Pneumonia (SultanAli) Flashcards
delete whatever he said we don't need to learn
How is pneumonia characterized?
- fever/chills
- respiratory signs and symptoms
(cough, dyspnea, hemoptysis, pleuritic pain, expectoration) - at least one opacity on CXR
- possible flu-like symptoms
T/F: lung infection has the greatest global burden of all diseases
T
____ is the #8 leading cause of death in the US
community acquired pneumonia
Who is most commonly infected with pneumonia?
very young and the elderly (bimodal disease)
What are the risk factors for comm acquired pneumonia?
- age (very young and very old)
- personal habits (etoh/smoking)
- comorbidities
- immunodeficiency (neutropenia, asplenia)
- occupational (soldiers, animal exposure)
- geographic
(*do we need to learn the specifics?)
Marijuana use increases the risk of infection by what organism?
Aspergillus
Common causes of CAP in patients who do NOT require hospitalization:
Streptococcus Pneumoniae Mycoplasm Chlamydia Haemophilus
(Severe Pneumonia Makes me Cough Hard)
Common causes of severe CAP
Strep pneumoniae enteric g- bacilli Staph aureus Legionella Mycoplasma pneumoniae Respiratory viruses Pseudomonas aeruginosa
Routes to the lung:
what are the two most common?
*aspiration
*inhalation
hematogenous
contiguous spread
reactivation (more common in immunocompr)
Hospital acquired pneumonia usually results from what route to the lung?
inhalation
By what routes does TB infect?
inhalation
reactivation in immunocompromised indv
What three factors determine if exposure will result in pneumonia?
- host defenses
- agent virulence
- inoculum load
What are common oral flora?
anaerobes
gram + cocci
alpha-hemolytic strep
Moraxella sp.
What flora are common sub-epiglottis?
none–it’s sterile
What type of infections are related to:
hospitalizations?
antibiotics?
dental/gum disease?
g-
superinfections
anaerobes
What are mechanical host defense mechanisms?
gag/sneeze
cough reflex
mucus/cilliary
How do macrophages function in host defense?
- initial defense against pathogens–prevent in alveoli
- eliminate intracellular organisms (Legionella)
- “clean-up”
- APC
What cellular immune cells protect against:
- TB
- bacteria
- fungi
- T cell lymphocytes
- B cell lymphocytes
- T cell lymphocytes
Level of hypoxia correlates with:
severity of disease
How does pneumonia cause hypoxia?
shunt**
What cytokines are produced by inflammation?
What does this cause?
TNF, IL1, IL6, PAF
cellular damage > capillary leakage
Exudate and pus in the lungs causes:
impaired gas exchange
Pneumonia = infection of:
lung parenchyma
What three symptoms, when present, correlate to a pneumonia likelihood ratio of 5?
fever + tachypnea + tachycardia
Chest exam findings that = pneumonia: (7)
- dullness to percussion
- increased fremitus
- egophony
- crackles
- pleural friction rub
- rales (in sitting position)
- bronchial breath sounds (louder and harsher than vesicular breath sounds)
What is the function of quantifying characteristics of patients with pneumonia (pneumonia severity index)?
determine risk of mortality in order to drive decisions for management (admit, ICU, discharge, etc)
What are the pneumonia severity index criteria?
consciousness
BUN
resp rate
BP 65
CAP results in __% requiring ICU admission; among those patients, there is a ___% mortality rate
2
35
How is pneumonia confirmed?
CXR
