Respiratory infections: pneumonia (R1) Flashcards
Symptoms
- Chest pain (often pleuritic)
- SOB
- Cough +- haemoptysis
- Fever, sweats, rigours
- If bad, vomiting, confusion
Risk factors
Community acquired pneumonia
- Sick contacts
- Vaccination status
- Occupation
- Recent travel
- Country of origin
- Exposure to birds, farms, animals moulds, soils
Healthcare/hospital/ventilator acquired pneumonia
- Do you live in a nursing home?
- Have you recently been hospitalised?
- Have you recently been put on a ventilator?
Immunocompromised
- Underlying lung conditions: eg. COPD, asthma, cystic fibrosis
- Immunosuppressive disease: diabetes, cancer, HIV, transplant
- Immunosuppressive medications
- Alcoholics
Exam:
- General inspection
- Vital signs
General inspection: respiratory distress, use of accessory muscles
Vitals
- ↑Resp rate, ↓PO2
- Potentially ↑temp, ↑HR, ↓BP (think sepsis)
Exam: auscultation
- Breath sounds (increased or decreased)
- Percussion notes
- Vocal resonance
- Decreased breath sounds
- Dull percussion
- Increased vocal resonance
Exam: auscultation
- Additional sounds?
Bronchial breath sonds
Coarse crackles
Expiratory wheeze
Pleural friction rub
Investigations
- Bedside?
Investigations:
- Labs?
Investigations
- Imaging?
Investigations
- What are some tools uesd to assess pneumonia severity
CURB-65 (alternatives: CORB-65, CRB-65)
SMART-COP
CURB-65
- What are the measures?
- What is O in CORB-65?
O: PO2 <90%
CURB-65
- What are the levels of severity?
SMARTCOP
- What are the measures?
SMARTCOP
- What are the scores?
IRVS: intensive respiratory or vasopressor support
Treatments
- 3 categorise?
Treat underyling cause - antibiotics, antivirals, antifungals
Treat/prevent complications (ie. sepsis)
Symptom relief
Antibiotics
- Empirical cover for community acquired pneumonia?
