Pneumonia Flashcards
What is pneumonia?
A lower respiratory tract infection
How does Pneumonia present?
Focal chest symptoms and new shadowing on CXR
Symptoms of Pneumonia?
Fever Malaise Productive Cough Anorexia Sweating Dyspnoea Rigors
Describe expansion in Pneumonia?
Diminished
Describe percussion in pneumonia?
Dull
Describe resonance in pneumonia?
Increased
Describe the CXR
New shadowing
Describe the breathing?
Bronchial Breathing (Due to consolidation)
Investigations of Pneumonia?
FBC CXR ABGs Urea Sputum/Blood Cultures/Bronchial Lavage
Results of Investigations?
CXR = New Shadowing FBC = High WCC ABGs = Type1/Type2 Respiratory Failure Urea = Look for legionella Blood Culture/Sputum/Bronchial Lavage = Identify causative agents
Complications of pneumonia?
Respiratory Failure
Empyema
Pleural Effusion
Death
How is Community Acquired Pneumonia assesed?
CURB 65
What does CURB 65 stand for?
C = Confusion (New Onset) U = Urea > 7 R = Respiratory Rate > 30 B = Blood Pressure
Most common organism in Community Acquired Pneumonia?
Streptococcus Pneumonia
Most common pneumonia causing agent in the young?
Mycoplasma Pneumonia
Most common pneumonia causing agent in the old?
Streptococcus Pneumonia
Most common pneumonia causing agent in bird owners?
Chlamydia Psittaci
Most common pneumonia causing agent in Sheep Workers?
Coxiella Burnetti
Most common pneumonia causing agent that causes red jelly sputum?
Klebsiella Pneumoniae
Most common pneumonia causing agent that causes rusty sputum?
Pneumococcal Pneumonia?
Most common pneumonia causing agents that causes COPD exacerbation?
Streptococcus Pneumonia
Haemophilus Influenzae
Most common pneumonia causing agents in travellers?
Legionella Pneumophila
Treatment in Mild Community Acquired Pneumonia? (0-2)
Amoxicillin IV
Treatment in Mild Community Acquired Pneumonia (0-2) if pencillin allergy?
Doxycycline OR Clarithromycin
Treatment in Severe Community Acquired Pneumonia (2+)
Co-amoxiclav + Clarithromycin OR Doxycycline
Treatment in Severe Community Acquired Pneumonia if Pencillin allergic?
Levofloxacin
Describe the risk factors for hospital acquired Pneumonia?
Malnutrition Age Chronic Disease Immunosuppression Mechanical Ventilation
Early onset organisms of hospital acquired pneumonia? (less than 4 days)
Streptococcus Pneumoniae
Haemophilus Influenza
Staph Aureus
Late onset organisms of hospital acquired pneumonia? (more than 4 days)
Streptoccous Pneumoniae
Haemophilus Influenza
Staph Aureus
Klebsiella Pneumoniae
Treatment for non severe Hospital Acquired Pneumonia?
Amoxicillin + Metronidazole
Treatment for severe Hospital Acquired Pneumonia?
Amoxiciilin + Metronidazole + Gentamicin
Treatment for Severe Hospital Acquired Pneumonia if penicillin allergic?
Co-trimoxazole + Metronidazole + Gentamicin
Different between non severe and severe hospital acquired pneumonia treatment?
Gentamicin is given in severe
Difference between severe and severe + penicillin allergy hospital acquired pneumonia?
Amoxiciilin in normal
Co-trimoxazole in penicillin allergy
Patient comes in with mild community acquired pneumonia… Treatment?
Amoxicilin
Patient comes in with mild community acquired pneumonia and they are penicllin allergic.. Treatment?
Doxycycline
Patient comes in with severe community acquired pneumonia… Treatment?
Co-Amoxiclav + Clarithromycin or Doxycycline
Patient comes in with severe community acquired pneumonia and pencillin allergy.. Treatment?
Levofloxacin
Patient with mild hospital acquired pneumonia… Treatment?
Amoxicillin and Mentronidazole
Patient with severe hospital acquired pneumonia… Treatment?
Amoxicillin + Metronidazole + Gentamicin
Patient with hospital acquired pneumonia and pencillin allergy… Treatment?
Same as normal except replace Amoxicillin with Co-trimoxazole
