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respiratory > pneumonia > Flashcards

pneumonia Flashcards

1
Q

what is it

A

inflammation of the substances of the lungs

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2
Q

what is it caused by

A

bacteria
viruses
fungi

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3
Q

symptoms

A
  • acute illness
  • cough
  • purulent sputum
  • breathlessness
  • fever
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4
Q

what does the lung look like

A

consolidation

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5
Q

where is community acquired pneumonia contracted

A

in the community in a person who has no underlying immunosuppression or malignancy

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6
Q

where is hospital acquired pneumonia contracted

A

in nursing home or hospital

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7
Q

where does bronchopneumonia affect

A

bronchi and bronchioles

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8
Q

how is infection spread

A

by respiratory droplets

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9
Q

risk factors

A
  • age
  • HIV
  • diabetes
  • kidney disease
  • malnutrition
  • cystic fibrosis
  • bronchiectasis
  • COPD
  • smoking
  • alcohol
  • IV drug use
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10
Q

symptoms

A
  • cough (can be productive)
  • haemoptysis
  • breathless
  • coarse crackles
  • bronchial breath sounds
  • fever
  • chest pain, pleuritic
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11
Q

what is sputum like in pneumococcal pneumonia

A

rust-coloured

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12
Q

why does patient get breathless

A

alveoli become filled with pus and debris

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13
Q

why can coarse crackles be heard

A

due to consolidation of the lung

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14
Q

what does swinging fever indicate

A

empyema

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15
Q

why is chest pain present

A

due to inflammation of the pleura

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16
Q

extrapulmonary features of community acquired pneumonia

A
  • myalgia
  • myocarditis/pericarditis
  • headache
  • abdominal pain
  • diarrhoea
  • skin rashes
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17
Q

what causes myocarditis and pericarditis

A

mycoplasma pneumonia

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18
Q

what causes headaches

A

legionella pneumonia

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19
Q

what is a feature of legionella pneumonia

A

hepatitis

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20
Q

why can be reactivated by pneumococcal pneumonia

A

labial herpes simplex

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21
Q

symptoms often in elderly

A
  • confusion
  • recurrent falls
  • generally un well
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22
Q

what is most common cause of pneumonia

A

streptococcus pneumonia

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23
Q

what should be excluded

A
  • tuberculosis
  • lung cancer
    etc
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24
Q

what should mild infections be treated with

A

antibiotic:
- amoxicillin
- clarithromycin (penicillin allergic)

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25
Q

how is severity assessed

A

CURB 65

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26
Q

CURB 65 stand for

A 
C: confusion 
U: urea >7mmol/L
R: resp rate >30 
B: BP systolic <90 
65: age > 65

1 point for each of above

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27
Q

what should all patients get when admitted to hospital

A

chest X-ray
blood test
microbiological test

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28
Q

how can causative organism be identified

A

sputum culture and gram stain

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29
Q

what is strep pneumonia

A

gram positive diplococci

30
Q

what is staph aureus

A

gram positive cluster (like bunch of grapes)

31
Q

is legionella seen on gram stain

A

no

32
Q

what should be offered to all patients with pneumonia

A

HIV test

33
Q

general management

A
  • oxygen
  • intravenous fluids
  • antibiotics
  • thromboprophylaxis
  • physiotherapy
  • analgesia
34
Q

why is oxygen given

A

to maintain saturations between 94-98%

35
Q

what antibiotic does staph aureus need

A

flucloxacillin

36
Q

what is a side effect of cephalosporin

A

diarrhoea

37
Q

what is used to treat pleuritic pain

A

analgesia such as paracetamol or NSAIDs

38
Q

preventative measures

A
  • stop smoking

- vaccine against influenza

39
Q

is consolidation always pneumonia

A

NO

think upper lobe can be tuberculosis

40
Q

sputum in streptococcus pneumonia

A

rust coloured

41
Q

symptoms of streptococcus pneumonia

A
  • cough
  • rusty sputum
  • high fever
  • pleuritic chest pain
42
Q

symptoms of mycoplasma pneumonia

A
  • headache
  • malaise
  • myalgia
  • anaemia
  • hepatitis
43
Q

how is legionella pneumonia acquired

A

inhaling water mist containing bacteria

just back from holiday?

44
Q

who is legionella more common in

A
  • smokers

- male

45
Q

complication of staph aureus

A

recent influenza

46
Q

who is H.influenza more common in

A
  • cystic fibrosis
  • bronchiectasis
  • COPD
47
Q

what is chlamydia psittaci acquired from

A

birds

48
Q

who is more likely to get coxiella burnetti

A

young men

49
Q

symptoms of coxiella burnetti

A
  • dry cough

- high fever

50
Q

what is coxiella burnetti a recognised cause of

A

endocarditis

51
Q

who is more likely to get klebsiella pneumonia

A
  • men
  • alcohol excess
  • poor dental hygiene
  • diabetes
52
Q

complications of pneumonia

A
  • respiratory failure
  • sepsis
  • pleural effusion
  • empyema
  • lung abscess
53
Q

what kind of empyema does pneumonia cause transudative or exudative

A

exudative

54
Q

what are early indications of empyema

A
  • ongoing fever
  • rising inflammatory markers

all despite antibiotic therapy

55
Q

what should be done to diagnose empyema

A

thoracocentesis

56
Q

what should aspiration been done under

A

ultrasound guidance

57
Q

what should be done to treat empyema

A
  • urgently drained to prevent further complication
58
Q

what organisms can cause lung abscess

A
  • klebsiella pneumonia
  • staphylococcus pneumonia
  • mycobacterium tuberculosis
  • H. influenza
59
Q

what is essential to diagnose lung abscess

A

CT

bronchoscopy

60
Q

what is hospital acquired pneumonia defined as

A
  • new onset cough
  • purulent sputum
  • CXR showing consolidation
61
Q

what are causative organisms of HAP

A
  • pseudomonas aureginosa
  • e.coli
  • k. pneumonia
  • staph aureus
  • enterobacter
62
Q

where is most usual site for aspirated material to end

A

right middle lobe

63
Q

where is pneumocystis jiroveci found

A

in air

64
Q

what is first line treatment for pneumocystis jiroveci

A

co-trimoxazole

65
Q

what kind of consolidation

A

patchy consolidation

66
Q

is bronchopneumonia bilateral

A

yes

67
Q

what is lobar pneumonia mostly due to

A

strep pneumonia

68
Q

who gets klebsiella pneumonia

A
  • elderly
  • diabetics
  • alcoholics
69
Q

sputum in strep pneumonia

A

rusty coloured

70
Q

how is legionella pneumonia spread

A

via water droplets

71
Q

what is alveoli like in pneumocystis jirovecii

A

filled with pink exudate

72
Q

types of fungi

A
  • candida

- aspergillus

respiratory (20 decks)

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