PNEUMONIA Flashcards
WHAT IS THE PATHOPHYSIOLOGY OF PNEUMONIA?
- lung inflammation with consolidation or interstitial lung infiltrate (macrophage and neutrophils)
- caused by a causative organism
WHAT ARE THE SYMPTOMS OF PNEUMONIA?
- pleuritic chest pain
- dyspnoea
- fever
- cough with sputum production - purulent (bacterial)
- rigors- sudden feeling of cold with shivers
WHAT ARE THE SIGNS OF PNEUMONIA?
- Auscultation - increase bronchial breath sounds, coarse crackles
- Percussion - dull
- Vocal resonance - increased in affected areas
- Reduced chest expansion
- Pyrexia
- Tachycardia
- Hypotension
- Tachypnoea
- Cyanosis
WHAT INVESTIGATIONS ARE CARRIED OUT FOR PNEUMONIA?
1) CXR - consolidation
2) Pulse oximetry - <94% oxygen therapy
3) ABG
4) Blood test - FBC, U+E, CRP (look for improvement before and after treatment), LFT
5) Sputum culture - identify pathogen
WHAT IS THE CRITERIA FOR ASSESSING PNEUMONIA SEVERITY AND ITS INDICATIONS?
CURB-65 Confusion Urea > 7mmol/L Respiratory rate > 30 bpm BP < 90 systolic 65 - age >65
high score means increase mortality and ITU referral
WHAT IS COMMUNITY ACQUIRED PNEUMONIA?
- acquired outside the hospital
WHAT ARE THE 3 COMMON CAUSATIVE ORGANISMS FOR COMMUNITY ACQUIRED PNEUMONIA?
1) Streptoccocus pneumoniae
2) Haemophilus influenzae
3) Mycoplasm pneumoniae
WHAT IS THE MANAGMENT OF COMMUNITY ACQURED PNEUMONIA ( LOW, MODERATE AND HIGH SEVERITY)?
1) Low severity - oral amoxicillin
2) Moderate severity - oral amoxicillin and clarithromycin
3) High severity - IV co-amoxiclav and clarithromycin
WHAT SUPPORTIVE TREATMENT IS AVAIBLE FOR PNEUMONIA?
1) IV fluid resuscitation
2) oxygen therapy
3) vasopressors
4) analgesia
WHAT ANTIBIOTIC IS GIVEN FOR PREGNANT WOMEN?
erythromycin
WHAT ANTIBIOTIC IS GIVEN IN PENCILLIN ALLERGY?
doxycycline or clarithromycin
WHAT IS HOSPITAL ACQUIRED PNEUMONIA?
pneumonia >48 hours after hospital admission
WHAT ARE THE 2 CAUSATIVE ORGANISMS OF HOPSITAL ACQUIRED PNEUMONIA?
1) Pseudomonas aeruginosa
2) Escherichia coli
WHAT IS THE MANAGMENT OF HOSPITAL ACQUIRED PNEUMONIA?
guided by microbiology results
WHAT ARE THE DIFFERENTIAL DIAGNOSIS OF PNEUMONIA?
- pulmonary embolism
- pleural effusion
- TB
- lung cancer