Pneumonia Flashcards
What does CURB 65 stand for?
C - onset of confusion U - Urea >7 R - Respiratory rate >30 B - Systolic BP 65 - over this age
What is the commonest cause of community acquired pneumonia?
Streptococcus pneumonia
pneumococcus
How does streptococcus pneumonia present?
Fever, pleurisy and herpes labialis
Which organism is associated with pneumonia following influenza?
Stapholococcus aureus
Which organism is commonest in patients who have COPD?
Haemophilus influenzae
Who is most likely to get staphylococcal pneumonia?
Elderly, IV drug users or patients with an underlying disease
What is the commonest cause of pneumonia in alcoholics?
Klebsiella pneumonia
Which is commonest in those with bronchiectasis and CF?
Pseudemonas
Which pneumonia generally has epidemics about every four years?
Mycoplasma pneumonia
What are the symptoms of mycoplasma pneumonia?
Flu like symptoms and a dry cough
What are the complications of mycoplasma pneumonia?
Guillian-Barre syndrome
Where is legionella pneumonia colonised?
Water tanks typically
What are the clinic features of legionella pneumonia?
Flu like symptoms, deranged LFTs and haematuria
Which pneumonia usually follows a hoarseness of voice?
Chlamoydophila pneumonia
How is chlamydophilia pneumonia spread?
Person to person
Which is commonly associated with birds?
Chlamydophila psittaci
What would a CXR show in chlamoydophila psittaci?
Patchy consolidation
How would chlamoydophila psittaci present clinically?
Headache, fever, dry cough and lethargy
Which is commonest in those who are immunosuppressed e.g. have HIV?
Pneumocystic pneumonia
How is pneumocystis pneumonia diagnosed?
Bronchioalveolar lavage or lung biopsy
What is the treatment for pneumococcal pneumonia?
Amoxicillin (Cephalosporin if penicillin allergic)
What is the treatment for staphlococcal pneumonia?
Flucloxacillin +/- Rifampacin
If MRSA, what should be used?
Vancomycin
What is the treatment for Klebsiella?
Cefotaxime
What is the treatment for pseudomonas pneumonia?
Ceftazidine/meropenem/ciprofloaxin + aminoglycoside
what is the treatment for mycoplasma pneumonia?
Clarythromycin or doxycycline
What is the treatment for legionella pneumophillia?
Fluoroquinolone for 2/3 weeks
What is the treatment for chlamoydophila pneumonia?
Doxycycline or clarythromycin
what is the treatment for chlamoydophila psittaci?
Doxycycline or clarythromycin
What is the treatment for pneumocystis pneumonia?
High dose co-trimoxazole + steroids
What is the treatment for mild/moderate CAP?
Oral/IV amoxicillin
What is the treatment for sever CAP?
Co-amoxiclav + clarythromycin
What is the treatment for mild/moderate HAP?
Amoxicillin + metronidazole
What is the treatment for severe HAP?
Amoxicillin + metronidazole + gentamicin
Investigations for pneumonia
Blood culture Serology ABGs FBCs Urea Liver function CXR
What are the 3 classifications of pneumonia
Clinical setting
Organism
Morphology - lobar etc.
What is the most common cause of lobar pneumonia?
Streptococcus pneumonia
Which two cells infiltrate in pneumonia?
Neutrophils and macrophages
Define bronchopneumonia
Infection starting in the airways and spreading to adjacent alveolar lung
Patients with which conditions most often present with bronchopneumonia
COPD
Cardiac failure
Those who have had a viral infection
Those who aspirate gastric contents
Main organisms in bronchopneumonia
Strep.
H. Influenza
Staph anaerobes
What is usually the cause of bronchiectasis
Fibrous scarring following infection
