Pneumonia Flashcards by Daniel Aznor

What is the meaning pneumonia

-it is the inflammation of the lung parenchyma

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What are types of the pneumonia based on etiology

-bacterial
-viral

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What are the most common virures causing pneumonia

-influenza virus
-rsv
-adenovirus

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What are the bacterial classification of pneumonia

-typical
-atypical

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What are the examples of atypical bacteria

-mycoplasma pneumonia
-chlamyophila pneumonia
-legionella

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What are types of the pneumonia based on morphology

-lobar
-segmental
-bronchopneumonia

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What are the characters of bronchopneumonia

-patchy
-multifocal

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What are the predisposing factors of pneumonia

-immunosupression (>infection; ABPA)
-smoking (chronic lung disease; COPD)
-aspiration (LOC, stroke and parkinsonism)

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What are types of the pneumonia based on clinical

-community acquired pnemonia
-hospital acquired pneumonia

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Ventilation associated pneumonia is a subtype of _____

-HAP

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What is the definition of CAP

-it is a pneumonia acquired outside of hospital
-within 48-72h of hospitalisation without instrumentation

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What is the CAP causative agent of outpatient without comorbidity

-gram +
-strep. pneumonie

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What is the CAP causative agent of outpatient with comorbidity

-gram -

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What is the CAP causative agent of aspiration

-anaerobes

(tips: remember the first name)

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What is the definition of HAP

-pneumonia acquired after 48h of hospitalisation

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What is the HAP causative agent for early onset

-gram +
-as strep. pneumonie

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What is the HAP causative agent for late onset

-gram -
-as klebsiella and pseudomonas

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What is the HAP causative agent for ICU

-gram -

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What is the HAP causative agent for air conditioning pneumonia

-atypical
-legionella

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What is the HAP causative agent for aspiration

-anaerobes

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What is the pathology of consolidation of pneumonia

-congestion
-red hepatization
-grey hepatization
-resolution

What are the clinical presentations for typical pneumonia

-high grade fever
-productive cough
-dyspnea
-stabbing chest pain
-lies on affected site to decrease pain

What is the typical clinical finding during inspection of pneumonia

-patient looks ill
-use of accessory muscle

What is the typical clinical finding during palpation of pneumonia

-increase TVF

What is the typical clinical finding during percussion of pneumonia

-dullness

What is the typical clinical finding during auscultation of pneumonia

-bronchial sound -crackle

What is the typical radiological finding during CXR of pneumonia

-increase density -air bronchohgram -pleura effusion

What are the methods of detection of organism

-sputum -invasive

What is the example of sputum examination

-culture -immunodetection -stain

What is the example of invasive examination

-nasopharyngeal swap -bronchoscopy -thoracentesis -biopsy

What is the purpose of the nasopharyngeal swab

-DFA

What is the purpose of the thoracentesis

-differentiate between simple or complete effusions

What are the complications of pneumonia

-ARDS -bronchioectasis -lung abscess -pleura effusion -sepsis

What are the general approach to treatment of pneumonia

-types -risk factor -age -concomitant disease -severity

What is CURB-65 indicates

-prognostic value

What is CURB-65 meaning

-confusion -urea > 7 -respiratory rate > 30 -blood pressure (out of 60-90) -age > 65

What is the indicative and management for 0 score

-mortality rate: 1.5 -treat outside the hospital

What is the indicative and management for 2 score

-mortality rate: 10% -treat inside of the hospital

What is the indicative and management for 3 score

-mortality rate: 20% -ICU

What is the indications of ICU

-septic shock -ARF -3 minors from 9

What are the criteria of ICU admission (9)

-confusions -urea>20 -respiratory rate -bp (hypotension) -PaO2/FiO2<250 -hypothermia -leukopenia -thrombocytopenia -multiple focal

What is the empirical therapy of outpatient with and without risk factor

-macrolide -fluoroquinoles or macrolide with beta lactam

What is the empirical therapy for inpatient ICU or non ICU

-ICU: fluoroquinoles with macrolide and beta lactam -non ICU: fluoroquinoles or macrolide with beta lactam

Definition of recurrent pneumonia

-2 or more attack of pneumonia -with complete resolution of 1 month in between -in a year

What is the definition of bronchioectasis

-persistent and irreversible -dilation of the bronchi -due to repeated inflammation

What are the most important signs of bronchioectasis

-cupful of pus -nail clubbing

What are the types of bronchioectasis

-cylindrical -varicose -cyst

What are the complications of bronchioectasis

-recurrent infection -severe hemoptysis -corpulmonale -lung abscess -empyema -secondary amyloidosis

What are the specific findings of CRX in bronchioectasis

-tram tracking -signet ring

What are the specific findings of CRX in bronchioectasis

-air fluid level -finger in glove

What are the specific findings of CT in bronchioectasis

-signet ring (>1) -loss of bronchial tapering

What are the main management of bronchioectasis

-postural drainage -percussion physiotherapy