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Respiratory > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Top 3 commonest pathogens causing CAP

A

1) strep pneumoniae
2) haemophilus influenzae
3) mycoplasma pneumoniae

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2
Q

Other common CAP pathogens x4

A

Staph aureus
Chlamydia
Legionella
Moraxella catarrhalis

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3
Q

What is HAP

A

Pneumonia acquired > 48hours after admission to hospital

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4
Q

Common HAP pathogens x2

A

Staph a or gram negative enterobacteria (salmonella, e.coli, shigella, y.pestis, klebsiella)

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5
Q

Other HAP pathogens

A

Pseudomonas
Bacteriodes
Clostridia

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6
Q

Symptoms of pneumonia

A

Fever, malaise, rigours, anorexia
Dyspnoea, cough, purulent (yellow/green/rust) sputum
Haemoptysis
Pleuritic pain

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7
Q

Signs of pneumonia

A 
Pyrexia 
Cyanosis 
Confusion
Tachycardia and tachypnoea
Hypotension
Reduced expansion
dull percussion
Bronchial breathing
Increased tactile vocal fremitus 
Pleural rub 
Coarse creps
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8
Q

Severity score for pneumonia

A 
CURB 65 
Confusion (amts) 
Urea - serum - >7mmol/L
Resp rate >30
Blood pressure systolic below 90 or diastolic below 60 
Age over 65
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9
Q

Consequences of curb 65 score

A

0-1 - go home for treatment
2 - hospital therapy
>/= 3 - severe - may need ITU

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10
Q

General non-antibiotic management of Pneumonia

A

Fluids
VTE prophylaxis
Analgesia

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11
Q

Antibiotic management of mild CAP pneumonia (not previously treated)
(What are pathogens)

A

Strep p and haem.i

Amoxicillin
Or
Clarithromycin
Or doxi

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12
Q

Treatment of moderate CAP pneumonia and pathogens

A

Strep p, haem.i, mycoplasma.pn

Amoxicillin + clarithromycin
Or doxi

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13
Q

Treatment of severe CAP by the top 3 pathogens

A

Co-amoxiclav (augmentin)
Or cephalosporin
AND clarithromycin

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14
Q

Antibiotic if staph a

A

Flucoxacillin + rifampicin

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15
Q

Antibiotic if MRSA

A

Vancomycin

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16
Q

Legionella antibiotic

A

Fluoroquinolone

With clarithromycin or rifampicin if severe

17
Q

Chlamydia antibiotic

A

Doxycycline

18
Q

Pnemocystis jiroveci

A

Co-trimoxazole

19
Q

HAP treatment

A

Gentamicin
Penicillin
Cephalosporin

20
Q

Aspiration pneumonia treatment

A

Cephalosporin + metronidazole

21
Q

Which pneumonia pathogen do you herpes labialis with?

A

Strep pneumoniae

22
Q

What does klebsiella pneumonia cause?

A

Upper lobe cavitating pneumonia

23
Q

How does mycoplasma pneumoniae occur?

A

In epidemics every 4years
Flu like symptoms (myalgia, arthralgia and headache)
Followed by dry cough
Shadowing or patchy consolidation of lower lobe (usually one)

24
Q

How does chlamydia pneumoniae present?

A

Biphasal
Pharyngitis, hoarseness, otitis
Followed by pneumonia

25
Q

Who in and how does pneumocystis pneumonia present?

A

In immunocompromised patient

Dry cough, exertional dyspnoea, fever
Bilateral creps
Bilateral perihilar shadowing

26
Q

What is SARS?

A

Severe acute respiratory distress syndrome caused by SARS virus

27
Q

How does SARS present?

A 
Fever, chills, rigours
Myalgia
Dry cough and dyspnoea 
Headache
Diarrhoea
28
Q

Tests in SARS

A

Decreased WCC and abnormal CXR

29
Q

Major complication of SARS

A

Respiratory failure

30
Q

Management of SARS

A

Supportive
No druc dg been shown to be effective
Early isolation

31
Q

Main complications of pneumonia x9

A 
Respiratory failure
Hypotension
AF
Pleural effusion
Abscess
Empyema
Septicaemia 
Jaundice
Pericarditis and myocarditis
32
Q

Why does hypotension occur as a complication of pneumonia?

Management

A

Dehydration and vasodilation due to sepsis

Give fluid challenge if systolic

33
Q

Presence of AF with pneumonia

A

Common especially in elderly
Usually resolves with pneumonia
May need to give beta blocker or digoxin to slow ventricular contraction in mean time

34
Q

What is empyema, presentation and management

A

Infected pleural effusion meaning pus in pleural space
Resolving pneumonia but recurrent fever
Drain (yellow fluid)

35
Q

Lung abcess in pneumonia, presentation and treatment

A

Cavitating area of localised suppurative infection
Swinging fever, cough with purulent foul smelling sputum, chest pain, haemoptysis and malaise and weight loss

Antibiotics and postural drainage, aspiration

36
Q

Incidence of pneumonia

A

5-11/1000 - higher in elderly and very young

37
Q

When do you give pneumococcal vaccine

A

Over 65
Diabetes
Chronic renal, liver, heart or lung disease
Immunosuppression

Respiratory (7 decks)

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