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RESPIRATORY > PNEUMONIA > Flashcards

PNEUMONIA Flashcards

1
Q

What is Pneumonia?

A

An acute lower respiratory tract infection that inflamed the air sacs in one or both lungs

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2
Q

What are typical organisms of CAP?

A

Strep. pneumoniae

Haemophilia Influenzae

Mortadella Catarhalis

Straph. Aureus

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3
Q

What is the definition of HAP?

A

Pneumonia that develops more than 48hrs after hospital admission or 10days of discharge

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4
Q

What are the typical Organism of HAP?

A

Gram Negative Enterobacteria

Pseudo Aeruginosa

Pseudomonas

Klebsiella

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5
Q

What is commonly aspired in aspiration pneumonia?

A

Anaerobes from the throat

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6
Q

Where is acquired pneumonia mainly seen?

A

Stroke patients

Myasthenia

Bulbar Palsies (Impaired CN X due to LMN lesion in Medulla)

Decreased consciousness

Oesophageal disease (alchalasia, GORD)

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7
Q

What are the typical organisms seen in Immunocompromised pneumonia?

A

Strep. Pneumoniae

H. Influenzae

Straph. aureus

M. catarrhalis

Gram -ve baccalli

Fungi

Viruses (CMV, HSV)

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8
Q

What are some symptoms of pneumonia?

A

Fever

Rigours

Malaise

Anorexia

Constant Dyspnoea

Cough

Purulent Sputum

Haemoptysis

Sharp pleuritic pain (worse on inspiration)

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9
Q

What are the signs of pneumonia?

A

Signs of consolidation

Cyanosis

Confusion

Tachycardia

Tachypnoea

Hypotension

Pleural rub

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10
Q

What are the common signs in older patients?

A

Confusion w/ hypothermic

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11
Q

What are the risk factors of Pneumonia?

A

Age

Aspiration

Immunosuppression

Alcoholism

Diabetes

Smoking

COPD

Nursing Home Resident

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12
Q

What is the severity assessment?

A

Predicts mortality and management

Confusion
Urea >7
Respiratory >30
Blood Pressure <90s <60d
65 age
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13
Q

How do you interpret the different CURB-65 scores?

A

Score 0-1: 2.4-8% mortality - treat from home

Score >2: 23% consider hospital admission

Score >3: 33% consider intensive care assessment

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14
Q

What are the common OBS of pneumonia?

A

BP: <90s <60d

Oxygen Saturation: <95%

Pulse Rate: >100bpm

Temperature: high

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15
Q

What would you expect from a pneumonia blood test?

A

FBC: elevated WBC, high neutrophils

U&E: look for AKI - high urea, high creatinine, low eGFR

LFT: check liver malfunction in sepsis

Lactate: general marker for severity and used on sepsis scoring system

CRP: high

ABG: respiratory Acidosis

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16
Q

What would you see on a pneumonia CXR?

A

Lobar or multilobar infiltrates

Cavitation

Pleural effusion

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17
Q

Which samples would you take?

A

URINE: look for legionella/Pneumoccocal urinary antigens

SPUTUM CULTURE

PLEURAL FLUID CULTURE

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18
Q

How is Pneumonia managed which ABCDE?

A

Oxygen: keep Sats >92%

Analgesia: Aspirin and Ibuprofen

Antipyretic: Acetaminophen

VTE Prophylaxis: compression stocking, pharmacological agents

IV FLUID: Anorexia, dehydration, and shock

19
Q

Which antibiotics are used to treat pneumonia?

A

Mild: amoxicillin or Clarithromycin

Severe: duel antibiotics - co-amoxiclav

20
Q

What is the duration of antibiotics in pneumonia?

A

Mild: 5-7days

Severe: 10days

Suspect straph./legionella/gram -ve: 14-21days

21
Q

Why May antibiotics not work in pneumonia?

A

Incorrect diagnosis

Secondary complications

Impaired immunity (systemic or Local)

Viral

22
Q

When would you consider ITU in pneumonia?

A

In shock, hypercapnia or remains hypoxic

23
Q

Who qualifies for a pneumoccocal vaccine?

A

> 65

Chronic heart, liver, renal or lung condition

Diabetes not controlled by diet

Immunosupression

24
Q

What type of respiratory failure is seen in pneumonia? How is it treated?

A

Type 1

Treat with high flow oxygen (60%)

25
Q

What causes hypotension in pneumonia and how is it treated?

A

Due to dehydration and vasodilation due to sepsis

Treat with IV fluid if <90s

26
Q

What type of effusion is seen as a complication of pneumonia and how is it treated?

A

Parapneumonic - inflammation of pleura by adjacent pneumonia can cause fluid exudation into pleural space

Treat with chest drain if infected and symptomatic

27
Q

What is Empyema? How is it treated?

A

Pus in pleural space

Clinical features will include hypoglycaemia and raised LDH

Treated with a chest drain

28
Q

What is a lung abscess and how is it treated?

A

Cavitating area of localised, suppurative infection within the lungs

Treated with 4-6week course of antibiotics; postural drainage; surgery excision

29
Q

What are clinical presentation of lung abscess?

A

Swinging fever

Foul-smelling sputum

Pleuritic chest pain

Finger clubbing

Crepitations

30
Q

What is septicaemia? How is it treated?

A

Spread of bacteria from lung parenchyma into the bloodstream leading to metastatic infection (infective endocarditis or meningitis)

Treated with IV antibiotic

31
Q

What are complications of pneumonia?

A

Jaundice

Pericarditis and myocarditis

Lung abscess

Empyema

Parapneumonic pleural effusion

Atrial fibrillation

Hypotension

Respiratory failure

32
Q

What are the signs of consolidation in a lung?

A

Dull percussion

Bronchial breathing

Focal coarse crackles

Reduced expansion

Increased tactile vocal frémit us or vocal resonance

33
Q

Where is fungal pneumonia mostly seen?

A

People with chronic health condition or weak immune systems or those who have aspired large amount of foreign bodies

34
Q

What is the most common example of fungi pneumonia?

A

Pneumocystic Jiroveci

Seen in patients with immunosuppresion

35
Q

What is the treatment for fungi pneumonia?

A

Co-Trimoxazole

36
Q

What is the most common cause of viral pneumonia?

A

Influenza

Swine flu

Measles

CMV

Varicella Zoster

COVID-19

37
Q

Who is mostly at risk of viral pneumonia?

A

Children under 5

38
Q

How is viral pneumonia treated?

A

You leave it and check again later to see progress

39
Q

What is atopic pneumonia? And how is it treated?

A

Pneumonia caused by an organism that can not be detected using gram stain

Treated with clarithomycin, levofloxacin or doxycycline

40
Q

What is legionella pnemophila?

A

Caused by infected water supplies or air containing

Presents with flu-like symptoms and hyponatraemia

41
Q

What is mycoplasma pneumoniae?

A

Organism that causes milder pneumonia and can cause erythema multiforme (skin rash) and neurological symptoms in younger patients (e.g. guillons-barre syndrome)

42
Q

What is chlamydophila pneumoniae?

A

Organisms seen in younger patients

Pneumonia tends to follow pharyngitis, hoarseness and otitis

43
Q

What is coxiella Burnetii?

A

Q Fever

Linked to exposure to animals and their bodily fluids

44
Q

What is chlamydia psittaci?

A

Organism found in infected birds

Contact with birds leading to pneumonia

RESPIRATORY (4 decks)

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