Pneumonia Flashcards
What is the definition of pneumonia?
- Inflammation of lung tissue accompanied with swelling and filling up of alveoli with inflammatory cells
What is the differential diagnosis for pneumonia?
- Lung cancer
- PE
- Cardiac failure
- Pulmonary vasculitis (Wegner’s granulomatosis)
How is pneumonia classified?
- Anatomically
- Aetiologically
- Microbiologically
What patterns are shown by bronchopneumonia?
- Bilateral basal patchy opacification
- Focal nature of consolidation
What patterns are shown by lobar pneumonia?
- One lobe affected
What can cause aspiration pneumonia?
- Vomiting
- Oesophageal lesion
- Neuromuscular disorders (dysphagia)
- Sedation
What are the symptoms of pneumonia?
- Malaise
- Fever
- Chest pain (pleuritic)
- Cough
- Rusty sputum
- Dyspnoea
What are the clinical sugns of pneumonia?
- Tachycardia
- Pyrexia
- Tachypnoea
- Central cyanosis
- Dullness on percussion of site
- Bronchial breath sounds across consolidated areas
- Inspiratory crackles
- Reduced expansion when unilateral pneumonia of one side
What causes pneumonia?
- Infection of a microorganism
What investigations should be done for pneumonia?
- Serum biochemistry
- FBC
- Throat swab
- Sputum microscopy and culture
- ESR (erythrocyte sedimentation rate) /CRP
- Urinary legionella antigen
- Pneumoccocal urinary antigen
- CXR
What is the CURB score?
- Assesses risk of death from pneumonia
- 0 - 5
- 5 being highest chance
What treatment is followed for pneumonia of CURB 0 - 1?
- Amoxycillin/clarithromycin/doxycycline
What treatment is followed for a CURB score of 2?
- Amoxycillin/clarithromycin/levofloxacin
What treatment is followed for a CURB score of 3-5?
- Co amoxiclav + clarithromycin/levofloxacin
What classes of antibiotics are used to treat pneumonia?
- Beta lactams
- Macrolides
What clinical treatments should be performed alongside antibiotic treatments?
- Oxygen
- IV fluids
- Continuous positive air pressure (CPAP)
- Intubation if serious risk of death
- Analgesia
- Antypyrectics
What procedures can be performed to get diagnosis of the microbe involved?
- Bronchoscopy
- Biopsy
What are the 4 most common bacterium that cause pneumonia?
- Strep pneumoniae
- Haemophilius influenzae
- Chlamydia psittachi
- Mycoplasma pneumoniae
What are common complications of pneumonia?
- Septicaemia
- Lung abcess
- Haemolytic anaemia
- ARDS
- Pleurisy
- Pleural effusion
- EMPYEMA THORACIS
- Bronchiectasis
What is empyema thoracis?
- Spread of infection into pleura causing severe chest pain and malaise
