pneumonia Flashcards
what is pneumonia
inflam and fluid collection in the lungs due to infection
tpyes of pneumonia
CAP - community aquired
HAP - hospital aquired
Aspiration
Rfs of pneumonia
elderly smoking immuno comp copd dm Cystic fibrosis bronchiectasis IVDU XS alcohol
DDx of pneumonia
TB
lung cnacer
Causes of pneumonia bacteria
Strep pneumonia (most common) H influenza staph aureus MRSA legionella pneumophilia (spain, air con) pneumocystitis jirovecci (HIV immunocomp)
causes of pneumonia viruses
adenovirus
influenza virus
h influenza
symptoms of pneumonia
Cough, productive (sputum - rusty = bacterial) SOB pleuritic chest pain haemoptysis symptoms of infection: malaise fatigue (low oxygen) rigor sweating
signs of pneumonia
CONFUSION fever low bp increased resp rate dull to percuss - alveoli pus/debris filled = COARSE CRACKLES - lung consolidation tachycardia reduced chest expansion
Ix of pneumonia
CXR - pleural effuson- CONSOLIDATION FBC - raised WBC ESR CRP increased exclude sepsis Legionella? - URINARY ANTIGEN TEST sputum sample and blood culture - gram stain (Z
What components make up a CURB-65 score?
Confusion, Urea (over 7 mmol/L) Resp Rate >30/min Blood pressure less than 90 +/- less than 60) age over 65 over 2 ADMIT
treatment of pneumonia
CURB65 score
0-1 = mild = amoxicillin
Moderate (2)- Amoxicillin plus Clarithromycin
Severe (3+)- Co-Amoxiclav plus Clarithromycin
if hypoxia- O2
ABX for legionellas
clarithromyocin
What fungal pathogen is likely to cause pneumonia in a HIV infected man with a high viral load?
Pneumocystis Jirovecii
What is the 1st line Management of Pneumocystis Jirovecii
Co-Trimoxazole
if hypoxic in pneumonia tx what oxygen sats aiing for
94-98%
if co2 retention with loss of hypoxic drive (COPD) = 88-92%
