Pneumonia Flashcards
1
Q
What is pneumonia?
A
infection of the gas exchanging regions of the lung
2
Q
Signs of pneumonia
A
- acute illness usually with fever, cough and purulent sputum
- associated with new alveolar changes on a CXR
- new signs of consolidation on auscultation
3
Q
Classifications of pneumonia
A
- community acquired pneumonia
- hospital acquired pneumonia
- pneumonia in the immunocompromised host
- aspiration pneumonia
- pneumonia unique to particular geographical locations
4
Q
What is the pathogenesis of pneumonia?
A
- most pneumonia is caused by Oro/nasopharynx and then colonisation before spreading to the lungs and causing pneumonia
- but some very important pathogens transmitted by droplet spread (e.g. flu, TB, legionella pneumophilia)
- very small proportion of cases from haematogenous spread
5
Q
4 organisms that cause pneumonia
A
- strep (cause 70-90% of CAP cases)
- legionella (small proportion of CAP but will kill
high fevers, chills, cough, chest pain
infected water cooling system
causes Pontiac fever (mimics exams) - staph
-influenza (especially during flu seasons)
6
Q
symptoms of CAP
A
- preceding URTI common
- cough
- breathlessness
- pleuritic pain
- new sputum production
- haemoptysis
- extra pulmonary symptoms (confusion, abdo pain, GI upset, myalgia, headache)
7
Q
signs of CAP
A
- fever, rigors, tachycardia, hypotension, tachypnoea
- crackles, reduced expansion, bronchial breathing, pleural rub
- confusion and abdo tenderness
- abscess/pleural effusion/emphysema
8
Q
What is CURB 65?
A
- confusion (MST<8)
- urea>7
- RR>30
- SBP<90 or DBP<60
- age>65
score 0-1: low severity
score 2: moderate severity
score 3-5: high severity
9
Q
Management of pneumonia
A
- no CURB factors - manage at home
- > 2 CURB factors - manage in hospital
- low severity: oral amoxycillin 5000mg
- moderate severity: oral amoxycillin and clarithromycin
- high severity: IV co-amoxiclav and clarithromycin
