Pneumonia And ARDS - Dr. Miller Flashcards
Pneumonia SX
Rales on lower lung field, dullness to percussion, increased tactile fremitus
Fever, low O2 sat, higher RR, higher BP
= HIGH WBC , HIGH PLT
= HIGH BUN and CR (low BF to renal, dehydration….)
Pneumonia TX ACUTE
ABs
Pleural effusion CXR
You don’t see diaphragm borders
Pneumonia CXR
Consolidations white in lung usually lower , you still see diaphragmatic borders
Most common community acquired pneumonia
- Streptococcus pneumonia
2l Haemophilus influenza
Most common pneumonia in children
Mycoplasma pneumonia
Pseudomonas aeruginosa pneumonia is from what
Hospital acquired, ventilation acquired
DM
Risk for pneumonia severity in community acquired is done what what
CURB-65 score
Hospitalized pt for pneumonia TX
IV Piperacillin/tazobactum + ciprofloxacin = ANTI-pseudomonas
Azithromycin (macrolides) + Ceftriaxone (B-Lactam) = COMMUNTIY ACQUIRED
Quinolone + Moxifloxacin + Levofloxacin (ORAL for outpatient management)
Children pneumonia tx
Amoxicillin (B-lactam)
Easiest and cheapest drug for pneumonia
Azithromycin
Pleural effusion can happen from
Pneumonia = exudattive
Pleural effusion fluid is assessed for
- Protein
- LDH
and compare with serum
Protein f : Protein s > 0.5
LDH f : LDH s > 0.6
LDH > 0.67 x upper limit serum LDH
Light’s criteria
Exudate or transudate effusion
Protein f : Protein s > 0.5
LDH f : LDH s > 0.6
LDH > 0.67 x upper limit serum LDH
= EXUDATE
Pt has had pneumonia and then follows up and CXR looks the same after SX are over
Normal, follow up 6 weeks to repeat CXR
Pneumonia pt cleared sx then comes back after 2 weeks with new onset SOB, fever, cough
TX and what is it
Hospitalization causing pneumonia
Pseudomonas aeruginosa
MRSA (STAPH AURES)
= Cefepime (pseudomonas) + Vancomycin (S. AURES)
Community acquired pneumonia tx
- B-lactam
2. Macrolide OR respiratory fluoroquinolone (oral, if not severe)
Pleural Effusion DX And sx
Pleuriric pain , SOB, Cough, asymptomatic
CXR
COVID SX and labs
Tachy, 76% O2 sat, high RR, = wheezing, = loss of taste , SOB, fever, cough = high WBC, Plt, BUN, Cr = HIGH D-dimer, CRP
COVID CXR
Ground glass appearance: hazy all over like ARDS