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Breathlessness > Puemonia > Flashcards

Puemonia Flashcards

1
Q

Why are post surgical patients more at risk of puemonia?

A

Shallow breathing due to abdo pain

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2
Q

Why are patients in hospital at a higher risk of resistant bacteria causing infection? (2)

A
  • Recent antibiotic exposure

- More resistant organisms in hospital environment

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3
Q

Why is hospital accquired pneumonia more difficult to diagnose? (3)

A
  • Non specific (Low O2 sats/breathlessness could be another cause)
  • Multiple sources of infection e.g catheter
  • Chest x ray difficult to interpret - chronic changes?
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4
Q

What pathogens cause hospital accquired pneumonia? And which is the most typical?

A
  • Multi drug resistant organisms e.g MRSA (most typical)
  • Gram negative/bowel flora (klebsiella pneumoniae/escherichia coli)
  • Environmental organisms (pseudomonas spp)
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5
Q

What does MRSA stand for?

A

Meticillin resistant staphyococcus aureus

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6
Q

Give 2 examples of bowel flora causing HAP and how do they cause it?

A
  • Kebsiella pneumoniae
  • Escherichia coli
    Pathogens usually living in bowel colonising throat
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7
Q

Give an environmental organism that causes hospital accquired pneumonia. Where does it grow? (2)

A

Pseudomonas app

  • Showerheads/taps
  • Measured in hospital water supply
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8
Q

Under what criteria is pneumonia classified? (4)

A
  • Community acquired: no recent hospital contact
  • Hospital acquired: after 48 hours in hospital
  • Ventilator associcated: after 48 hours of ventilation
  • Aspiration: not time related = community/hospital = different cause (intrinsic)
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9
Q

What factors in patients are associated with aspiration pneumonia? (3)

A
  • Reduced consciousness
  • Dysphagia (stroke)
  • Upper GI tract disorders : poor swallow e.g acid reflux
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10
Q

What factors in patients are associated with streptococus pneumoniae distinctly from other types of pneumonia? (3)

A
  • Extremes of age
  • Immunocompromised patients e.g HIV/diabetes/asplenic
  • Family history: children spreading to grandparents
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11
Q

What factors in patients are associated with streptococus aureus distinctly from other types of pneumonia? (2)

A
  • Young adults

- Post infuenza

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12
Q

What does strep aureus pneumonia tend to progress to?

A

Caviating pneumonia

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13
Q

What type and examples of symptoms are more common in mycoplasma pneumoniae? (4)

A

Extra-resp manifestations:

  • Haemolysis: RBC breakdown (jaundice)
  • Skin: erythema multiforme (hypersensitivity reaction to infection - round red/pink flat macules, backs of hand and tops of feet spread to trunk)
  • Skin: Steven Johnsons syndrome (flu with maccule rash like targets on starting on trunk)
  • Cardiac: pericarditus, myocarditus
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14
Q

What factors in patients are associated with leginella distinctly from other types of pneumonia? (3)

A
  • Moderate - severe community accquired puemonia (sometimes hospital)
  • Outbreak in hotels/nursing homes etc
  • Failure to respond to antibiotics
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15
Q

What signs more common in legionella infections than other puemonias? (3)

A
  • Low sodium
  • GI symptoms
  • Elevated ALT/AST
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16
Q

What factors in patients puts them at risk of hospital accquired puemonia? (3)

A
  • Post surgical patients
  • Chronic lung disease
  • Aspiration risk factors
  • Immunocompromised
17
Q

How can the particular cause for puemonia be detected? (2)

A
  • Indirect detection: complement fixation test

- Direct detection: PCR

18
Q

What is a complement fixation test for the indirect detection of the cause of puenmonia?

A

Immunological test= detects presence of specific antibody/antigen in patient’s serum based on if complement fixation occurs

19
Q

What is the advantage of using PCR for the direct detection of the puemonia cause?

A

Detects dead organisms too - if someone had previous infection

20
Q

Why do legonella antigens detected in a urine test suggest definite infection?

A

Legionella not naturally found in humans, if detected=infection

21
Q

Why can investigations for pneumonia be unreliable? (2)

A
  • Sputum : some patients have a little pnuemonae

- Urine: children have some colonisation of pnuemonae bacteria : false positive

22
Q

What type of patients is mycoplasma pneumoniae associated with?

A

Children and adolescents

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