Respiratory 2 - Pneumonia Flashcards
summarise signs of pneumonia
SOB productive cough fever haemoptysis (can be) pleuritic pain (can be) delirium sepsis
3 auscultation signs with pneumonia
bronchial breathing
focal coarse crackles
dullness to percussion
CURB65
confusion, urea >7, resp >30 breaths/min, BP below 90, 65 years old
if 2+ consider hospital admission
2 main pneumonia bugs
strep pneumo
h influenzae
3 conditions and associated bugs
pseudomonas - CF, bronchiectasis
staph - CF, viral infection
moraxella - IComp, chronic pulmonary disease
define atypical pneumonioa
can’t be cultured or gram stained
don’t respond to penicillins
5 main atypical pneumonias + facts
legionella - Legionnaire’s, hyponatraemia, infected water or air con
mycoplasma - erythema multiforme +/- neuro signs in younger patient
chlamydia pneumo
coxeilla burnetti / Q fever - farmer etc, need exposure to animal body fluids
chlamydia psittaci - parrot owner
fungal pneumonia, PCP
describe, treat etc
pneumocystis jiroveci
IComp (HIV, or other)
dry cough + no sputum
exertional dyspnoea
night sweats
give co-trimoxazole, Septrin
3 bloods + 4 other inv for pneumonia
CXR
FBC, UE, CRP
sputum culture
blood culture
legionella + pneumococcal urinary antigens
WBC more up to date than CRP which lags
CAP treatment
mild
mod
severe
local guidelines always
mild CAP - 500mg amox TDS 5days
moderate - 500mg amox TDS + 500mg clarithro BD 5 days
severe - 500/125mg co-amox TDS + 500mg clarithro BD 5 days
HAP treatment
mild - co-amox 500/125mg TDS
severe - many options: tazocin 4.5g TDS, ceftriaxone 2g OD, meropenem etc etc
MRSA - vancomycin, linezolid
5 complications of pneumonia
sepsis pleural effusion empyema lung abscess death
