Resp - Complications Of Pneumonia

Question 1

Respiratory failure: 2 types and Mx

Answer 1

• Type 1: PaO2 <8kPa + PaCO2 <6kPa
• Type 2: PaO2 <8kPa + PaCO2 >6kPa
• Mx: O2 therapy, ventilation

Question 2

Complication - hypotension: cause and Mx

Answer 2

-Cause: dehydration + septic vasodilatation

Mx

• If SBP<90 → 250ml fluid challenge over 15min
• If no improvement: central line + IV fluids
• If refractory: ITU for inotropes

Question 3

Complication - AF (when does it go away and Mx)

Answer 3

• Usually resolves ̄c Rx

- Mx: Digoxin or β-B for rate control

Question 4

Complication - Pleural effusion (what is it and what is Mx?)

Answer 4

• Exudate in the pleural space

- Mx: tap and send for MC+S, cytology and chemistry, Rx with appropriate ABX

Question 5

Complication - Empyema (Definition, bugs, pt symptoms, MX)

Answer 5

• Pus in pleural cavity
• Bugs: anaerobes, staph and gram -ve bacteria
• Pt with resolving pneumonia develops a recurrent fever
• Mx: US guided chest drain and ABX

Question 6

Lung abscess: causes

Answer 6

• Aspiration
• Bronchial obstruction: tumour, foreign body
• Septic emboli: sepsis, IVDU, RH endocarditis
• Pulmonary infarction
• Subphrenic / hepatic abscess

Question 7

Lung abscess: features

Answer 7

• Swinging fever
• Cough, foul purulent sputum, haemoptysis
• Malaise, wt. loss
• Pleuritic pain
• Clubbing
• Empyema

Question 8

Lung abscess Mx

Answer 8

• ABX according to sensitivities
• aspiration
• surgical excision