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Medicine > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Define Pneumonia

A

A pneumonia is defined as an acute lower respiratory tract infection with recent radiological lung shadowing that may be segmental, lobar, multilobar

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2
Q

List 4 types of pneumonia

A

Community Acquired
Hospital Acquired
Aspiration Pneumonia
Ventilator Associated Pneumonia

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3
Q

What is community-acquired pneumonia?

A

This is defined as a pneumonia that was contracted outside of the health-care system

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4
Q

What are three common bacterial causative agents of a community-acquired pneumonia?

A
  • Streptococcus Pneumoniae
  • Haemophillus Influenzae
  • Mycoplasma Pneumoniae
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5
Q

What is the most common causative organism of CAP in young patients

A

Mycoplasma Pneumoniae

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6
Q

What is the most common causative organism of CAP in the elderly?

A

Haemophillus Influenzae (gram negative)

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7
Q

What is the most common causative organism of CAP ?

A

Streptococcus Pneumoniae (Gram positive diplococci)

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8
Q

Viruses can also cause CAP, list 3

A
  • Influenza
  • Cytomegalovirus
  • Coronavirus
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9
Q

How is CAP spread?

A

Droplet infection

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10
Q

List 6 factors that can predispose a pt to CAP

A
  • pre-existing lung disease
  • Old age
  • URTI
  • recent Influenza infection
  • HIV
  • Cigarette smoking
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11
Q

What is pulmonary consolidation

A

This a radiological sign seen when a region of lung tissue is filled with substances (such as pus, blood, water, stomach contents or cells) instead of air.

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12
Q

List some systemic features of CAP

A

rigors, chills, malaise, fever, LOA

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13
Q

List some symptoms of CAP

A
  • initial dry-painful nonproductive cough
  • late muco-productive cough
  • pleuritic chest pain
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14
Q

Rust-coloured productive cough is usually associated with which causative organism of CAP?

A

Haemophillus Influenzae

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15
Q

What are the clinical signs of CAP on Respiratory Examination?

A

Consolidation»
1) Dull percussion note
2) Inc tactile/vocal fremitus
3) Bronchial breath sounds (Expi>Inspi, loud pitch)

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16
Q

List 3 differentials for Pneumonia

A

Pulmonary Infarction
Pulmonary Oedema
Pulmonary Tuberculosis

17
Q

List investigations that should be done to diagnose pneumonia

A

CBC (WBC >20, neutrophil leukocytosis)

CXR (lobar pneumonia, bronchopneumonia)

Sputum Cx

18
Q

What Chest X-ray findings may be seen in a CAP

A

Patchy opacification evolves into homogeneous consolidation of
affected lobe
OR
Typically patchy and segmental shadowing

19
Q

Which investigations are used to determine the severity of the pneumonia?

A

CBC: WBC <4 x 10^9 /L
U&E: Urea >7mmol/L
hyponatremia
LFT: hypoalbuminaemia
Blood Cx: Bacteraemia
ABG: SaO2 <92%

20
Q

Which score is used to determine the need for ICU treatment in patients with CAP

A

Curb- 65
C-onfusion
U-rea >7mmol/L
R-espiratory Rate >30bpm
B- Blood Pressure (sys <90 or dias <60)
Age >65y/o

Each feature + 1pnt
4-5 pnts & not responding to therapy severe

21
Q

What are the three pillars of management of pneumonia?

A

Oxygen Therapy
Fluid Resuscitation
Antibiotic Therapy

22
Q

List 4 complications of pneumonia

A

para-pneumonic effusion
suppurative pneumonia/lung abscess
pneumothorax
empyema

23
Q

Define Hospital Acquired Pneumonia

A

This is a new onset acute respiratory infection that presents within 90 days of a hospital admission >2days.

24
Q

What are the 6 clinical signs that would lead to the diagnosis or consideration of diagnosing a Hospital Acquired Pneumonia

A
  • Hospitalized pt
  • Purulent cough
  • New pulmonary infiltrates on CXR
  • Pyrexia >38oC
  • increased O2 requirement (with no other cause)
  • Leukocytosis/Leucopenia
25
Q

List 4 factors that pre-dispose a pt to a HAP

A
  • Reduced host defense against bacteria
  • Aspiration of Nasopharyngeal or Gastric secretions
  • Bacteria introduced into the lower respiratory tract
  • Bacteraemia
26
Q

Define Suppurative Pneumonia

A

any pneumonia associated with the formation of pus and destruction of pulmonary tissue; abscess formation may occur. Synonym (s): septic pneumonia

Medicine (14 decks)

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