Respiratory - Pneumonia Flashcards
pneumonia
a syndrome caused by infection
inflammation of the lung parenchyma
consolidation- new lung shadowing on cxr
how is pneumonia classified
by source of infection
community acquired
hospital acquired
aspiration pneumonia
symptoms of pneumonia
fever, purulent cough,SOB, pleuritic chest pain
signs: increased resp, increased HR, coarse crep and decreased air entry, hypotension
auscultation sounds in pneumonia
a.coarse crepitations
b.fine inspiratory crackles
c.pleural rub
a.coarse crepitations
new radiographic infiltrate in prescence of infection with onset at least 48 hrs after hospital admission (or within 2 weeks of discharge)
hospital acquired pneumonia
aspiration pneumonia occurs at the upper airway when it is colonised with gram……..
a.positives
b.negatives
b.negatives
esp if prev antibitoics
enteric bacilli
pseudomonas
MRSA
Which bacteria usually present in hopsital acquired pneumona
a.enteric bacilli, pseudomonas,MRSA
b.strep pneum, haem influenzae
a.enteric bacilli, pseudomonas,MRSA
risk factors for hopsital acquired pneumonia
> 70
comorbidities
surgery
NG tube
gram……… are the main cause of community acquired pneumonia
a.positives
b.negatives
a.positives
which gram positive cause of community acquired pneumonia is more common in copd
a.strep pneum
b.haemophillus influenzae
c.moraxella catarrhalis
d.pseudomonas
c.moraxella catarrhalis
which bacteria cause atypical pneumonia
legionella
mycoplasma
chlamydia
first line investigation for community acquired pneumonia
a.o2 assessment
b.cxr
c.bloods
d.microbiology
a.o2 assessment
check if can go home
second line investigation for community acquired pneumonia
a.o2 assessment
b.cxr
c.bloods
d.microbiology
b.cxr
shows consolidation in lower lobes (patchy changes cant make out border of diaphragm)
if consolidation is upper consider other causes …
TB, aspirated, tumour (if tumour occludes bronchus then can cause pneumonia)
which blood test is deranged if pneumonia is caused by mycoplasma or legionella
a.wcc
b.crp
c.u and e
d.lft
d.lft
poor prognosis factors
> 65 yrs
rr >30
confusion
hypotension
urea >7
albumin <35