Pneumonia + Abscess + Empyema Flashcards

Question

What do fine crackles suggest

Answer 1

``` Oxygen if hypoxic Analgesia if pleurisy Fluid balance CPAP Neb - SABA / SAMA to open up Suction if needed Anti pyretic Antibiotic Chest physio ```

Answer 2

B lactam | Macrolide

Answer 3

``` If in 24 hours 37.5 RR >24 HR >100 Systolic <90 Sats <90 Abnormal mental Inability to eat ```

Answer 4

CXR at 6 weeks

Answer 5

>65 Chronic heart / liver / lung DM Immunosuppression

Answer 6

``` Used in community to decide need for admission Confusion - AMTS <8 Urea >7 - don't use in community RR >30 BP <90 or <60 Age 65 ```

Answer 7

``` Low risk Treat in community Amoxicillin 500mg TDS or If allergic Clarithromycin 500mg or Doxycycline 100mg BD with 200mg loading ```

Answer 8

Do O2 sats + CXR If sats low or CXR shows bilateral shadows = admit to hospital Same as above

Answer 9

Hospital Rx Amoxicillin + Clarithromycin / levofloxacin

Answer 10

Consider ITU Coamoxiclav 1g TDS Ceftriaxone 1.5g TDS Tazobactam + Clarithromycin + levofloxacin

Answer 11

``` Sepsis AKI Pleural effusion Pneumothorax Atelactasis Fibrosis if doesn't clear Empyema Lung Abscess ARDS Type 1 resp failure AF Bronchiectasis ```

Answer 12

COPD | Bronchiectasis

Answer 13

Klebsiella | Staph if Hx of influenza

Answer 14

Mycoplasma

Answer 15

``` 1 week fever resolves 4 week chest pain and sputum stop 6 week cough and Sob reduced - follow up CXR 3 months = fatigue 6 months = normal ```

Answer 16

``` TB Lung cancer - CXR PE CF Pulmonary vasculitis ```

Answer 17

High flow O2 Transfer to ITU if CO2 rises or hypoxia doesn't improve Aim sats 94-98%

Answer 18

Dehydration | Vasodilation due to sepsis

Answer 19

If systolic <90 = fluid challenge 250ml of crystalloid over 15 minutes Central line + IV to maintain Inotropic support in ITU

Answer 20

``` Pus in pleural space May see pleural effusion on CXR - Pneumonia - Abscess - Post-op / trauma - OM ```

Answer 21

``` Pneumonia resolving but fever persisting Chest pain Fever SOB No cough ```

Answer 22

``` Pleural aspiration - Yellow - pH <7.2 - Decreased glucose - Increased LDH CXR = pleural effusion Bronchoscopy ``` Rx - IV Ax - Chest drain - Surgical excision

Answer 23

``` Cavitating area of local infection caused by Pneumonia Aspiration Lung cancer Obstruction Infarction PE Septic emboli - IVDA ``` S.aures post influenza Pseudomona Klebsiella

Answer 24

``` Swinging fever Cough Purulent sputum Pleuritic pain if discharge into pleural space Haemoptysis Lethargy Weight loss Clubbing Anaemia Crepitations ```

Answer 25

FBC, CRP, culture Sputum microscopy and culture and cytology CXR CT to exclude obstruction

Answer 26

``` Ax until healed (minimum 6 weeks) Postural drainage Percutaenous drainage Repeated aspiration Surgical excision Intrapleural tPA/DNase to break down adhesions ```

Answer 27

Elderly Improves with Rx Can use BB or digoxin to slow

Answer 28

Myocarditis Pericarditis Meningitis Jaundice 2 to Ax or sepsis

Answer 29

Don't respond to cephalosporin / penicillin Affect upper lobe Associated LN and deranged LFT

Answer 30

Form abscess and empyema | Red current jelly sputum

Answer 31

Alcohol DM Elderly

Answer 32

``` Bronchiectasis CF ITU HAI As resistant to Ax which these people are on ```

Answer 33

``` Dry cough no sputum SOB on exertion Fever Night sweats Exercise induced desaturations Absent chest signs Pneumothorax Bilateral infiltrates ```

Answer 34

CXR = bilateral consolidation | BAL as sputum doesn't pick up with silver stain - often needed

Answer 35

IV pentandimine Co-trimoxazole Prophylaxis if severely low CD4 Steroid if severe hypoxia

Answer 36

``` Flu like Dry cough Erythema multiform rash Neuro Sx in young patient Atypical CXR - bilateral Bilateral consolidatin ```

Answer 37

Viral throat swab PCR sputum Cold agglutinins IGM

Answer 38

Macrolide - clarithromycin or doxycycline

Answer 39

``` Erythema multiform / nodosum Deranged LFT Haemolytic anaemia ITP Encephalitis Myocarditis GBS - weakness / loss of reflexes Hepatitis Pancreatitis Acute GN ```

Answer 40

``` Flu like Dry cough Brady Confusion Hyponatrameia Abnormal LFT D+V Lymphopenia PLeural effusion Renal failure Haemolytic anaemia Can get hepatitis ```

Answer 41

After holiday to Spain | Contact with infected water etc

Answer 42

Urinary antigen in urine sample

Answer 43

Erythromycin

Answer 44

``` Fever FLu Conjunctivitis Dry cough Hx of bird contact Severe headache No response to penicillin ```

Answer 45

Tetracycline | Macrolide 2nd line

Answer 46

``` Meningoencephalitis IE Hepatitis Nephritis Splenomegaly ```

Answer 47

Pharyngitis Hoarse Otits media Pneumonia

Answer 48

Doxycline or clarithromyin

Answer 49

Very sick stomach

Answer 50

``` Neurological - poor swallow Stroke MS Spinal cord injury Alcohol intoxication Poor dental hygiene Prolonged hospital Achalasia Reflux Intubation Impaired consciousness Impaired mucociliary clearance ```

Answer 51

Klebsiella - red current jelly S.Pneumonia S.Aureus H.influenza

Answer 52

R lower lobe | Absence of fever

Answer 53

Intrapleural tPA/DNase

Answer 54

Shallow breathing