PNEUMONIA Flashcards

1
Q

WHAT IS THE PATHOPHYSIOLOGY OF PNEUMONIA?

A
  • lung inflammation with consolidation or interstitial lung infiltrate (macrophage and neutrophils)
  • caused by a causative organism
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2
Q

WHAT ARE THE SYMPTOMS OF PNEUMONIA?

A
  • pleuritic chest pain
  • dyspnoea
  • fever
  • cough with sputum production - purulent (bacterial)
  • rigors- sudden feeling of cold with shivers
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3
Q

WHAT ARE THE SIGNS OF PNEUMONIA?

A
  • Auscultation - increase bronchial breath sounds, coarse crackles
  • Percussion - dull
  • Vocal resonance - increased in affected areas
  • Reduced chest expansion
  • Pyrexia
  • Tachycardia
  • Hypotension
  • Tachypnoea
  • Cyanosis
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4
Q

WHAT INVESTIGATIONS ARE CARRIED OUT FOR PNEUMONIA?

A

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

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5
Q

WHAT IS THE CRITERIA FOR ASSESSING PNEUMONIA SEVERITY AND ITS INDICATIONS?

A
CURB-65
Confusion
Urea > 7mmol/L
Respiratory rate > 30 bpm
BP < 90 systolic
65 - age >65

high score means increase mortality and ITU referral

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6
Q

WHAT IS COMMUNITY ACQUIRED PNEUMONIA?

A
  • acquired outside the hospital
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7
Q

WHAT ARE THE 3 COMMON CAUSATIVE ORGANISMS FOR COMMUNITY ACQUIRED PNEUMONIA?

A

1) Streptoccocus pneumoniae
2) Haemophilus influenzae
3) Mycoplasm pneumoniae

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8
Q

WHAT IS THE MANAGMENT OF COMMUNITY ACQURED PNEUMONIA ( LOW, MODERATE AND HIGH SEVERITY)?

A

1) Low severity - oral amoxicillin
2) Moderate severity - oral amoxicillin and clarithromycin
3) High severity - IV co-amoxiclav and clarithromycin

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9
Q

WHAT SUPPORTIVE TREATMENT IS AVAIBLE FOR PNEUMONIA?

A

1) IV fluid resuscitation
2) oxygen therapy
3) vasopressors
4) analgesia

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10
Q

WHAT ANTIBIOTIC IS GIVEN FOR PREGNANT WOMEN?

A

erythromycin

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11
Q

WHAT ANTIBIOTIC IS GIVEN IN PENCILLIN ALLERGY?

A

doxycycline or clarithromycin

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12
Q

WHAT IS HOSPITAL ACQUIRED PNEUMONIA?

A

pneumonia >48 hours after hospital admission

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13
Q

WHAT ARE THE 2 CAUSATIVE ORGANISMS OF HOPSITAL ACQUIRED PNEUMONIA?

A

1) Pseudomonas aeruginosa

2) Escherichia coli

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14
Q

WHAT IS THE MANAGMENT OF HOSPITAL ACQUIRED PNEUMONIA?

A

guided by microbiology results

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15
Q

WHAT ARE THE DIFFERENTIAL DIAGNOSIS OF PNEUMONIA?

A
  • pulmonary embolism
  • pleural effusion
  • TB
  • lung cancer
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16
Q

WHAT IS IMPORTANT TO CONSIDER WHEN ASSESSING PNEUMONIA?

A
  • sepsis