Pneumonia Flashcards
Which pneumonia type causes hyponatremia?
Legionella pneumonia, from air conditioning and contiamiend water sources.
How does legionella present?
Fever
Dry cough
Bibasal consolidation
Mild hepatic dysfunction
What is a rapid diagnostic test for legionella?
Urinary legionella antigen
How does mycoplasma pneumonia present?
Dry cough, bilateral crackles/consolidation affecting younger patients. Complications include haemolytic anaemia and inflammation of heart, liver, pancreas and kidney s
What is the treatment for pneumonia from staphylococcus aureus infection?
Flucloxacillin
What does air fluid level in the lung on CXR indicate?
Cavitating lesion, likely due to klebsiella pneumonia which is gram negative rod causing currant jelly red sputum.
Pseudomonas
How is pseudomonas aeruginosa usually spread?
Within hospital by contaminating ventilators
What is the most common cause of aspiration pneumonia?
Streptococcus pneumonia, a gram POSITIVE AEROBIC
Which pneumonia infection should be suspected in immunocompromised patients?
Pneumocystis is pneumonia
What should patients at risk of pneumocystis is pneumonia be treated with?
Prophylaxis co-trimoxazoe
What is the definitive investigation for pneumocystitis pneumonia?
Bronchoscopy with bronchoalveolar lavage
What will sputum samples show for pneumocystisis pneumonia?
Patients typically have very little sputum so may need saline nebulisers. Silver staining is required
Which imaging investigations are ideal?
CXR showing bilateral hilar interstitial infiltrates
High resolution CT scan if CXR is normal
What is the treatment for severe cases of pneumocystis pneumonitis?
High dose co-trimoxazole is the primary treatment
Which scoring system is used to manage patients?
CURB-65 score
How are patients with a CURB score of 0-1 managed?
Home treatment with 5 days of amoxicillin
-> if allergic, provide doxycycline or erythromycin if pregnant
How are patients with a CURB-65 score of 2 treated?
Hospital admission onto ward with combination of beta-lactam (e.g amoxicillin) antibiotic and macrolide like clarithromycin
-> if allergic, only offer macrolide antibiotic
How is a patient with CURB-65 of 3-5 managed?
Admit to hospital and consider ITU referral
When is ITU referral considered in pneumonia?
CURB-65 score over 3 OR evidence of sepsis
What is the urea value in CURB-65?
Over 7
When is CRB-65 used?
In primary care as immediate bloods are not available
What are the signs of respiratory failure?
CONFUSION= encephalopathy
Tachypnoea
Cyanosis
Fatigue
Condition predisposing to ARDS development
