pneumonia Flashcards
pathophysiology pneumonia
LRTI –> neutrophils –> fever + fluid + pus –> hypoxia
RF pneumonia
<5 or >65 // smoking // recent viral RTI // CF, COPD// immunosuppressed // aspiration eg Parkinson’s // IV drugs
presentation pneumonia
cough + sputum // SOB // chest pain // fever // fever, tachycardia, hypotension, confused, tachypnoea // hypoxia // dull percussion
CURB65 criteria
confusion // urea >7 // RR >30 // BP <90 or <60 // age >65
what assessment is done in primary care and what would indicate high risk
CRB65 // 0 = home management // 1-2 = intermediate // 3-4 = high
which blood marker can guide need for abx in primary care
CRP <20 = no // CRP 20-100 = delayed abx // CRP >100 = abx
invx hospital pneumonia
CXR // blood, sputum, urinary antigens // CRP monitoring
CAP vs HAP
HAP = 48hrs + in hospital
mx simple CAP
1 = amox 5 days // 2 = macrolide eg clarithromycin or tetracycline eg doxycycline
mx moderate-severe CAP
1 = amox + macrolide eg clarithromycin // V severe = co-amox, pipercillin + tazobactom, ceftriaxone
delaying discharge pneumonia
2+ in past 24hrs: temp >37.5 // RR >24 // HR >100 // BP <90 // O2 <90 // altered mental status // cannot eat
follow up care pneumonia
CXR at 6 weeks
most common causes CAP
strep pneumo!!!! // H influ // Staph A
which pneumonia is common after flu injection
staph A
pneumonia in alcoholics
klebseialla
features pneumococcal pneumonia (strep)
rapid onset // high fever // pleuritic chest pain // cold sores!!!
RF aspiration pneumonia
incompetent swallow eg stroke, MS, alcohol // poor dental hygiene // prolonged hospital // impaired LOC // impaired mucociliary clearance
most common site aspiration pneumonia
right middle + Lower lobe
