[pneumonia] Flashcards

1
Q
A

Strep. Pneumoniae
Haemophilus Influenzae
Mycoplasma pneumoniae

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2
Q
A

strep pneumoniae
haemophilus influenzae
mycoplasma pneumoniae

staphylococcus aureus
legionella pneumophilia
moraxella catarrhalis
chlamydia

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3
Q
A

Strep. Pneumoniae
Haemophilus Influenzae
Mycoplasma pneumoniae

+
other

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4
Q
A

strep pneumoniae
haemophilus influenzae
mycoplasma pneumoniae

staph aureus
legionella
moraxella catarrhalis
chlamydia

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5
Q
A
Staph aureus
klebsiella
shigella
salmonella
yersinia pestis
e coli
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6
Q
A

Staph Aureus

gram negative enterobacteria

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7
Q
A
Salmonella
klebsiella 
Shigella
E coli
Yersina pestis
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8
Q
A
Staph aureus
klebsiella
shigella
salmonella
yersinia pestis
e coli
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9
Q
A

Staph Aureus
gram negative enterobacteria
Pseudomonas

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10
Q
A
Staph aureus
klebsiella
shigella
salmonella
yersinia pestis
e coli
pseudomonas
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11
Q
A

aspiration oropharyngeal anaerobes

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12
Q
A

Pneumocystis jiroveci

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13
Q
A

tachypnoea
consolidation
pleural rub
cyanosis

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14
Q
A
dyspnoea
pleuritic pain
purulent sputum 
haemoptysis
cough
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15
Q
A

anorexia
fevers
rigors
malaise

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16
Q
A

confusion

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17
Q
A

tachypnoea
consolidation
pleural rub
cyanosis

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18
Q
A

increased tactile vocal fremitus/resonance
reduced expansion
dull percussion note
bronchial breathing

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19
Q
A

sputum

pleural fluid

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20
Q
A

pyrexia
confusion
tachycardia
hypotension

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21
Q
A

normal lung architecture replaced by cavity

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22
Q
A

cavitation
unilobar/multilobar
pleural effusion

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23
Q
A

sputum

pleural fluid

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24
Q
A

Strep pneumoniae

Legionella

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25
Q
A

immunocompromised patients

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26
Q
A

CURB-65 score

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27
Q
A

less than 90 systolic

less than 60 diastolic

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28
Q
A
confusion 
urea
Respiratory rate
BP
>=65yrs
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29
Q
A

abbreviated mental test score

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30
Q
A

> 7mmol/L

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31
Q
A

severe - ICU transfer

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32
Q
A

> = 30

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33
Q
A

less than 90

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34
Q

[pneumonia]: CURB-65: define ‘65’ +ve

A

> = age 65

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35
Q
A

Tx at home

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36
Q
A

Tx in hospital

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37
Q
A

severe - ICU

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38
Q
A

multilobular involvement

bilateral involvement

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39
Q
A

94%

8 kPa

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40
Q
A

Respiratory failure
pleural effusion
empyema
abscess

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41
Q
A
myocarditis
pericarditis
hypotension
septicaemia
Atrial fibrillation
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42
Q
A

jaundice

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43
Q
A

type 1

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44
Q
A

venous blood bypasses ventilated alveoli (e.g. right to left cardiac shunt)
under-ventilated alveoli

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45
Q
A

60% high-flow oxygen

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46
Q
A

PaCO2 levels

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47
Q
A

empyema

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48
Q
A

COPD

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49
Q
A

normally PaCO2 is major driving force behind respiratory drive
COPD hypoxia is a major drive for rr and pulmonary venous constriction
o2 therapy reduces hypoxia
therefore reduced respiratory drive
REDUCED HYPOXIC CONTROLLED VASOCONSTRICTION

VQ mismatch as increased blood flow to poorly ventilated areas
therefore increase in CO2

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50
Q
A

fluid challenge

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51
Q
A

250mL colloid over 15 mins

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52
Q
A

increase in cardiac output of 10-15%

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53
Q
A

pleural inflammation
fluid exudation
accumulates faster than reabsorbed

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54
Q
A

drainage

55
Q
A

empyema

56
Q
A
turbid
yellow
low glucose
high LDH
low pH
57
Q
A

chest drain

58
Q
A

localised suppurative infection

59
Q
A
aspirational
embolic (IE)
bronchial obstruction
pulmonary infarction
subphrenic/hepatic abscess
partially treated pneumonia
60
Q
A
foul smelling sputum
swinging fever 
haemoptysis
cough
pleuritic chest pain
61
Q
A
walled cavity 
fluid level (often)
62
Q
A

Abx - to sensitivity

surgical excision if failure above

63
Q
A

cholestatic

64
Q
A

sepsis

2ry to drugs

65
Q
A

flucloxacillin

co-amoxiclav

66
Q
A

AF

67
Q
A

usually resolves with pneumonia Tx

B-blockers

68
Q
A

at risk groups

69
Q
A

pregnancy
lactation
increased temperature

70
Q
A

Pneumovax 2 0.5mL SC

71
Q
A

immunosupressed
chronic organ failure
diabetes mellitus
>65 age

72
Q
A

at risk groups

73
Q
A

immunosupressed
chronic organ failure
diabetes mellitus
>65

74
Q
A

f

75
Q
A

Amoxicillin 500mg/8hrs
Clarithromycin 500mg/12hrs
Doxycycline 200mg load - 100mg dose

76
Q
A

Amoxicillin 500mg/8hrs
Clarithromycin 500mg/12hrs
Doxycycline 200mg load - 100mg dose

77
Q
A

Macrolide

78
Q
A

tetracycline

79
Q
A

Legionella
Chlamydia
Pneumocystis jiroveci

80
Q
A

mod/severe pneumonia with legionella/pneumococcal species suspected

81
Q
A

staphylococcus aureus

82
Q
A

staphylococcus aureus

83
Q
A

pseudomonas

84
Q
A

mycoplasma pneumoniae

85
Q
A

pseudomonas pneumoniae

86
Q
A

legionella pneumophilia

87
Q
A

Chlamydiophilia ptsittaci

88
Q
A

Pneumocystis jiroveci

89
Q
A

Pneumocystis jiroveci

90
Q
A

pneumocystis jiroveci

91
Q
A

pneumocystis jiroveci

92
Q
A

H5N1 (influenza strain–> death from pneumonia)

93
Q
A

contact with poultry

94
Q
A

contact with poultry

95
Q
A

cold sores

96
Q
A

cold sores

97
Q
A

history of COPD

history of hypercapnia

98
Q
A

5

99
Q
A

ABC assessment

100
Q
A

less than 88%

101
Q

[pneumonia]: Mx: what 2 assessments must you include in ‘C’ assessment

A

hypotension/shock (from infection)

Dehydration (IV support)

102
Q
A

Send off investigations

103
Q
A

if pyrexial

104
Q
A

analgesia (pleuritic chest pain)

105
Q
A

consider CPAP

106
Q
A

consider CPAP

107
Q
A

Co-amoxiclav 1.2g/8h IV
+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin

108
Q
A

Cefuroxime 1.5g/8hr IV
+
Clarithromycin 500mg/12hrs or Ciprofloxacin

109
Q
A

Co-amoxiclav 1.2g/8h IV
+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin

110
Q
A

Cefuroxime 1.5g/8hr IV
+
Clarithromycin 500mg/12hrs or Ciprofloxacin

111
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Flucloxacillin 
\+
Rifampicin
112
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Vancomycin or Teicoplanin
113
Q
A

Co-amoxiclav 1.2g/8h IV
+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin

114
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Vancomycin or Teicoplanin
115
Q
A
Amoxicillin 500mg/8hrs
or
Clarithromycin 500mg/12hrs
or
Doxycycline 200mg load 100mg dose
116
Q
A
Amoxicillin 500mg/8hrs
\+
Clarithromycin 500mg/12hrs
or
Doxycycline 200mg load 100mg dose
117
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Co-trimoxazole 120mg/kg/d
118
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
levofloxacin
\+
rifampicin
119
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Doxycycline
120
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Doxycycline
121
Q
A
gentamicin
\+
Ticarcillin (anti-pseudomonal) 
or
cephotaxime
122
Q
A

Paracetamol 1g/6hrs

analgesia: pleuritic chest pain

123
Q
A
gentamicin
\+
Ticarcillin (anti-pseudomonal) 
or
cephotaxime
124
Q

[pneumonia]: a ‘rusty’ sputum is classically seen with wha t organism

A

pneumococcus

125
Q
A

if O2 sats are less than 92%

Severe pneumonia

126
Q
A

after 6 weeks

127
Q
A

after 6 weeks

128
Q
A

asplenic patients

129
Q
A

asplenic patients

130
Q
A

Cephalosporin
+
Metronidazole

131
Q
A

infective endocarditis

132
Q
A
Co-amoxiclav 1.2g/8h IV 
\+
Clarithromycin 500mg/12hrs IVI or Ciprofloxacin
\+
Doxycycline
133
Q
A

infective endocarditis

134
Q
A

Oseltamivir