Pneumonia Flashcards
Common upper respiratory tract conditions
Coryza, pharyngitis, sinusitis, epiglottis
Common lower respiratory tract conditions
Acute bronchitis, acute exacerbations of chronic bronchitis, pneumonia, influenza
What is Coryza
Common cold, acute inflammation of mucous membranes lining nasal cavity. Causes a runny nose, nasal congestion, often sore throat with fever. Viral cause such as Adenovirus, Rhinovirus, Respiratory Syncytial virus
What is acute sinusitis
Acute infection or inflammation of membranes that line your sinuses preventing mucus drainage from nose. Preceded by common cold. Resolves in 10 days on its own, rarely requires antibiotics
What is Quinsy
Potentially serious complication of tonsillitis. Abscess forms between tonsils and wall of throat. This is due to bacterial spread from infected tonsil to surrounding area
What is Diptheria
Infection caused by Corynebacterium diptheriae. Toxin are produced which may be life threatening. Symptoms are sore throat, fever, characteristic barking cough and pseudomembrane formation which may block airway
What is acute epiglottitis
Inflammation of epiglottis and tissues around that may lead to blockage of airway and impairing breathing process
What is also known as chest cold
Acute bronchitis - Inflammation of bronchi
Chest examination and x-ray of acute bronchitis
Normal. Is usually self limiting and antibiotics aren’t indication. Can lead to morbidity in patients with COPD
What is acopia
Inability to cope with activites of daily living
When should COPD patients be referred to hospital
If there’s evidence of respiratory failure or not coping at home
What is red hepatisation
Consolidation due to pneumonia causing resemblance to live tissue rather than lung
What are rigors
Sudden feeling of cold with shivering accompanied by a rise in temperature often with sweating
Signs of pneumoniae
Fever, rigors, herpes labialis, tachypnoea, crackles, pleural rub, cyanosis, hypotension
Investigating pneumoniae
Blood culture, serology, arterial gases, full blood count, urea, liver function test, chest x-ray
What can be used to assess pneumoniae severity
CURB65
How does CURB 65 work
C - New onset of confusion
U - Urea > 7
R - Respiratory rate > 30 / min
B - Blooc pressure systolic < 90 or diastolic < 61
65 - More than 65 years of age
1 points fore each
Increase in CURB65 score increases mortality
What factor in CURB 65 rarely makes difference to management
Urea
Markers for pneumoniae severity other than CURB65
Temperature < 35 or > 40
Cyanosis, PaO2 < 8 kPa
WBC < 4 or > 30
Multi lobar involvement
Most common cause of pneumoniae (community and hospital)
Streptococcus pneumoniae
2nd most common for community acquired pneumoniae is Haemophilus influenzae and for hospital acquired is Mycoplasma pneumoniae
Adult smoker presents with pneumoniae and chicken pox in primary care setting. Next step?
Admit to hospital as varicella pneumoniae can be fatal
Bird keepers are bound to get what type of pneumoniae
Psittacosis - Known as parrot fever or ornithosis. Caused by bacteria known as Chlamydia psittaci. Contracted from birds such as parrots, macaws, pigeons, sparrows, ducks, hens etc
Management of community acquired pneumoniae
Antibiotics, oxygen, fluids, bed rest, no smoking
Complications of Pneumoniae
Respiratory failure, pleural effusion, empyema and death
Extra steps in hospital acquired pneumoniae
Extended gram negative cover
Extra steps in aspiration pneumonia
Anaerobic cover
How can pneumonia be prevented
Giving an influenza and pneumococcal vaccine to -
> 65, immunocompromised, diabetics, chronic chest or cardiac disease, health care workers
Clinical presentation of influenza
Fever - High, abrupt onset Malaise Myalgia Headache Cough Prostration - Extremely unwel
Haemophilus influenzae and influenza
Not the primary cause of influenza but was believed to be. May be a secondary invader. Common cause is influenza A and B virus
How in influenza transmitted
Droplets or direct contact with secretions of someone with infections
Complications of flu
Primary influenzal pneumonia, secondary bacterial pneumonia, bronchitis, otitis media