Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonology > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Pneumonia

A

inflammation of the alveoli, distal airways,
interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Inflammation due to infection is called pneumonia (T/F?)

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non- infective pneumonia types and location

A

seen in interstitium
o Idiopathic interstitial pneumonitis
(idiopathic pulmonary fibrosis)
o Connective tissue disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does organisms get into the airways in pneumonia

A
  • Inhalation
  • Aspiration
  • Haematogenous spread
  • Direct spread form mediastinum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MC way of MOs entry in pneumonia

A

Inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why does organisms enter in pnenumonia

A
  • Defect in host defences
    o Specific
    o Non specific – Systemic (old age,
    alcoholism, immunosuppression,
    institutionalization), local (smoking,
    COPD)
  • Virulent organism
  • Large infective dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Main types of classification of pneumonia

A
  • Community acquired pneumonia
    o Typical lobar pneumonia
    o Atypical
  • Hospital acquired pneumonia
    o Early
    o Late
    o Ventilator-associated pneumonia
  • Aspiration pneumonia
  • Pneumonia in immunocompromised host
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MO associated with ventilator- associated

A

Acenatobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who are at higher risk of getting aspiration pneumonia

A

Unconscious patients
alcoholics
swallowing disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Typical MOs causing pneumonia

A

o Streptococcus pneumoniae
o Haemophilus influenzae
o Staphylococcus aureus
o Klebsiella pneumoniae
o Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Atypical MOs causing pneumonia

A

o Mycoplasma pneumoniae
o Legionella species
o Respiratory viruses (influenza)
o Chlamydia pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CAP typical lobar pneumonia MOs

A

o Streptococcus pneumonia
o Haemophilus influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CAP atypical pneumonia MOs

A

o Mycoplasma pneumonia
o Legionella species
o Respiratory viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Streptococcus pneumonias aka

A

Pneumococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of pneumonia

A
  • Vary from mild to severe
  • Fever with chills & rigors
  • Cough
  • Dyspnoea
  • Pleuritic pain
  • Systemic symptoms
    o Myalgia, headache
    o Confusion
  • Febrile, tachycardic, tachypnoeic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Signs of typical pneumococcal pneumonia

A

signs of lobar consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Signs of Pneumonia due to atypical organisms

A

more systemic Sx
Signs are not localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Difference between typical and atypical

A

TYPICAL
Onset- sudden
Fever- High
Chills, rigors - Usual
Sputum - Mucopurulent
Hemoptysis - Common
Lung signs - consolidation
Effusion- common
CXR - Alveolar
Response to Rx- Yes

ATYPICAL
Onset- Gradual
Fever- not High
Chills, rigors - unusual
Sputum - not prominent
Hemoptysis - uncommon
Lung signs - few
Effusion- uncommon
CXR - interstitial
Response to Rx- No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mendelson Syndrome

A

Chemical pneumonitis due to aspiration.
Eg- Emergency C- section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fever w chills and rigors DDs

A

Pyelonephritis
Cholangitis
Abscess
Malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why is aspiration causing pneumonia in the apical or posterior segment of the Right lower lobe segment

A

Right bronchi is wider, shorter and more in-line with the trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dx tests done for pneumonia

A

CXR
Microbiology - Gram stain, Sputum cullture, ABST, blood culture, urinary antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Supportive tests done for pneumonia

A

FBC
ESR
CRP
BUN
SpO2, ABG
ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

findings of pneumonia

A

CXR- air bronchogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Air bronchogram

A

can see airways inside the consolidated area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

supportive tests findings of Pneumonia

A

FBC- high neutrophils
High ESR, CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

blood cultures will be positive only in

A

severe cases of pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Rx of pneumonia depends on

A

Home vs hospital
General ward vs ICU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Home Rx for pneumonia is considered in

A

patients who are at a state of taking and complying with pills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hospital based treatment for pneumonia is considered in

A
  • Vital signs
    o PR>120 bpm
    o RR>30/min
    o Temp >400C
  • Radiograph
    o Multi lobar involvement
    o Complications (abscess, effusion)
  • Co-morbities (diabetes, heart failure,
    COPD, malignancies, renal failure)
  • Systemic complications (hypotension,
    confusion, oliguria)
  • Advanced age
  • Unable to take oral drugs
  • Poor family/social support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ICU care for pneumonia is considered in

A
  • Hypoxameia (PaO2<60 mmHg)
  • Hypercarbic (PaCO2> 50 mmHg)
  • Acidotic
  • Hypotensive (DBP <60, SBP < 90)
  • Oliguric (UOP < 30)
  • Uraemic
  • Confused
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CURB 65

A

Pneumonia is severe if 2 or more of the
following are present
* Confusion
* Blood urea > 7 mmol/L
* Respiratory rate > 30/min
* Diastolic blood pressure < 60 mmHg
* Age > 65
* Multi lobar
* PaO2 < 8kPa (60 mmHg)
* Blood culture is positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

ABx therapy is based on

A
  • Suspected organism
  • Patient & underlying conditions
  • Availability
  • Cost
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ABx therapy for ambulatory patients with typical lobar consolidation previously well young adult

A

o Amoxicillin (pneumococcal)
o Macrolide (drug resistant SP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Interstitial shadowing with systemic
feature (atypical pneumonia) ABx

A

Macrolide (clarithromycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Co-morbidities present ABx therapy for ambulatory patients with pneumonia

A

o Respiratory
fluroquinolones
(levofloxacin)
o Amoxicillin / clavulanate PLUS
macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

ABx therapy for hospitalized patients

A
  • Respiratory fluroquinolone (moxifloxacin,
    levofloxacin oral or i.v.)
  • Beta lactam (cefotaxime, ceftriaxone) i.v.
    PLUS macrolide (clarithromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Mx principles besides ABx for pneumonia

A
  • Fluid resuscitation
  • Oxygenation
  • Monitoring
  • Ventilation if necessary
39
Q

Possible causes if the patient is improving for 48-72 hours

A
  • Wrong diagnosis (malignancy,
    haemorrhage, infarct)
  • Resistant pathogen
  • Wrong drug
  • Wrong dose
  • Unusual pathogen
  • Nosocomial superinfection
  • Underlying lung pathology
    (bronchiectasis, bronchial obstruction)
  • Complications
40
Q

Complications of pneumonia

A
  • Sepsis with multi organ failure
  • Respiratory failure
  • Metastatic infections
  • Lung abscess
  • Pleural effusion
41
Q

How long does it take for fever to resolve in pneumonia

A

2-4 days

42
Q

how long does leucocytosis take to resolve in pneumonia

A

3-4 days

43
Q

How long does CRP take to reduce

A

1-3 days

44
Q

How long does it take for CXR abnormalities to resolve

A

3- 12 week

45
Q

Bronchopneumonia

A

Bronchial breathing
+patchy shadowing on CXR- patchy
consolidation not confined to one lobe

46
Q

Klebsiella pneumonia is MC in

A

Pt with heart disease, lung disease,
DM, alcohol excess, malignancy

47
Q

Clinical features of Klebsiella

A

Sudden onset with severe systemic illness
Purulent sputum- gelatinous, blood
stained

48
Q

mainly affected lobe in Klebsiella

A

Upper lobe

49
Q

sputum characteristics of Klebsiella

A

Redcurrant jelly

50
Q

Mycoplasma pneumonia generalized features

A

headache,
malaise often precede chest
symptoms by 1-5 days

51
Q

Extrapulomary features of Mycoplasma pneumonia

A
  • Myalgia, arthralgia
  • Rashes, erythema multiforme
  • Haemolytic anaemia,thrombocytopenia
  • GI symptoms –vomiting, diarrhoea
  • Meningoencephalitis and other
    neurological abnormalities
  • Myocarditis and pericarditis
52
Q

CXR findings of Mycoplasma pneumonia

A

usually one lobe involvement but
sometimes bilateral, no correalation
between XRay appearance and clinical
symptoms

53
Q

WBC levels in Mycoplasma pneumonia

A

not raised, 50% Cold agglutinins
positive

54
Q

Dx of Mycoplasma pneumonia

A

confirmed by increased
complement fixing antibodies

55
Q

Rare findings of Mycoplasma pneumonia

A

Lung abscess
Pleural effusions

56
Q

Rx of Mycoplasma pneumonia

A

Macrolides/ tetracyclines

57
Q

Staphylococcus aureus pneumonia seen in?

A

Following preceding viral
illness/IVDU/prolong catheters

58
Q

Common features in Staph aureus Pneumonia

A

Empyema
cavitation
Abscess formation
Pneumothorax
Septicemia
Metastatic abscess

59
Q

BP , RR and PaO2 levels in Staph aureus pneumonia

A

Hypoxemia
Hypoventilation
Hypotension

60
Q

Respi failure can be seen in

A

Pneumonia due to Staph aureus

61
Q

Frequent cause of exacerbation in
COPD patient seen in

A

Haemophilus influenzae pneumonia

62
Q

Rx of pneumonia due to Haemophilus influenzae

A

Oral amoxicillin 500mg/3 days

63
Q

Pneumonia that can occur due to exposure to birds

A

Chalmydia psittaci

64
Q

Sx and signs of pneumonia due to Chlamydia psittaci

A

Muscle pain
liver and spleen occasionally enlarged
Occasionally photophobia and neck stiffness

65
Q

Legionella pneumonia can be seen in

A

Outbreaks in individuals staying in
hotels institutions or hospitals where
shower facilities or cooling systems
are contaminated with organism

66
Q

Sx of Legionella pneumonia

A

Prodromal virus like illness
Dry cough, confusion, diarrhoea

67
Q

FBC findings of Legionella

A

Lymphopenia without marked leukocytosis

68
Q

Sodium levels and albumin levels of legionella pneumonia

A

Hyponatremia Hypoalbuminaemia

69
Q

liver transaminase levels in Legionella pneumonia

A

Increased

70
Q

Ix done for Legionella pneumonia

A

Urinary antigen test

71
Q

Rx of legionella pneumonia

A

Macrolides

72
Q

Pneumonia seen in alcoholics

A

Klebsiella

73
Q

Pneumonia Extrapulmonary features are mostly seen in

A

Mycoplasma

74
Q

Anemia seen in mycoplasma pneumonia

A

Cold AIHA

75
Q

Photophobia and neck stiffness in pneumonia is

A

Chlamydia psittaci

76
Q

Pneumonia due to outbreaks in a common place

A

Legionella

77
Q

Klebsiella mainly affects … part of the lung

A

upper lobe

78
Q

Pneumonia due to a preceding viral illness is

A

Staph aureus

79
Q

Myocarditis and pericarditis is associated with…. pneumonia

A

Mycoplasma

80
Q

Neurological features can be seen in….. pneumonia

A

Mycoplasma

81
Q

Lung abscess is rare in….. pneumonia while common in….. pneumonia

A

Mycoplasma
Staph

82
Q

Pneumonia associated with COPD

A

Haemophilus influenzae

83
Q

Hepatosplenomegaly is associated with….. pneumonia

A

Chlamydia psittaci

84
Q

Pneumonia associated with fungal infection

A

Pneumocystis jiroveci

85
Q

Pneumocystic jiroveci is mostly seen in

A

Immunocompromised and HIV patients

86
Q

CXR findings of Pneumocystis pnenumonia

A

B/L hilar shadowing

87
Q

HRCT findings of Pneumocystis jiroveci

A

Ground glass appearance

88
Q

SpO2 feature in pneumocystis pneumonia

A

desaturates with exercises

89
Q

type of cough in pneumocystis jiroveci

A

Dry cough

90
Q

Dry cough seen in what types of pneumonia

A

Pneumocystis
Legionella

91
Q

Rx of pneumocystis pneumonia

A

Cotrimoxazole

92
Q

Pneumonia and Hyponatremia ?

A

Legionella

93
Q

Pneumonia and diarrhea?

A

Legionella

94
Q
A

Pulmonology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions