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Respiratory Medicine > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What are the 3 commonest causative bacterial organisms for community acquired pneumonia?

A

1st: Streptococcus pneumoniae
2nd: Haemophilus influenzae
3rd: Mycoplasma pneumoniae

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2
Q

What percentage of pneumonias are caused by viruses and what virus is most commonly responsible?

A

13-15%, influenza virus

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3
Q

What features might you see on a CXR for a community acquired influenza pneumonia complicated by staphylococcal infection, for example in an IV drug user?

A

Bilateral cavitating bronchopneumonia (where normal lung architecture is replaced with a cavity)

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4
Q

What organism most commonly causes hospital acquired pneumonia?

A

Gram negative enterobacteria or Staph Aureus

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5
Q

What rare causative organism of hospital acquired pneumonia causes cavitating pneumonia of the upper lobes?

A

Klebsiella pneumoniae

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6
Q

Give 6 conditions that increase an individuals risk of contracting aspiration pneumonia by aspirating oropharyngeal anaerobes

A 
Stroke
Myasthenia graves
Poor dental hygiene 
Bulbar palsy
Lower consciousness 
Oesophageal disease
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7
Q

Give 7 common clinical symptoms of pneumonia

A 
Any 7 from:
Fever
Rigors 
Malaise
Breathlessness
Pleuritic chest pain
Productive cough with purulent sputum
Anorexia
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8
Q

What common sign may be the only sign of a pneumonia in the elderly?

A

Confusion

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9
Q

Give 4 signs of consolidation you would find on examination

A

Reduced expansion
Dull percussion note
Bronchial breathing
Increased vocal resonance/fremitus

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10
Q

Give the indications for performing an pneumonia

A

Oxygen sats lower than 92%

Severe pneumonia

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11
Q

Why is urine tested in suspected pneumonia?

A

Pneumococcal antigen is detectable in urine

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12
Q

Describe the CURB65 score for assessing pneumonia severity

A 
Confusion = 1 point
Urea > 12 = 1 point
Respiratory rate > 30 = 1 point
Blood pressure <90/60 = 1 point
Age >65 = 1 point
Home based care for score 0
Consider admission for score 1+
IV antibiotics for score 3+
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13
Q

Give 2 atypical organisms that require different antibiotics to treat pneumonia

A

Legionella pneumophilia

Mycoplasma pneumoniae

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14
Q

If IV antibiotics are indicated, what is usually given?

A

Co-amoxiclav

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15
Q

What oral antibiotics are typically given for typical pneumonia?

A

Amoxicillin or clarithromycin (for atypical)

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16
Q

What dose of oral amoxicillin is given for community acquired pneumonia?

A

500mg to 1 gram/8hours

17
Q

In severe pneumonia, if Staphylococcus infection is suspected, what antibiotics should be added?

A

Flucloxacillin

18
Q

In severe community acquired pneumonia, if MRSA infection is suspected, which antibiotic should be added?

A

Vancomycin

19
Q

If legionella is suspected in community acquired pneumonia, what antibiotic should be considered?

A

Rifampicin

20
Q

If chlamydia infection is suspected for the cause of pneumonia, what antibiotic should be added?

A

Tetracycline

21
Q

If pneumocystis Jiroveci is suspected in community acquired pneumonia, what antibiotic should be added?

A

Co-trimoxazole

22
Q

In hospital acquired pneumonia with a gram negative bacilli causing it, what antibiotics should be used and by what route?

A

Aminoglycosides e.g. Streptomycin or gentamicin

IV route

23
Q

If pseudomonas is suspected in hospital acquired pneumonia what antibiotic should be given?

A

Antipseudomonal penicillin IV, or 3rd generation cephalosporin e.g. Cefotaxime

24
Q

Give 10 complications of pneumonia

2 respiratory, 4 infective, 3 cardiovascular, 1 liver

A 
Pleural effusion
Empyema
Lung abscess
Brain abscess
Respiratory failure type 1
Septicaemia
Pericarditis
Myocarditis
Atrial fibrillation
Cholestatic jaundice
25
Q

Give 4 causes of a lung abscess

A

Untreated pneumonia
Foreign body obstruction (tumour, foreign body)
Aspiration
Septic emboli (endocarditis, IV drug use)

26
Q

Give the common symptoms of a lung abscess

A 
Swinging fever
Pleuritic chest pain
Productive cough with purulent sputum
Haemoptysis
Weight loss
27
Q

Give the common signs of a lung abscess

A

Finger clubbing
Anaemia
Crepitations
Empyema in 20-30%

28
Q

What might you find on a Chest X-ray for a lung abscess?

A

Walled cavity often with a fluid level

29
Q

Besides a CXR, what diagnostic tests can confirm a lung abscess?

A

CT will exclude obstruction

Bronchoscopy will produce diagnostic specimens

30
Q

Atrial fibrillation is one complication of pneumonia especially in the elderly. It usually recovers with treatment of the pneumonia. If it wins troublesome in the short term how can it be treated?

A

Digoxin or a beta blocker

31
Q

What condition can a chronic or recurring pneumonia lead to?

A

Bronchiectasis

Respiratory Medicine (1 decks)

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