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118 Pneumonia > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Why are lungs susceptible to infection?

A

they are deliberately permeable.
very large surface area
10-20,000 Litres of air per day.

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2
Q

Symptoms of typical pneumonia

A

Sudden onset
Fever
Purulent sputum
Focal consolidation

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3
Q

Symptoms of atypical pneumonia

A

Gradual onset
Dry cough
Myalgia
Headache.

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4
Q

If the pneumonia is G-, where is it most likely to have come from?

A

GIT

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5
Q

What is the most common pathogen that causes pneumonia?

A

Streptococcus pneumoniae

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6
Q

Abrupt onset
Very ill
One lobe affected only (although not exclusively)

A

Strep pneumoniae

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7
Q

BRONCHIOPNEUMONIA
causing pneumonia in lungs
URTI
Small effusions

A

Haemophilus influenza

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8
Q

SKIN INFECTION
BEEN IN HOSPITAL
Spread of bacteria through blood - e.g. endocarditis
Abscesses common

A

Staph aureus -
spreads through skin to blood
G+

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9
Q

HEAMOPTISIS
G-
GIT history
very ill

A

Klebsiella

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10
Q

G-
CHRONICALLY ILL
Lowe lobes

A

E-coli

aspiration often into R lung due to shorter, straighter)

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11
Q

Gradual onset
lung disease
COPIOUS GREEN SPUTUM

A

Pseudomonas aeriginosa

This is never really eradicated, just managed.
Penicillin does not touch it!

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12
Q

WATER/AIR CON

IMMUNOCOMPRAMISED

A

Legionella pneumophilia

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13
Q

BIRDS
fever
myalgia

A

Chlamydia psittacci

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14
Q

FOREIGN TRAVEL

CAVITATION

A

Mycobacterium tuberculosis

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15
Q

FUNGAL SPORES

immunocompromised

A

Aspergillus or
Cryptococcus

both fungal.

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16
Q

IMMUNOSUPPRESSED
AIDS/HIV
CANCER

A

Pneumocystis carinii pneumonia

PCP

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17
Q

What must be done after diagnosing TB pneumonia?

A

Isolate patient
contact trace
Notify

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18
Q

Closed community
YOUNG - TEENS/20’S
CYCLES OF 3-4 YEARS

A

Mycoplasma pneumoinae

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19
Q

Symptoms of pneumonia

A 
Fever
Rigors
Dyspnoea
Cough
Purulent sputum
Pleuritic pain
Heamoptysis
20
Q

Signs of pneumonia

A 
Pyrexia
Cyanosis
Confusion
Tachypnoea
Tachycardia
Diminished expansion
21
Q

What percussion and auscultation signs would be found with pneumonia?

A

Dull percussion
Increased tactile vocal fremitis (over consolidation)
Increased vocal resonance
Bronchial breathing

22
Q

Tests for suspected pneumonia

A 
assess severity (CURB65)
identify pathogen
CXR
SATS
FBC, U&E, LFT, CRP.
23
Q

How is the severity of pneumonia assessed?

A

CURB65 (1 point for each)

CONFUSION - Mini mental state less than 8
UREA - more than 7mmol/l
RESP RATE - over 30
BP - less than 90 systolic
65+ years old
24
Q

What do the CURB65 scores mean?

A

0-1 - home
2 - hospitalise
3 - severe pneumonia

25
Q

What is the most common cause of pharyngitis?

A

Strep A

26
Q

What is the most common cause of Epiglottitis?

A

H influenza B

27
Q

What is EBV?

A

Epstein-Barr Virus

90% of people will at some point be infected, causing URTI.

28
Q

What are the symptoms of epiglottitis?

A

Drooling
Dysphagia
Dysphonia
Stridor

29
Q

What is the initial management for epiglottitis?

A

Medical emergency
Secure airway
IV cefuroxime (cephalosporin)

30
Q

Pneumonia with recent travel to a shit country (e.g. Afghanistan)

A

TB

31
Q

Pneumonia with recent travel to the Med

A

Legionella

32
Q

Pneumonia with recent travel to SE Asia/Australia

A

Pseudomonas

33
Q

What sign would be apparent if the lung had collapsed due to pneumonia (but no air has entered)?

A

CXR white out.

34
Q

e.gs of antibiotics used for pneumonias caused by aspiration

A

Think G- from GIT

IV
cefuroxime
metronidazole

35
Q

What is the management plan for pneumonia wrt antibiotics?

A

Sputum present? send for culture and start on dos appropriate antibiotic until results come back.

No sputum to send? Start on most appropriate antibiotics, if not working - bronchoscopy brushings - culture, tailor antibiotics.

36
Q

antibiotics for mild pneumonia

A

oral amoxycillin or

clarithromycin

37
Q

Antibiotics for moderate pneumonia

A

oral amoxycillin or

clarithromycin

38
Q

Antibiotics for severe pneumonia

A 
IV
co-amoxiclav OR
cefuroxime
AND 
clarithromycin

?Staph suspect
Flucloxacillin
rifampicin

39
Q

Treatment for TB

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

all antibiotics….for 6 months

40
Q

What is the Bohr effect?

A 
Increased PCO2
Increased blood acidity
more stable haem groups
O2 dissociation curve shifts R
It is easier for o2 to dissociate and get to tissue
41
Q

What shifts the O2 dissociation curve to the R?

A

Bohr effect (CO2)
BPG
Temperature increase

42
Q

How does BPG affect the O2 dissociation curve?

A

Bisphosphoglycerate is required to maintain a normal curve; it shifts the curve to the R. In prolonged hypoxic conditions, more BPG is produced.

43
Q

What is the Haldane effect?

A

haemoglobin becomes acidic when is is oxygenated.
The less O2 in the blood, the less acidic the blood is, allowing for more CO2 to dissolve into the blood.
ie, when O2 is being rapidly depleted in exercise, the excess CO2 being produced is more easily removed.

44
Q

In what form is CO2 mostly carried in the blood?

A

90% as HCO3

45
Q

Due to the ventilation perfusion ratio, where on the O2 dissociation curve do the apices and lower lungs fall?

A

Apices have more O2:blood therefore near the top of the dissociation curve.
Lower lobes have lower O2:blood therefore only halfway up the curve.

118 Pneumonia (1 decks)

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