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Core Conditions third year > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Define pneumonia

A

It is an acute respiratory illness associated with segmental, lobar, or multi-lobar radiological shadowing (consolidation)

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2
Q

Classifications of pneumonia

A

Community acquired pneumonia (CAP)

Hospital acquired pneumonia (HAP)

Aspiration Pneumonia

Or pneumonia in an immunocompromised host

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3
Q

Symptoms of pneumonia

A

Fevers

Rigors

Malaise

Anorexia

Dysponea

Cough

Purulent Sputum

Pleuritic chest pain

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4
Q

Define Hospital acquired pneumonia (HAP)

A

It is when symptoms develop after 48 hours of hospital admission

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5
Q

What is the commonest cause of Community acquired pneumonia (CAP)

A

Streptococcus pneumoniae

Followed by:

haemophilus influenzae

mycoplasma pneumoniae

Most of the remainder are:

Staphylococcus aureus

Legionella species

Moraxella Catarrhalis

Chlamydia

Immunocompromised patients follow same pattern however can present with atypical pathogens

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6
Q

Is it possible that Community acquired pneumonia (CAP) be caused by viruses

A

Yes, they account for 15% of CAP

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7
Q

What is the commonest cause of Hospital acquired pneumonia (HAP)

A

Gram negative enterobacteria and staphylococcus aureus

Pseudomonas

Klebsiella

Clostridia

Bacteroides

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8
Q

When do aspiration pneumonia occur

A

Patients with stroke

myasthenia

bulbar palsies,

reduced consciousness (postictal/drunk)

Oesophageal causes (Achalasia/reflux)

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9
Q

Signs of pneumonia

A

Pyrexia

Cyanosis

Confusion

Tachyponea

Tachycardia

Hypotension

Reduced expansion

Dull percussion note

Increased tactile vocal fremitus/resonance

Bronchial breathing

Pleural rub

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10
Q

What is pleurisy

A

It is inflammation of the pleura

Commonest symptoms is sharp chest pain on deep inhalation

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11
Q

What is pleural rub

A

It is an audible sign of pleurisy, check youtube

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12
Q

How to investigate pneumonia

A

CXR

O2 sats

ABG

BP

Sputum sample

FBC

U&E

LFT

CRP

Blood cultures

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13
Q

What is empyema

A

It is accumulation of pus in the pleural cavity

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14
Q

What do you need to consider if your are investigating an immunocompromised patient with pneumonia

A

Aypical organisms

Bronchoscopy

Branchoaalveolar Lavage

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15
Q

What to investigate if there is a influenza epidemic

A

Throat/nasopharyngeal swabs

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16
Q

What tool you would use to assess severity of pneumonia and explain it to me

A

CURB-65

Confusion

Urea >7mmol

Respiratory rate >30/min

Blood pressure systolic <90 or diastolic <60

Age > or equal to 65

Score 1 point for each

If 0 or 1 most likely safe at home Rx

If 2 may be need admitting to hospital or Rx at home but supervised by hospital

If 3 or more admit to hospital and check if need to go to ICU especially if score of 4 or 5

17
Q

Complications of pneumonia

A

Pleural effusion

empyema

Lung abscess

respiratory failure

septicaemia

brain abscess?

pericarditis

Myocarditis

Cholestatic jaundice

18
Q

Prevention of pneumonia

A

Pneumococcal vaccine could be helpful

19
Q

How would you manage pneumonia

A

It depends on the presentation

If it is acute ill take a different course of action

but if it is moderate ill start with

Antibiotic therapy

IV fluids

Oxygen

Analgesia

Follow up

20
Q

Tell me about the antibiotic therapy for pneumonia

A

Oral if not severe

If severe IV

21
Q

Tell me about the O2 therapy for pneumonia

A

Try to keep sats 94% or over

22
Q

Tell me about analgesic therapy for pneumonia

A

Given if pleurisy or patient is in pain

23
Q

When do you want to follow up a patient with pneumonia

A

In 6 weeks

24
Q

When would you consider IV fluids for a patient with pneumonia

A

Like any other patients who require IV fluids

Dehydration

Anorexia

Shock

25
Q

Management of a pretttyyyy serious pneumonia

A

Go over ABCDE

Treat hypoxia with oxygen

Treat shock from infection

Investigate like normal pneumonia

Start Abx - sometimes even if cultures are not back

Analgesia for pleurisy

If no improvement consider - continuous positive airways pressure (CPAP) or intubation

Core Conditions third year (78 decks)

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