Pneumonia Flashcards

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1
Q

Causes

A

Strep pneumonia- 80%; high fever, rapid onset, herpes labialis

Haemophilus influenzae- particularly in COPD

Staph aureus- following influenza infection

Mycoplasma pneumonia- dry cough and atypical xray findings

Legionella pneumophilia- hypnatraemia and lymphopenia

Klebsiella pneumoniae- alcoholics

Pneomocystis jiroveci- HIV; dry cough, exercise induced desaturations

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2
Q

Idiopathic interstitial pneumonia

A

Group of non-infective causes

Cryptogenic organising pneumonia
- complication of rheumatoid arthritis or amiodarone therapy

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3
Q

Symptoms

A

Cough

Sputum

Dyspnoea

Chest pain

Fever

Delirium

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4
Q

Signs

A

Tachypnoea

Tachycardia

Hypoxia

Hypotension

Fever

Confusion

Reduced breath sounds

Bronchial breathing

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5
Q

Investigations

A

FBC- neutrophilia in bacterial

U&Es- check dehydration, other changes in atypical

CRP- raised in infection

ABG

Chest xray

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6
Q

CURB 65

A

Confusion (AMTS <8/10)

Urea >7

Resp rate >30

BP systolic <90/ diatstolic <60

Aged >65

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7
Q

CRB 65 management

A

0- low risk, treatment at home

1 or 2- intermediate risk, hospital assessment considered

3 or 4- high risk, urgent admission to hospital

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8
Q

CURB 65 management

A

0 or 1- low risk, home-based care

> 2- intermediate risk, hospital based care

> 3- high risk, consider ICU

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9
Q

Management of low-severity CAP

A

Amoxicillin first-line

Marcolide or tetracycline if pen allergic

5 day course

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10
Q

Management of moderate-severe CAP

A

Dual antibiotic amoxicillin and macrolide

7-10 day course

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11
Q

Don’t discharge if in past 24 hours

A

2 or more
- temp >37.5
- RR >24
- HR >100
- systolic BP <90
- O2 sats <90
- abnormal mental status
- inability to eat without assistance

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12
Q

Follow up

A

Repeat chest xray at 6 weeks after clinical resolution

Ensure consolidation has resolved and no underlying secondary abnormalities

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13
Q

Complications

A

Sepsis

Pleural effusions

Empyema

Lung abscess

Death

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