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Resp > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What is pneumonia

A

Inflammation of alveoli due to infection

It results in cellular exudate accumulation in the alveolar spaces

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2
Q

What types of pneumonia exist

A

Lobar

Broncho-

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3
Q

How do we classify pneumonia

A 
Source of infection:
HAP
CAP
Aspiration
In immunocompromised patients
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4
Q

What is pneumonitis

A

Inflammation of alveoli not due to an infection

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5
Q

Common causative organisms of CAP

A 
Strep pneumoniae 
Haemophilus influenzae 
Moraxella catarrhalis 
Staph aureus 
Klebsiella pneumoniae
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6
Q

Atypical causative organisms of CAP

A

Mycoplasma pneumoniae
Legionella pneumophila
Chlamydia pneumoniae

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7
Q

Atypical manifestations of pneumonia

A 
Autoimmune haemolysis
Rash
Hyponatraemia
Hepatitis 
Arthralgia
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8
Q

Treatment for strep pneumoniae infection

A

Amoxicillin or benzylpenicillin

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9
Q

Treatment for mild to moderate CAP

A

Amoxicillin or doxycycline

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10
Q

Treatment for severe CAP

A

Co-amoxiclav and doxycycline

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11
Q

When is HAP more likely

A

Comorbidities
Ventilator use
Previous antibiotics

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12
Q

Causative organisms of HAP

A 
Staph aureus 
Enterobacteriaciae 
Pseudomonas aurigonosa 
Haemophilis influenzae
Candida albicans
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13
Q

Treatment for HAP

A

First line - Co-amoxiclav

Second line - pipperacillin, tazobactam or meropenem

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14
Q

What is aspiration pneumonia

A

Aspiration of contaminated exogenous or endogenous material

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15
Q

When is aspiration pneumonia more likely

A

Impaired consciousness

Oropharyngeal dysphasia

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16
Q

Causative organisms of aspiration pneumonia

A

Oral flora e.g viridans strep

Anaerobes

17
Q

Treatment of aspiration pneumonia

A

Co-amoxiclav

18
Q

What are the causative organisms of pneumonia in immunocompromised patients

A

HIV - pneumocystis jivoreci
Neutropenia - aspergillus
Bone marrow transplant - CMV
Splenectomy - encapsulated bacteria e.g strep pneumoniae and haemophilus influenzae

19
Q

Causative organisms of viral pneumonia

A

Influenza
Parainfluenza
Respiratory syncytial virus
Adenovirus

20
Q

Complications of viral pneumonia

A

Necrosis and haemorrhage into lung parenchyma

21
Q

CXR of viral pneumonia

A

Ground glass opacity

22
Q

Symptoms of pneumonia

A 
Fever
Malaise
Cough productive of sputum
Pleuritic chest pain
Dyspnoea
23
Q

Findings on examination in pneumonia

A 
Pyrexia 
Tachypnoea
Tachycardia
Hypotension 
Cyanosis 
Bronchial breathing 
Crackles
24
Q

Investigations in pneumonia

A 
FBC
CRP
Gram stain suitable sample
Us and Es
ABGA
CXR
25
Q

Examples of samples for analysis in pneumonia

A 
Sputum
Blood
Bronchoalveolar lavage fluid 
Nose/throat swab
Lung biopsy 
Urine (legionella) 
Serum (virus)
26
Q

What is a severe CURB-65 score and what is the significance

A

At least 2

Needs hospital admission

27
Q

What is the CURB-65 score

A 
New mental confusion
Urea >7mmol/L
Resp rate >30
Blood pressure <90 systolic or <60 diastolic 
>65 years old
28
Q

What factors indicate a poor prognosis

A 
High CURB-65 score
Elderly
Very high or very low WBC count 
No fever
Significant hypoxia
Significant blood urea
29
Q

General management of pneumonia patients

A 
Antipyretics
Hydration
Analgesics
IV fluids 
O2 therapy if cyanosis (and has good respiratory drive)
30
Q

Complications of pneumonia

A

Lung abscess
Empyema
Bronchiactasis
Pleural effusion

31
Q

What might have occurred if treatment makes no improvement

A 
Empyema
Obstruction
Resistant pathogen
Antibiotics not absorbed
Immunosuppressed 
Wrong diagnosis (lung cancer?)
32
Q

Prevention of pneumonia

A

Flu vaccine every year and Pneumococcal vaccine every 5 years for high risk patients
Penicillin or erythromycin prophylaxis
Smoking advice

Resp (15 decks)

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