Pneumonia part 1 Flashcards
5 most common pathogens causing CAP?
Strep pneumonia, h influenza, klebsiella, staph aureus, PA.
What are 6 atypical pathogens causing CAP?
Mycoplasma pneumonia, c pneumonia, Legionella pneumonia influenza, parainfluenza, and RSV.
What is the first line defense antibiotic for ambulatory patients with CAP? What do we give if they can’t tolerate the first line defense?
Macrolide.
Doxycycline
What if the patient has increased drug resistance with CAP, what do we prescribe? Also, what 3 things would cause someone to be drug resistant?
Antibiotics in the past 90 days, Immunosuppression, exposed to kids.
Fluor or macrolide with beta lactam
What do we prescribe to patients with CAP in the hospital?
Fluoro
What do we prescribe a patient with CAP in the ICU?
Fluoro and 3rd generation cephalosporin.
Give penem for PA coverage.
What age does atypical CAP present in and what are the symptoms?
Young Adults
Follow symptoms of URI
What 3 antibiotic types do we need to give for atypical pneumonia pathogens?
Macrolide, Fluoro or tetracycline
What is a unique clinical symptoms of chlamydia pneumonia?
Hoarse voice
All treatments for CAP must be how many days at minimum?
5
What lab can be ordered to aid in differentiating between viral and bacterial Pneumonias and why?
Procalcitonin because it is a precursor of calcitonin that becomes elevated in pro inflammatory stimuli, especially bacterial in origin.
What are the 5 criteria to determine the severity of someone’s pneumonia when they show up at the ED?
Confusion, BUN over 20, RR over 30, BP less than 90/60, and older than 65. Each one, if positive, gets you a point.
0-1 low risk, outpatient
2 -moderate risk, closely monitor
3-5 sever pneumonia and admit to hospital.
3 things to know about legionella?
Gram negative, bacillus, artificial water sources like AC or hot tub.
What are the two things that macConkey agar selects for?
Gram negative and fermenters
What 3 things to know about klebsiella itself as the pathogen as far as features of the bug?
Encapsulated, gram negative, fermenter
What are your 3 fast fermenters?
Klebsiella, E. coli, and Enterobacter
What are your two slow fermenters?
Citrobacter an serratia
In general, what type of bacteria are lactose fermenters?
Gram negative rods.
What anatomical type of pneumonia does strep pneumonia cause?
Lobar
What kind of sputum does strep pneumonia cause?
Rust colored
3 things to remember about strep pneumonia itself, its features?
Alpha hemolytic, has a urinary antigen, and encapsulated
3 things to remember about mycoplasma pneumonia she talked about?
No cell wall, causes microcytic anemia, and amoxicillin will not work.
2 features of pseudomonas?
Gram negative bacillus and encapsulated
2 features of H influenza?
Gram negative diplocci and can be encapsulated
What agar do we use for h influenza?
Chocolate agar
What two conditions does h influenza like to colonize?
Smokers and immunocompromised
What patients does m catarrhalis like to colonize?
Smokers, COPD, and asthmatics
What two conditions does PA like to colonize?
CF and bronchiectasis
2 features of staph aureus to know?
Gram positive, catalase and coagulase positive
