Pneumonia Flashcards
What is pneumonia?
Inflammatory condition affecting alveoli of lungs, often bacterial infections.
What bacteria is responsible for 80% of pneumonia cases?
Streptococcus pneumoniae (pneumococcus)
What si the common caus eo fpneumonai in patients with COPD?
Haemophilus influenae
What is the association of *Staphylococcus aureus *with pneumonia?
Common in patients with recent flu infection.
What is the common cuase of pneumonia in alcoholics?
Klebisella pneumoniae
List the causes of pneumonia.
- Bacteria
- Virus
- Fungi (Pneumocystis jiroveci)
- Idiopathic interstitial pneumonia
- Aspiration pneumonia
What is aspiration pneumonia commonly associated with?
ITU admission - Most commonly presents as a right lower lobe infection.
What are the risk factors for pneumonia?
- Age under 5 or over 65
- Smoking
- Chronic respiratory disease
- Immunosuppression
- IV drug users
- Risk of aspiration
What are the two classifications of pneumonia?
- Community acquired pneumonia (CAP)
- Hospital acquired pneumonia (HAP)
When is pneumonia classified as hospital acquired?
Must be 48 hours or more after admission.
What are common symptoms of pneumonia?
- Cough with purulent sputum
- Dyspnoea
- Chest pain
- Fever
- Malaise
What signs indicate pneumonia?
- Fever
- Tachycardia
- Reduced O2 stats
- Tachypnoea
- Reduced breath sounds
- Dull percussion note
What does CRB-65 assess in pneumonia patients?
Risk of death.
What score is used to treat pneuonia + how is it calcuated?
CURB 65
(Confusion, Urea, RR, BP, 65+)
What is the risk of death associated with a CRB-65 score of 0?
Low risk (<1%)
What CRB-65 score indicates the need for hospital assessment?
2 or more
(3+ usually = ITU)
What is the CURB-65 score used for?
Secondary care assessment of pneumonia risk.
What CURB-65 score indicates low risk and at-home care?
0-1.
What CURB-65 score indicates high risk and ITU care?
3 or more.
What does a positive CXR in pneumonia indicate?
Diffuse consolidation (opacity).
What blood tests are indicated in pneumonia management?
- FBC - ↑WBC
- U&Es
- CRP - ↑ with infection
- Blood cultures
- Legionella antibodies
When is an ABG indicated in pneumonia patients?
If O2 stats are low or in patients with pre-existing conditions.
What is the first-line treatment for low-severity CAP (CURB 65 = 2)?
Amoxicillin (5 day course).
PenAll: Tetracycline/Macrolide ABX
What is the treatment for high-severity CAP (CURB-65 = 3+)?
Amoxicillin + a macrolide (7-10 day course).
Macrolide = e.g. azithromycin, clarithromycin, erythromycin
What is the first-line treatment for hospital-acquired pneumonia (HAP)?
Co-amoxiclav (5 days).
What are the discharge criteria for pneumonia patients?
- Temperature > 37.5°C
- Respiratory rate ≥ 24
- Heart rate > 100
- Systolic BP ≤ 90
- O2 saturation < 90%
- Abnormal mental status
- Inability to eat without assistance
What is the expected time frame for pneumonia recovery?
Symptoms should resolve within 6 months.
When should a repeat CXR be performed after pneumonia discharge?
6 weeks after discharge.
