Pneumonia Flashcards
1
Q
What is pneumonia?
A
Lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid. May affect both or one lung.
2
Q
What are the most common causes of community-acquired pneumonia (CAP)?
A
Primary or secondary to underlying disease.
- **Steptococcus pneumoniae **(gram+ diplococci)
- Haemophilus influenzae
- Mycoplasma pneaumoniae
- Staphylococcus aureus
- Viruses (15%)
3
Q
What are the most common causes of hospital-acquired pneumonia (HAP)?
A
- Gram -ve enterobacteria
- Staph. aureus
4
Q
What are the clinical features of pneumonia?
A
Symptoms;
- Fever, rigors, malaise, anorexia
- Dyspnoea
- Cough, purulent (pus) sputum, haemoptysis
- Pleuritic chest pain (pleurisy)
Signs;
- Fever, tachypnoea, tachycardia
- Hypotension, cyanosis, confusion
- Signs of consolidation
- Diminished expansion
- Dull percussion note
- Inc tactile fremitus/ vocal resonance
- Bronchial breathing
- Plerual rub
5
Q
How would you assess severity of pneumonia?
A
CURB-65;
- Confusion (abbreviated mental test <=8)
- Urea >7mmol/L
- Resp rate >=30/min
- BP <90systolic or <60diastolic
- >=65yrs age
>=3 indicates severe pneumonia
6
Q
What are complications of pneumonia?
A
SLAP HER
- Septicaemia - spread into blood
- Lung abcess - cavitation
- Atrial Fibrilation - common, esp elderly
- Pleural effusion & Pericarditis/ myocarditis)
- Hypotension - dehydration + vasodilation(sepsis) & Haemoptysis
- Empyema - pus in pleural space
- Resp Failure - type 1 common
7
Q
What investigations would you perform in suspected pneumonia?
A
-
CXR
- Consolidation (multi/lobar)
- Cavitation
- Pleural effusion
- Sputum (pleural fluid aspirate, blood) for microscopy & culture
-
Bloods;
- High WCC
- Lymphopenia - legionella
- Red cell agglutinations - mycoplasma
- U&E (urea)
- ABG; type 1 resp failure
- ECG; AF
- Bronchoscopy/ bronchoalceolar lavage is immunocompromized or on ITU
8
Q
How would you manage pneumonia?
A
- Antibiotics
- Oxygen
- IV fluids
- Analgesia
