhaling a foreign object
2) Streptococcus pneumoniae
3) Stroke, myasthenia gravis, bulbar palsies, decreased consciousness, oesophageal disease
4) Strep. pneumoniae, H. influenzae, Staph aureus, moraxella catarrhalis, mycoplasma pneumoniae. Fungi i.e. pneumocystis jirovecii. Viruses (CMV + HSV) and fungi.
Specific pneumonias (1)
1) Name a group of patients that pneumococcal pneumonia is commoner in
2) How is pneumococcal pneumonia treated (3)?
3) Specifically what pneumonia does staphylococcal pneumonia cause?
4) How is it treated (2)?
1) Elderly, immunocompromised, alcoholics, post-splenectomy
2) Amoxicillin, benzylpenicillin, cephalosporin
3) Bilateral cavitating bronchopneumonia
4) Flucloxacillin +/- rifampicin
Specific pneumonias (2)
1) Which group of patients does klebsiella pneumonia more commonly occur in?
2) Specifically what pneumonia does it cause?
3) How is it treated (2)?
4) Pseudomonas pneumonia is a common pathogen in what 2 conditions, and in what scenario?
1) Diabetics, elderly, alcoholics
2) Cavitating pneumonia specifically in the upper lobes
3) Cefotaxime or imipenem
4) CF and bronchiectasis. Hospital acquired pneumonia after surgery/on ITU
Atypical pneumonia
1) What is atypical pneumonia?
2) Which major group of antibiotics are not useful in the treatment of atypical pneumonia?
3) What can atypical pneumonia be treated with (3)?
4) How do outbreaks of legionella pneumophila (Legionnaires’ disease) occur?
1) Pneumonia caused by an organism that cannot be cultured in the normal way or detected using a gram stain
2) Penicillins
3) Macrolides, fluoroquinolones, tetracyclines
4) When the bacteria colonises water tanks/air conditioning units
Atypical pneumonia (2)
1) What is the hallmark of an infection with mycoplasma pneumonia?
2) Infection with coxiella burnetii (Q fever) is linked to what?
3) Chlamydia psittaci is typically contracted when exposed to what?
1) Rash called erythema multiforme
2) Exposure to infected animals or their bodily fluid
3) Birds
Viral pneumonia
1)What is the commonest cause of viral pneumonia?
2) Name another cause of viral pneumonia
1) Influenza
2) Swine flu, CMV, varicella zoster, measles
Fungal pneumonia (Pneumocystis pneumonia)
1) Which group of patients is this most common in?
2) How does it present?
3) How is it treated?
1) Immunocompromised - low CD4
2) Dry cough, shortness of breath on exertion and night sweats
3) Co-trimoxazole
Name 2 symptoms of pneumonia
- Shortness of breath
- Cough productive of sputum
- Fever
- Haemoptysis
- Pleuritic chest pain – sharp chest pain worse on inspiration
- Malaise
- Rigors
Name 2 signs of pneumonia
- Delirium (acute confusion with infection)
- Tachypnoea
- Tachycardia
- Signs of sepsis
- Hypotension if shock
1) What is the CURB-65 score?
2) What do each of the letters represent?
1) A severity scoring system to guide patient treatment
2) Confusion, Urea > 7, Respiratory rate ≥ 30, Blood pressure < 90 systolic or ≤ 60 diastolic, Age ≥ 65
1) How is mild community acquired pneumonia managed?
2) How is moderate to severe community acquired pneumonia managed?
1) Amoxicillin or macrolide - 5 day course
2) Amoxicillin and macrolide - 7-10 day course
Name 2 complications of pneumonia
- Sepsis
- Pleural effusion
- Empyema
- Lung abscess
- Death
Complications (1)
1) What type of respiratory failure can occur as a complication of pneumonia?
2) How can pneumonia cause hypotension?
3) How can pneumonia cause pleural effusion?
4) What is an empyema?
5) In which patient should empyema be suspected in?
1) Type I resp failure
2) Combination of dehydration and vasodilation from sepsis
3) Inflammation of the pleura by adjacent pneumonia may cause fluid to exudate into the pleural space. If this accumulates faster than the fluid is reabsorbed, pleural effusion occurs
4) Pus in the pleural space
5) Patient with a resolving pneumonia that develop a fever
