Pneumonia Flashcards
What is the definition of pneumonia?
An acute lower respiratory tract infection associated with recently developed radiological signs
What is community acquired pneumonia?
It is picked up from home, rather than in a hospital
What is pneumonia?
An infection that inflames the alveoli
They may fill with fluid or purulent material (pus)
What is a pulmonary consolidation and how does it appear on a chest X-ray?
a region of lung tissue that has filled with fluid, rather than air
Areas of consolidation appear cloudy on X-ray
What are the 5 main symptoms of pneumonia?
- Progressive breathlessness
- Fever with shivering attacks (rigor)
- Sharp chest pain
- General malaise/lethargy
- Hypotension
What causes the sharp chest pain in pneumonia patients?
The pain is due to pleurisy which is inflammation of the pleura
The pain becomes worse on inspiration
Why is hypotension a symptom of pneumonia?
Due to an inflammatory stimulus
This decreases peripheral arterial resistance - dilation
Cardiac output increases to compensate, leading to tachycardia
What are the 4 main clinical signs of pneumonia?
- hot, flushed with peripheral dilatation
- dull to percussion but increased breath sounds on auscultation
- crackles due to the presence of fluid
- pleural rub
What is pleural rub?
The sound of the pleural linings rubbing together
Occurs when pleura are inflamed and have lost their lubrication
What are the 7 treatments for pneumonia?
- antibiotics
- oxygen
- analgesia
- fluids to treat hypotension and maintain perfusion
- physiotherapy
- nutrition
- stop smoking
How is pneumonia classified?
Based on a CURBA score:
Confusion (8 or less) Urea (>7) Respiratory rate (>/= 30) Blood pressure (S<90 D= 60) Age >/= 65
A score of 1 point is added for each abnormal reading
What do the CURBA scores mean for treatment?
0 or 1 - likely suitable for home treatment
2 - consider hospital Rx
3 or more - manage in hospital as severe pneumonia
What other lung conditions can pneumonia lead to?
- lung abscess due to collection of pus or fluid
- pleural effusion
- empyema
What is empyema?
Similar to pleural effusion, but the fluid becomes infected and contains pus
What are the 5 treatments for pneumonia?
- antibiotics
- pleural aspiration
- drain
- VATS/Surgery
- rhDNase/TPA (breaks down areas of scarring in tissue)