Pneumonia Flashcards
1
Q
What is Pneumonia ?
A
- Pneumonia is an infection of the lung tissue, causing inflammation in the alveolar space. ( It shows as a consolidation on a chest X-ray )
2
Q
Pneumonia classification?
A
- Community-acquired pneumonia (CAP)
• Develops in the community - Hospital-acquired pneumonia (HAP)
• Develops after more than 48hours in a hospital - Ventilator-acquired pneumonia (VAP)
• Develops in intubated patients in the intensive care unit (ICU)
3
Q
What are the types of Pneumonia ?
A
- Bacterial Pneumonia
- Viral Pneumonia
- Walking Pneumonia (atypical pneumonia)
- Fungal Pneumonia
4
Q
Bacterial Pneumonia?
A
- Most common
- Causes more severe illness than other types of Pneumonia
- Mostly caused by Streptococcus bacteria
• Symptoms may include: - Tachycardia
- Tachypnea
- Fever
- Bluish lips and nailbed
- Excessive sweating
- Confusion
• Treatment: - Antibiotics
5
Q
Viral Pneumonia?
A
- People with weak immune system such as children and old people are more likely to develop viral pneumonia
- Caused by viruses such as :
• Respiratory syncytial virus (RSV)
• Human parainfluenza viruses(HPIV)
• Adenovirus
• Measles virus
• SARS-Cov-2 ( which causes Covid-19) - Treatment :
• Antibiotics DO NOT TREAT viral pneumonia, in contrast corticosteroids may help if it’s diagnosed early
• Rest at home
• Get plenty fluids
• Advil (ibuprofen) or Tylenol ( acetaminophen) for fever
• IV fluids and supplemental oxygen in severe cases
6
Q
Walking Pneumonia ?
A
- Also called Atypical Pneumonia
- What Walking Pneumonia implies is that whatever cause of your pneumonia, it’s not severe enough to put you in bed
- Most common bacteria often cause Walking Pneumonia is Mycoplasma pneumoniae in people younger than 40
- Symptoms :
• Ear and Eye pain
• Sore throat
• Rash - Treatment :
• Antibiotics
• Rest at home
• Fluids
7
Q
Fungal Pneumonia ?
A
- Not contagious
- Types of Fungal Pneumonia :
• Histoplasmosis, caused by fungus histoplasma ( found in bird, bat droppings and soils)
• Pneumocystis pneumonia, pneumocystis jirovecci (PCP) is fungus in your lungs. Happens if it grows out of control (typically in people with weak immune systems). This type of fungal causes general pneumonia symptoms.
• Valley fever, caused by fungus Coccidiodes (found in soils) - Valley fever and Histoplasmosis typically do not cause symptoms
- Treatment :
• Anti-fungal
8
Q
Pneumonia symptoms?
A
- Generally feeling unwell
- Productive cough
- Shortness of breath
- Fever
- Tachycardia
- Cyanosis
- Haemoptysis
- Delirium
- Pleuritic chest
9
Q
The CURB-65 score is used to assess the severity of pneumonia based on what?
A
- C : confusion
- U : urea > 7mmol/L
- R : respiratory rate > or equal 30
- B : blood pressure, systolic < 90 or diastolic < or equal 60
- 65 - age > or equal 65
10
Q
What is the CURB-65 score predicts mortality?
A
- Score 0/1 : Consider treatment at home
- Score > or equal to 2 : Consider hospital admission
- Score > or equal to 3 : Consider intensive care unit
11
Q
Investigations ?
A
- Chest X-ray
- Full blood count ( raised WBC)
• In viral pneumonia : normal WBC with lymphocytes predominance
• In bacterial pneumonia : elevated WBC with granulocytes predominance - Renal profile (urea level for CURB-65 score and acute kidney injury)
- CRP
12
Q
Complications ?
A
- Sepsis
- Pleural effusion
- Lung abscess
- Emphysema
- ARDS
- Death
13
Q
Pneumonia differential diagnosis ?
A
- Asthma
- COPD
- CHF
- Pulmonary embolism
14
Q
Treatment ?
A
- Appropriate diet and fluid intake
- Medication for symptoms relief
- Suction of nasopharynx for clear airway
- Oxygen therapy ( nasal tube or oxygen mask)
- Antibiotics :
• Penicillin and cephalosporins
• Vancomycin and teicoplanin (to treat staphylococcal pneumonia)
• Macrolide antibiotics (azithromycin, erythromycin and clarithromycin) against mycoplasma - Corticosteroids ( in severe cases, oe with brain edema…)
