Pneumonia Flashcards by Melissa Ring

What is the pathophys of pneumonia

inflammation of the alveoli and bronchioles

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What is pneumonia caused by

infection
aspiration

*from bacteria, viruses, fungi

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What is the #1most deadly hospital acquired infection

Pneumonia

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What is the #1 cause of bacterial pneumonia

strep pneumonia

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What is the second most common bacterial pneumonia

H. influenza B

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How do typical community acquired pneumonia present

caused by bacteria
alveolar inflammation / exudate
Productive cough
High WBC

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What will be seen on CXR with typical community acquired pneumonia

Lobar consolidation

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How do atypical community acquired pneumonia present

organisms invade / destroy lung interstitium

Lack of alveolar exudate
dry cough
normal WBC

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How does atypical community acquired pneumonia present on CXR

Patchy infiltrate

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What are example of atypical community acquired pneumonia

mycoplasma
chlamydia
viral

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Where is the antibody created for typical community acquired pneumonia

in the spleen

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What symptoms will a patient have with typical community acquired pneumonia

Chest pain
absent lung sounds
productive cough
crackles

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What are some criteria for hospitalization of typical community acquired pneumonia

RR>30BPM
Mechanical ventilation
septic shock
O2 sat<90%

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What are some typical diagnostics for community acquired pneumonia

Crackles on exam
absent lung sounds
increased whispered pectoriloquy
Egophony
bronchophony
tactile remits
lobar consolidation

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How do you treat outpatient adult community acquired pneumonia

Azythromycin (zpack)
Doxy
Levofloxacin

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How do you treat pediatric outpatient community acquired infection

amoxicillin

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How do you treat inpatient adults with community acquired infection

Ceftriaxone + Azithromycin
OR
Levofloxacin

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How do you treat inpatient pediatric community acquired infection

ampicillin (If fully immunized)

Ceftriaxone otherwise

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Which population is atypical community acquired pneumonia more common in

Children

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What is bronchopneumonia known as on xray

Patchy infiltrate

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How does mycoplasma effect the lungs

Damage the epithelium allowing bacteria to overgrow

Where can chlamydia pneumonia come from

college
Koalas
Non-bullous myringitis

What type of pneumonia is legionnaires disease

gram negative bronchopneumonia

How is legionnaires disease transmitted

**NOT from person to person

Pathogen grows in water of vent systems

What are some symptoms of legionnaires pneumonia

fever chills malaise dry cough diarrhea

How do you test for legionnaires disease

urine antigen or sputum fluorescent antibody test

How do you treat legionnaires pneumonia

Levofloxacin *any delay in treatment increases risk of mortality

When is pneumonia considered hospital acquired

Pneumonia present after 48 hours after admission

What pathogen is most prevalent in hospital acquired pneumonia (In ICU)

Pseudamonas *Highest mortality rate

Which patients are at greatest risk for hospital acquired pneumonia

Intubation tracheotomy immunocompromised chronic lung disease

What treatment is used for aspiration pneumonia

clindamycin or Metronidazole + ceftriaxone

Which drugs are commonly used in nosocomial pneumonia

Cefepime Zosyn Meopenem Levofloxacin

What was one of the first diseases seen in the AIDS pandemic

PJP

How do HIV infected people acquire PJP

fungus found in soil

What is the presentation of PJP

Foamy exudates and cysts in lungs Cough, fever, weight loss CD4 <200

What is the leading cause of death for people with HIV world wide

pulmonary TB

How do you treat PJP pneumonia

Predisone first then TMP-SMX

Why are sickle cell disease patients prone to s. pneumoniae

from poor spleen function from infarct

What are the phases of fungal pneumonia

1: mild flu-like illness 2: Creation of cavitary lesions?similar to TB 3:Hepatosplenomegaly, pancytopenia, septic shock/death

Where does histoplasmosis come from

bird and bat droppings

How is histoplasmosis confirmed

urine testing

What is the treatment of choice for histoplasmosis

Itraconazole

What is another name for coccidiomycosis

valley fever (southwest U.S)

How is coccidiomycosis diagnosed

skin test

How do you treat coccidiomycosis

Generally self limiting can treat with 3-6 months diflucan

How long can symptoms last with coccidiomycosis

months

Where does cryptococcus come from

bird droppings

What can cryptococcus cause

meningitis in HIV patients with CD4<50

How do you detect cryptococcus

Serum antigen testing

How do you treat cryptococcus

Fluconazole x10wks

How does mortality change with cryptococcus in those without HIV compared to those with

Mortality increases without HIV

How can you prevent pneumonia

PCV20 flu shot (over 6months of age)