RESP Flashcards
What are the three types of pneumonia?
HAP
CAP
Aspiration
What is the definition of a HAP?
> 48 hours after admission
Name 5 signs of septic shock secondary to pneumonia.
• Tachypnoea (raised respiratory rate) • Tachycardia (raised heart rate) • Hypoxia (low oxygen) • Hypotension (shock) • Fever ConfusioN
Name 3 chest signs of pneumonia.
- Bronchial breath sounds - consolidation of surrounding lung tissue (inspiration and expiration)
- Focal coarse crackles - air passing through sputum (like a straw through a drink)
Dullness to percussion - due to collapse or consolidation
Which bacteria most commonly cause CAP?
Streptococcus pneumoniae
Haemophilus influenzae
Which bacteria cause pneumonia in immunocompromised patients?
Moraxella catarrhalis
Which bacteria cause pneumonia in patients with cystic fibrosis?
Pseudomonas aeruginosa
Staphylococcus aureus
Which investigations should be ordered for pneumonia?
CXR
FBC (WCC)
U&Es (for urea)
CRP
When is a rise in CRP expected in pnuemonia?
Delayed response, 2-3 days after.
WCC is more accurate of current infection.
Patients who are immunocompromised may not see a rise in CRP.
What scoring system is used to assess the severity of pneumonia? What are each of the parameters?
• C – Confusion (new disorientation in person, place or time)
• U – Urea > 7
• R – Respiratory rate ≥ 30
• B – Blood pressure < 90 systolic or ≤ 60 diastolic.
65 – Age ≥ 65
How should you interpret the CURB65 score?
• Score 0/1: Consider treatment at home
• Score ≥ 2: Consider hospital admission
Score ≥ 3: Consider intensive care assessment
What are the complications of pneumonia?
Sepsis Pleural effusions Empyema Lung abscess Death
What is the definition of an atypical pneumonia?
Cannot be cultured in the normal way OR detected using a gram stain.
How can you remember the 5 causes of atypical pneumonia?
Legionella pneumophila Psittaci Mycoplasma pneumoniae Chlamydia pneumoniae Coxiella burnetii (Q fever)
What electrolyte imbalance is seen in legionnaires disease? How is it caused?
Hyponatraemia
SIADH
Which bacteria causes pneumonia and erythema multiforme?
Mycoplasma pneumoniae
Which bacteria is associated with farming/animals?
Coxiella burnetii (Q fever)
Which bacteria is associated with infected birds?
Chlamydia psittaci
Which organism causes fungal pneumonia? Which patients are most likely to be infected?
Pneumocystis jiroveci (causes PCP in patients with HIV)
What antibiotics can be used to treat atypical pneumonias?
macrolides (e.g. clarithromycin)
fluoroquinolones (e.g. levofloxacin)
tetracyclines (e.g. doxycycline)
Which antibiotic is used to treat PCP?
Septrin
Which organisms is more common in patients who have recently had influenza?
Staphylococcus aureus
What are the two types of lung disease that can be distinguished using lung function tests?
Obstructive
Restrictive
What is FEV1?
Forced expiratory volume in 1 second
What is FVC?
Forced vital capacity
What is a reversibility test?
Use a bronchodilator e.g. salbutamol and repeat the test.
Describe the pattern seen in obstructive disease? Name two causes.
FEV1:FVC ratio is <75%
FEV1 <80%.