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respiratory > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

what is the scoring system for community-acquired pneumonia?

A

CURB-65

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2
Q

what does CURB-65 indiciate?

A

severity and risk of mortality

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3
Q

what are the common causes of pneumonia?

A
  • steptococcus pneumonia
  • haemophilus influenzae
  • mycoplasma pneumoniae
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4
Q

what are the typical symptoms for pneumonia?

A
  • fever
  • malaise
  • rigors
  • cough
  • purulent sputum
  • pleuritic chest pain
  • haemoptysis
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5
Q

what are the features of hospital-acquired pneumonia?

A

develops >48 hours after hospital admission

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6
Q

what are the common organisms in hospital-acquired pneumonia?

A
  • pseudomonas aeruginosa
  • staph aureas
  • enterobacteria
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7
Q

what are the features of aspiration pneumonia?

A
  • occurs in patients with an unsafe swallow
  • more commonly affects the right lung (as the right bronchus is wider and more vertical)
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8
Q

what are the risk factors for aspiration pneumonia?

A
  • stroke
  • myasthenia gravis
  • bulbar palsy
  • alcoholism
  • achalasia
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9
Q

what are the featurs of staphylococcal pneumonia?

A

bilateral cavitating bronchopneumonia due to staph aureas (gram +ve cocci found in clusters)

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10
Q

what are the risk factors for staphylococcal pneumonia?

A
  • IV drug users
  • elderly patients
  • patients who already have an influenza infection
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11
Q

what are the features of klebsiella pneumonia?

A
  • primarily affects the upper lobes resulting in a cavitating pneumonia
  • presents with ‘red-current sputum
  • caused by gram -ve anaerobic rod
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12
Q

what are the complications of pneumonia?

A
  • empyema
  • lung abscesses
  • pleural adhesions (more common in klebsiella pneumonia)
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13
Q

what are the risk factors for developing klebsiella pneumonia?

A
  • weakened immune system (e.g. elderly, alcoholics, diabetics)
  • malignancy
  • COPD
  • long-term steroid use
  • renal failure
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14
Q

what are the features of mycoplasma pneumonia?

A
  • presents with flu-like symptoms (flu, arthralgia, myalgia, dry cough, headache)
  • can present with erythema multiforme (multiple erythematous papules with deeply erythematous borders)
  • primarily affects younger patients
  • auto-immune manifestations due to cold agglutinins - causes autoimmune haemolytic anaemia
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15
Q

what complications are associated with mycoplasma pneumonia?

A
  • erythema multiforme
  • stevens-johnson syndrome
  • guillian-barre syndrome
  • meningoencephalitis
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16
Q

what are the features of legionella pneumonia?

A
  • fever, myalgia, malaise
  • followed by dyspnoea and dry cough
  • associated wiht legionnaires disease - patients who have been exposed to poor hotel air conditioning
17
Q

what positive investigation findings are found in legionella pneumonia?

A
  • hyponatraemia
  • derranged LFTs
  • legionella antigen in urine
18
Q

what are the features of chlamydophila psittaci pneumonia?

A
  • acquired from contact with infected birds (e.g. parrots, cattle, horse, sheep)
  • lethary, headache, anorexia, dry cough, fever
  • additional features = hepatitis, splenomegaly, nephritis, infective endocarditis, meningoencephalitis, rash
19
Q

what is chlamydophila psittaci?

A

intracellular bacteria that results in psittacosis (infected disease from bird)

20
Q

what are the features of pneumocystis pneumonia?

A
  • associated with patients who are immunocompromised (malignancy, chemotherapy and HIV +ve)
  • exertional dyspnoea, dry cough, fever
21
Q

what is the causative agent in pneumocystis pneumonia?

A

pneumocystis jiroveci (fungus)

22
Q

what is the best investigation to obtain a definitive diagnosis in legionella pneumonia?

A

urinary antigen enzyme immunoassay test

23
Q

what antibiotic is most appropriate for staphylococcal pneumonia?

A

flucoxacillin

24
Q

what is the normal antibiotic management in pneumonia?

A

oral or IV amoxicillin and clarithromycin

check antibiotic person

25
Q

what are the typical features of steptococcus pneumonia?

A
  • rusty-coloured sputum
  • rapid onset symptoms
  • high fever
26
Q

what additional investigations do you do in mycoplasma pneumonia?

A

PCR

27
Q

what additional investigations do you do in legionella and pneumococcal pneumonia?

A

urine antigen

28
Q

what is the most important investigation to perform on follow-up?

A

chest x-ray at 6 weeks to ensure there has been no complications and it has resolved

respiratory (10 decks)

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