Pneumonia Flashcards
What is pneumonia?
An infection of the alveoli
Infection -> Inflammation & Infected Fluid -> Pus/Damage/Fibrosisetc
What are the common aetiological types of pneumonia?
Community Acquired
Hospital acquired or Nosocomial
Aspiration
Atypical - Recurrent - Immunocompromised
What are the common organisms behind pneumonia?
What are the most common causative organisms in pneumonia?
Strep Pneumoniae (also called Pneumococcus) is the the most single cause and treatment and investigation stretegies need to cover this.
Haemophilus Influenzae
Viruses
Legionella - Mycoplasma Pneumoniae - Staph Aureus - MRSA
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Strep Pneumoniae Mycoplasma Pneumoniae Haemophilus Influenzae Viral Pseudomonas Aeruginosa Staph Aureus Legionella
What radiological types of pneumonia are there?
Lobar/Segmental - Pneumonia restricted to a specific Lobe or branch
Bronchopneumonia - Diffuse pneumonia over the entire lung
What are the symptoms of pneumonia?
Malaise - general feeling of discomfort
Fever
Pleuritic Pain
Dyspnoea -difficult or laboured breathing
Cough
Purulent Sputum -discharging pus (piyuu-ri-lant)
What are the signs of pneumonia?
Affected Area: Reduced Breath sounds Bronchial Breathing Increased Vocal Resonance Stony Dullness to Percussion Reduced Chest Expansion Inspiratory Crackles
Tachypnoea/Tachycardia
Central Cyanosis
~ Low BP
What investigations can we do for pneumonia?
What tests are done on suspected pneumoina?
ABG - FBC - U+E - CRP - LFT CXR CT Bronchoscopy/Bronchoalveolar Lavage Sputum Culture & Blood Culture Throat Swab for atypical pathogens Urine Legionella antigen
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FBC - CRP - ABG - U&E - LFT CXR Bronchoscopy + Bronchoalveolar Lavage Sputum & Blood Cultures Urinary Legionella Throat Swab for atypical Pathogens
What is the differential for pneumonia?
TB Lung Cancer Cardiac Failure PE Pulmonary Vasculitis
What are the complications of pnemonia?
differential diagnosis: the process of differentiating between two or more conditions which share similar signs or symptoms.
ARDS Pleural Effusion Lung Abscess Empyema Bronchiectasis Septicaemia
What are the non-antibiotic treatments for pneumonia?
O2 -> CPAP -> Intubate/Ventilate
IV fluids
Analgesia if pleuritic pain is bad
How do we grade pneumonia?
Explain the Curb 65 Score for severity and treatemnt of Pneumonia?
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CURB65
Confusion - Urea>7mmol/L - Resp>30 - BP D<60 or S<90 - Age>65
0 = treat in community 1-2 = hospitalise 3-5 = ITU the fuck out of them
2222222222222222222222222222 C - Confusion U - Urea>7mmol/L R - Resp. rate > 30/m B - BP <60 or 90 65 - >65yrs
o = community treated 1-2 = Hospital Treated 3-5 = ITU
o-1 = Clarithromycin (macrolide) or Amoxicillin (B-lactam) or Doxycyclin 2 = Clarithromycin and Amoxicillin (or Levofloxacin - Fluroquinolone) 3-5 = Clarithromycin & Co-Amoxiclav (Or Levofloxacin)
Add Vancomycin for MRSA
Add Flucloxacillin for Staph
Can also add rifampicin in severe cases
Explain the antibiotic treatment for pneumonia?
CURB65 again!!
0-1 = Amoxicillin or Clarithromyicn or Doxycyclin
2 = Amoxillin/Levofloxacin AND Clarithromycin
3-5 = Co-Amoxiclav/Levofloxacin AND clarithromycin
(Levofloxacin if penicillin allergic)
Add Vancomycin if MRSA
Add Flucloxacillin if Staph
What are the possible outcomes of penumonia?
Resolution
Complication (mainly abscess or emphysema)
Permanent bronchiectasis
Scarring (Crytogenic Organising Pneumonia)
