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Resp AM > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What is pneumonia?

A

Inflammation o the lung with consolidation or interstitial lung infiltrates

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2
Q

What are some common types of pneumonia?

A

Community acquired
Hospital acquired
Aspiration
Pneumocystic jirovecii pneumonia PJP

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3
Q

What are some risk factors for community acquired pneumonia?

A 
>65yo
Comorbidities e.g. COPD 
Smoking 
Contact with children 
Residence in residential home
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4
Q

What is the most common cause of community acquired pneumonia?

A

strep. pneumoniae

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5
Q

What are some common causes of community acquired pneumonia?

A 
Strep. pneumoniae
H. influenzae= most common with COPD 
Influenza virus 
Staph aureus 
Moraxella catarrhalis 
Mycoplasma pneumoniae= atypical
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6
Q

What can mycoplasma pneumoniae cause?

A

Autoimmune haemolytic anaemia

Erythema multiforme

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7
Q

What is hospital acquired pneumonia?

A

If been in hospital 48 hours before deve;loping symptoms

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8
Q

What are risk factors for hospital acquired pneumonia?

A

> 65yo
Intubation
Poor infection control measures

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9
Q

What are common causes of hospital acquired pneumonia?

A 
Strep pneumoniae
Pseudomonas aeroginosa= most dangerous 
E. coli 
Influenza virus 
Klebsiella pneumniae= classically in alcoholics
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10
Q

What is the pathophysiology of aspiration pneumonia?

A

Aspiration –> pneumonitis –> damage to lung parenchyma –> secondary bacterial infection

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11
Q

Where is aspiration pneumonia normally seen?

A

Right basal pneumonia

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12
Q

What is the presentation of pneumonia?

A 
Cough with increasing sputum production 
Dyspnoea 
Pleuritic chest pain 
Fever, arthralgia, myalgia 
Dullness to percussion 
Asymmetric reduced breath sounds
Bronchial breathing
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13
Q

What investigations are done for pneumonia?

A 
FBC, U&Es, CRP, glucose 
Blood culture 
Sputum culture 
CXR 
ABG if unwell
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14
Q

What is seen on CXR with pneumonia?

A

Consolidation

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15
Q

What is the scoring system for pneumonia?

A

CURB65

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16
Q

What are the features used in CURB65?

A 
Confusion 
Urea >7 
RR >25 
BP <60 diastolic 
>65 yo
17
Q

What scores of CURB65 indicate what?

A 
0-1= outpatient 
2-3= inpatient 
3-5= inpatient, consider ITU/HDU
18
Q

What is the management of pneumonia?

A

Antibiotics and supportive management

19
Q

What antibiotics are used for pneumonia?

A 
Outpatient= Oral amoxicillin or clairythromycin
Inpatient= IV amoxicillin and clairythromycin OR IV levofloxacin
20
Q

What indicates failure to improve in pneumonia?

A

Want CRP to half in 3 days

21
Q

What could be the causes of failure to improve in pneumonia?

A

Wrong diagnosis
Wrong antibiotics
Difficult/resistant pathogen
Complication e.g. abscess, empyema

22
Q

What are some complications of pneumonia?

A 
Sepsis 
ARDS
C. diff 
Heart failure 
Pleural effusion 
Lung abscess
Empyema
23
Q

When are lung abscesses esp common?

A

Staph aureus and klebsiella

24
Q

What is empyema?

A

Pus in pleural cavity

25
Q

What is the investigation and management of empyema?

A

Pleural aspiration/tap= bacteria and protein, pus

Chest drain

26
Q

What is PJP?

A

Fungal infection

Most common opportunist infection in AIDS

27
Q

Who is PJP seen in?

A

Severely immunocompromised e.g. AIDS
Bone marrow/organ transplant
Chronic immunosuppression

28
Q

What are the features of PJP?

A 
Dyspnoea
Dry cough 
fever 
Few chest signs 
Rare= hepatosplenomegaly, lymphadenopathy
29
Q

What investigations are done for PJP?

A

FBC, U&Es, CRP, check CD4
CXR
Sputum and bronchoalveolar lavage stain
Exercise induced desaturation

30
Q

What is the management of PJP?

A

Co-trimoxazole

Severe= + steroids

31
Q

When is PJP prophylaxis given?

A

HIV and CD4 <200

32
Q

What is a common complication of PJP?

A

Pneumothorax

Resp AM (17 decks)

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