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Pulmonology > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

2 types of pneumonia

A

Lobar and interstitial

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2
Q

Does lobar or interstitial pneumonia have better oxygenation?

A

lobar bc you can cough it out

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3
Q

A pneumonia that is acquired outside the hospital or within 48hrs admit

A

Community Acquired Pneumonia (CAP)

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4
Q

Top 3 CAP bacteria

A

S. pneumoniae (15%) (G+)
H. influenza (3-10%) (G-)
Mycoplasma Pneumonia (atypical)

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5
Q

CAP Viral

A
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6
Q

CAP Fungal Causes

A
  • Coccidiomycosis “cactusidiomycosis”
  • Histoplasmosis “ohio river valley”
  • Blastomycosis “blasting leaves”

in HIV -> Pneumocystis jirovecii

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7
Q

ppl <5 yo usually get (viruses/bac)
ppl >/=5yo usually get (viruses/bac)

A
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8
Q

Bacterial infx = ____ cough. Viral infx = ____ cough

A

bacterial = WET Cough
Viral = DRY Cough

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9
Q

Signs of CAP

A

Fever, tachypnea, tachychardia, crackles, egophony E->A changes, increased tactile fremitus,

infants: nasal flaring, accessory muscle use, cyanosis

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10
Q

Pneumonia symp

A

cough, fever, chills, malaise, dyspnea, chest pain

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11
Q

pt presents to ER with acute dyspnea. Order what to diff pneumonia vs heart failure

A

Serum procalcitonin levels

procalcitonin is produced in response to bac infections and tissue injury

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12
Q

Criteria to determine if pt needs to be admitted to the hosp

A

CURB-65

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13
Q

does this pt need to go home, be admitted, or ICU?

confused, BUN 21mg/dL, RR 35bpm, hypotensive, 70yo man

A

ICU

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14
Q

pts must maintain an O2 of > ____% (norm) OR > _____% (COPD)

A

> 92% Norm
88% COPD

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15
Q

CAP Steroid Rx

inpt and outpt

A
  • inpt -> methylprednisolone
  • outpt -> prednisone
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16
Q

Because cultures have low yield, when empirically treating pneumonia, we must cover for all most common types…

A

G+: Strep pneumoniae
G-: H. Influenza
Atypicals: Mycoplasma, Chlamydia

17
Q

Strep Pneumo Trmnts

A

Amoxil only for kids
Macrolides (Z-pak) for adults

18
Q

what & CXR findings?

Pneumonia + high fever, rusty purulent sputum

A
19
Q

what, CXR findings, & trmnt?

Pneumonia + COPD Smoker

A
20
Q

what, CXR findings, trmnt

Pneumonia + WATER exposure, diarrhea, wet cough

A
21
Q

what, CXR findings, & trmnt?

College teen living in dorm has pneumonia over WEEKS with dry cough

A
22
Q

What & trmnt

Child with LOW FEVER, persistent DRY COUGH, H/A, ST, and hoarseness. PE: wheezing and ronchi

A
23
Q

What, etiology, & trmnt

Alcoholic with Pneumoniae symptoms

A
24
Q

what, etiology,

Chronic WET COUGH, NIGHT SWEATS, WT LOSS, HEMOPTYSIS, pleuritic CP, foul smelling sputum

A
25
Q

CXR findings and trmnt

Chronic WET COUGH, NIGHT SWEATS, WT LOSS, HEMOPTYSIS, pleuritic CP, foul smelling sputum

A
26
Q

HIV pt has fever, cough, dyspnea, and clear lungs. Wdyd?

A

order a serum test for CD4 count. always be suss for pneumonia in immunocompromised

27
Q

Pneumocystis Jirovecii symptoms

A

HIV pts get this. They are immunocomp, so their only symptom may be fever

28
Q

Pneumocystitis Jirovecii trmnt and prevention

A

IV Bactrim (sulfamethoxazole/trimethoprim)
Prevention: BACTRIM FOR LIFE

29
Q

Pneumocystitis Jirovecii CXR fingings

A

diffuse interstitial infiltrates

30
Q

what & orders?

Pneumonia + from Arizona, red bumps and circles on skin

A
31
Q

trmnt

Coccidiomycosis trmnt

A
32
Q

what & trmnt

Pneumonia + birds/bats

A

Itraconazole unless mod-severe-> amphotericin B for a lil bit and then -> itraconazole

33
Q

Coccidiomycosis presentation

A

May be Asymptomatic aside from slight cold symptoms and skin lesions

34
Q

Pneumonia with hemoptysis, wt loss, night sweats, and chunky/slimy jelly sputum. What, etiology, and trmnt?

A

Lung abscess from aspiration pneumonia
Gram (-) Klebsiella
Rx Augmentin (Amoxil/clavulanate for G- ) or Clindamycin (for anaerobes)

35
Q

Lung abscess most common anaerobic pathogens?

A

Bacteroides, peptostrep, fusobacterium, prevotella

36
Q

Lung abscess most common aerobic pathogens?

A

Strep and staph (G+)
Klebsiella (G-)

37
Q

Pt who is an AC mechanic presents with flu like symptoms including high fever, myalgia, cough, and diarrhea had a (+) urine antigen test. What is it?

A

Legionella (legionnaire’s disease)

38
Q

Special test for Legionella?

A

Urinary legionella antigen

39
Q

Aspiration pneumonia

at risk population, microbes, Rx, complication?

A

Inhaling your own vomit
at risk -> Alcoholic, stroke, anything effecting swallowing
Microbes -> Anaerobes, G + (strep), G - (H. flu, Klebsiella), bacteroides
Rx -> Augmentin or clindamycin
Complication -> Lung abscess

Pulmonology (17 decks)

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