Pneumonia Flashcards
Define Pneumonia
A pneumonia is defined as an acute lower respiratory tract infection with recent radiological lung shadowing that may be segmental, lobar, multilobar
List 4 types of pneumonia
Community Acquired
Hospital Acquired
Aspiration Pneumonia
Ventilator Associated Pneumonia
What is community-acquired pneumonia?
This is defined as a pneumonia that was contracted outside of the health-care system
What are three common bacterial causative agents of a community-acquired pneumonia?
- Streptococcus Pneumoniae
- Haemophillus Influenzae
- Mycoplasma Pneumoniae
What is the most common causative organism of CAP in young patients
Mycoplasma Pneumoniae
What is the most common causative organism of CAP in the elderly?
Haemophillus Influenzae (gram negative)
What is the most common causative organism of CAP ?
Streptococcus Pneumoniae (Gram positive diplococci)
Viruses can also cause CAP, list 3
- Influenza
- Cytomegalovirus
- Coronavirus
How is CAP spread?
Droplet infection
List 6 factors that can predispose a pt to CAP
- pre-existing lung disease
- Old age
- URTI
- recent Influenza infection
- HIV
- Cigarette smoking
What is pulmonary consolidation
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.
List some systemic features of CAP
rigors, chills, malaise, fever, LOA
List some symptoms of CAP
- initial dry-painful nonproductive cough
- late muco-productive cough
- pleuritic chest pain
Rust-coloured productive cough is usually associated with which causative organism of CAP?
Haemophillus Influenzae
What are the clinical signs of CAP on Respiratory Examination?
Consolidation»
1) Dull percussion note
2) Inc tactile/vocal fremitus
3) Bronchial breath sounds (Expi>Inspi, loud pitch)
List 3 differentials for Pneumonia
Pulmonary Infarction
Pulmonary Oedema
Pulmonary Tuberculosis
List investigations that should be done to diagnose pneumonia
CBC (WBC >20, neutrophil leukocytosis)
CXR (lobar pneumonia, bronchopneumonia)
Sputum Cx
What Chest X-ray findings may be seen in a CAP
Patchy opacification evolves into homogeneous consolidation of
affected lobe
OR
Typically patchy and segmental shadowing
Which investigations are used to determine the severity of the pneumonia?
CBC: WBC <4 x 10^9 /L
U&E: Urea >7mmol/L
hyponatremia
LFT: hypoalbuminaemia
Blood Cx: Bacteraemia
ABG: SaO2 <92%
Which score is used to determine the need for ICU treatment in patients with CAP
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
What are the three pillars of management of pneumonia?
Oxygen Therapy
Fluid Resuscitation
Antibiotic Therapy
List 4 complications of pneumonia
para-pneumonic effusion
suppurative pneumonia/lung abscess
pneumothorax
empyema
Define Hospital Acquired Pneumonia
This is a new onset acute respiratory infection that presents within 90 days of a hospital admission >2days.
What are the 6 clinical signs that would lead to the diagnosis or consideration of diagnosing a Hospital Acquired Pneumonia
- Hospitalized pt
- Purulent cough
- New pulmonary infiltrates on CXR
- Pyrexia >38oC
- increased O2 requirement (with no other cause)
- Leukocytosis/Leucopenia
List 4 factors that pre-dispose a pt to a HAP
- Reduced host defense against bacteria
- Aspiration of Nasopharyngeal or Gastric secretions
- Bacteria introduced into the lower respiratory tract
- Bacteraemia
Define Suppurative Pneumonia
any pneumonia associated with the formation of pus and destruction of pulmonary tissue; abscess formation may occur. Synonym (s): septic pneumonia
