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2 - CPR (pulmonary) > Pneumonia and ARDS > Flashcards

Pneumonia and ARDS Flashcards

1
Q

What are some risk factors for Pneumonia?

A
  • Increasing age, smoking and alcohol use

- Comorbidities, poor oral hygiene, surgery

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2
Q

What are some risk factors for Pneumonia?

A
  • Increasing age, smoking, alcohol use

- Comorbidities, poor oral hygiene, surgery

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3
Q

Pathogenesis for Pneumonia

A
  • Pathogen enters nasopharynx and makes its way to lower airways via inhalation
  • Transitions from colonization to infection
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4
Q

What factors affect if the pathogen transitions from colonization to infection of the lower respiratory tract with pneumonia?

A

Host factors and Pathogen factors

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5
Q

Lung homeostasis depends on a balance between?

A
  1. Immune resistance - eliminate microbes

2. Tissue resilience - resolve tissue damage

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6
Q

Lung homeostasis depends on a balance between?

A
  1. Immune resistance

2. Tissue resilience

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7
Q

Symptoms of Pneumonia?

A

Cough with sputum production, dyspnea, chest pain and fatigue

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8
Q

Cough with sputum production, dyspnea, chest pain and fatigue can suggest?

A

Pneumonia

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9
Q

Pneumonia symptoms do not predict the outcome except for what 2 things?

A
  • Delirium = increased mortality

- Pleuritic chest pain = increased pleural effusion risk

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10
Q

How do you diagnose Pneumonia?

A
  • Symptoms of lower respiratory tract infection with acute onset
  • New infiltrates on CXR
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11
Q

Besides a history and CXR, what else can be used to diagnose Pneumonia?

A
  • Microbiology tests
  • Covid/influenza testing
  • CBC, CMP, CRP, procalcitonin
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12
Q

Microbiology tests are usually used when, when diagnosing Pneumonia?

A

Hospitalized patients/ICU

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13
Q

First treatment for Pneumonia?

A

Empirical therapy for most likely pathogens

– narrow down once testing results comes back

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14
Q

Empirical therapy for NON-severe community acquired pneumonia?

A
  • Beta lactam + Macrolide
    OR
  • Respiratory fluoroquinolone alone
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15
Q

Empirical therapy for severe community acquired pneumonia?

A
  • Beta lactam + Macrolide
    OR
  • Beta lactam + Respiratory Fluoroquinolone
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16
Q

When treating Pneumonia, what coverage could you add?

A

MRSA

Pseudomonas

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17
Q

When treating Pneumonia, when should you add MRSA or Pseudomonas coverage?

A

If recently hospitalized, on a parenteral antibiotic or at high risk for infection
– Also if due to aspiration

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18
Q

Besides empirical therapy, what are some more treatment options to add for Pneumonia?

A
  • Corticosteroids = severe CAP/inflammation
  • Oxygen
  • Non-invasive ventilation
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19
Q

If you are going to add Corticosteroids to Pneumonia treatment, what needs to be ruled out first?

A

Influenza

20
Q

What are the 3 complications of Pneumonia?

A
  • Increased risk of cardiovascular disease
  • Increased susceptibility of infection
  • Decreased cognition/functional status
21
Q

What are the 3 complications of Pneumonia?

A
  • Increased risk of cardiovascular disease
  • Increased susceptibility for infection
  • Decreased cognition/functional status
22
Q

What vaccinations can help prevent Pneumonia?

A

Influenza

Pneumococcal

23
Q

Imbalance of fluid forces create a _____ effusion

A

Transudative

24
Q

Inflammatory and malignant processes that increase permeability create a ______ effusion

A

Exudative

25
Q

Top 3 risk factors for a pleural effusion?

A
  1. Heart failure
  2. Bacterial pneumonia
  3. Pulmonary embolism
26
Q

Top 3 risk factors for a pleural effusion?

A
  1. Heart failure
  2. Bacterial pneumonia
  3. Pulmonary Embolism
27
Q

Possible symptoms of a pleural effusion?

A

Asymptomatic
OR
Cough, dyspnea, pleuritic chest pain

28
Q

Asymptomatic or cough, dyspnea, pleuritic chest pain can suggest?

A

Pleural effusion

29
Q

What exam findings will indicate a pleural effusion?

A

Dullness to percussion and diminished breath sounds in the lower fields

30
Q

Dullness to percussion can suggest?

A

Pleural effusion

31
Q

What type of CXR is the most helpful when detecting pleural effusions?

A

Lateral decubitus

32
Q

Treatment for a pleural effusion?

A

Thoracentesis - diagnostic and therapeutic

33
Q

What does Light’s Criteria suggest?

A

Exudative pleural effusion

34
Q

ARDS

A

Acute Respiratory Distress Syndrome

35
Q

What is ARDS and what is it usually associated with?

A

Rapidly progressive pulmonary edema

  • -> respiratory failure
  • Associated with pneumonia and sepsis
36
Q

What are some risk factors for ARDS?

A
  • Increasing age, alcohol and tobacco use
  • Air pollution, trauma, hypoalbuminemia
  • Black/latin males
37
Q

Pathogenesis of ARDS

A
  • Increased permeability that allows edema into alveoli and interstitium
  • Accumulation of debris and microthrombii
  • Proliferative phase
  • Fibrotic phase
38
Q

With ARDS, the accumulation of debris and microthrombii cause what to occur in the lungs?

A
  • Impaired gas exchange
  • Decreased compliance
  • Increased dead space
39
Q

What are the signs of ARDS?

A

Dyspnea - in distress

Tachypnea, Tachycardia, hypoxemia

40
Q

Dyspnea, tachypnea, tachycardia and hypoxemia could suggest?

A

ARDS

41
Q

Treatment for ARDS?

A

Supportive

- treat infections, give O2, maintain fluid

42
Q

Treatment for ARDS?

A

Supportive

- Treat infections, give O2 and maintain fluids

43
Q

How long does it take for most ARDS patients to recover lung function?

A

6 - 12 months

44
Q

What are the complications of ARDS?

A

Muscle wasting and weakness
PTSD
Cognitive issues

45
Q

What are the complications of ARDS?

A

Muscle wasting and weakness
Cognitive issues
PTSD

2 - CPR (pulmonary) (26 decks)

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