Pneumonia Flashcards
(37 cards)
What is pneumonia?
Acute inflammation of the lung parenchyma distal to the terminal bronchiole, including the alveoli.
What is the epidemiology of pneumonia in Kenya?
The leading cause of in-hospital death, with high mortality rates especially in ICU patients.
What are the primary risk factors for pneumonia?
Extremes of age, anatomic respiratory defects, immunodeficiency, altered consciousness, and underlying lung diseases.
Describe the lung defense mechanisms.
Nasopharyngeal filtering, gag and cough reflex, mucociliary action, phagocytosing alveolar macrophages, and immunoglobulins.
What are the routes of infection for pneumonia?
Aspiration, inhalation of infectious aerosols, hematogenous dissemination, and direct inoculation.
What is community-acquired pneumonia (CAP)?
Pneumonia acquired outside of hospitals or within 48 hours after admission, without recent healthcare facility exposure.
What are the typical causative organisms of CAP?
Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella, viruses like Influenza.
What is the pathophysiology of pneumonia?
Impaired host defenses, microbial invasion, inflammatory response, and cytokine release leading to lung tissue consolidation.
What are the pathophysiological causes of pneumonia?
Impaired defense mechanisms, virulent pathogens, and defects in host responses like reduced cough reflex and mucociliary clearance.
What are the typical symptoms of bacterial pneumonia?
Productive cough with rusty sputum, fever, chills, pleuritic chest pain, and dyspnea.
Describe the clinical presentation of pneumonia.
Acute cough, fever, chills, dyspnea, pleuritic chest pain, headache, altered mental status, and respiratory distress.
What investigations are used to diagnose pneumonia?
Full hemogram, UECs, CRP, imaging (chest X-ray), sputum cultures, and blood tests.
What is the role of imaging in pneumonia diagnosis?
To confirm the presence of infiltrates, assess the extent of lung involvement, and identify possible complications.
How is the CURB-65 score used in pneumonia?
It assesses severity and guides management; includes confusion, urea level, respiratory rate, BP, and age >65.
Why is CURB-65 important in pneumonia management?
It helps to stratify risk and decide whether a patient can be managed outpatient or requires hospitalization.
What are key components of managing CAP?
Oxygen therapy, IV fluids, antibiotics, antipyretics, and chest physiotherapy.
What is the treatment duration for CAP?
Typically 5-7 days, extended if complications like lung abscesses or empyema occur.
What is the primary treatment for community-acquired atypical pneumonia?
Macrolides (azithromycin) or tetracyclines.
What defines hospital-acquired pneumonia (HAP)?
Pneumonia developing 48 hours or more after hospital admission, not present at the time of admission.
What is healthcare-associated pneumonia (HCAP)?
Pneumonia in non-hospitalized patients who have frequent contact with healthcare environments, such as dialysis or nursing homes.
What is the common treatment approach for HAP?
Broad-spectrum antibiotics with empiric coverage, tailored after pathogen identification.
Describe ventilator-associated pneumonia (VAP).
Pneumonia occurring 48 hours after intubation; treated with empirical broad-spectrum antibiotics.
What are common causes of healthcare-associated pneumonia (HCAP)?
Frequent exposure to healthcare environments, recent hospitalization, long-term care, and immunosuppression.
How does aspiration pneumonia differ from typical pneumonia?
It involves inhalation of gastric contents, often causing a chemical pneumonitis or infection by anaerobic bacteria.
