Pneumonia - LSRC Flashcards
Investigations
blood gas FBC blood cultures U&Es CRP LFTs CXR urine dipstick ECG
typical blood results
raised creatinine raised urea raised CRP raised WCC raised neutrophils raised lactate
CXR
patchy opacification
air bronchograms
sparing of the costophrenic angle suggests middle lobar pneumonia
what are air bronchograms?
area of consolidation
suggest pneumonia
risk factors
elderly young children underlying respiratory disease -asthma, COPD immunosuppression/HIV co-morbidities - heart disease
clinical features
fever productive cough discoloured sputum shortness of breath pleuritic chest pain high respiratory rate low O2 sats crackles bronchial breathing
atypical pneumonia
more constitutional symptoms low grade fever malaise headaches myalgia cough
management
supportive
fluids
supplemental oxygen
antibiotics
what is pneumonia?
severe form of acute LRTI causing inflammation of lung in which the alveoli become filled with inflammatory cells
what are the stages of pneumonia?
consolidation
red hepatisation
grey hepatisation
resolution
consolidation timing
first 24 hours
consolidation
cellular exudates containing neutrophils, lymphocytes and fibrin replaces the alveolar air
capillaries surrounding the alveolar walls become congested
infection spreads to hilum and pleura causing pleurisy
timing of red hepatisation
2-3 days after consolidation
red hepatisation
lungs become hyperaemic
alveolar capillaries are engorged with blood
fibrinous exudates fill the alveoli
many erythrocytes, neutrophils, desquamated epithelial cells and fibrin within the alveoli
timing of grey hepatisation
2-3 days after red hepatisation
