Respiratory System - Pneumonia Flashcards
Define pneumonia?
Inflammation of the substance of the lungs
What is the commonest cause of community acquired pneumonia?
- Streptococcus pnuemoniae
2. Haemophilus infulenzae
Define hospital acquired pneumonia and state the commonest causes?
> 48 hours after hospital admission
Staphylococcus aureus
Which patient groups are at increased risk of aspiration pneumonia and where does the infection normally reside?
Stroke
Bulbar Palsy
Myesthenia Gravis
Due to anatomy, most commonly right middle and right lower lobes are affected
Describe the symptoms associated with pneumonia?
- Cough
- Breathlessness - alveoli fill with puss which impairs gas exchange
- Fever
- Chest pain - pleuritic in nature
Describe 6 extra-pulmonary symptoms associated with pneumonia?
Rigors Malaise Confusion Hallucinations Myalgia Headache
What are the clinical signs of pneumonia?
Pyrexia (39.5-40 degrees) Confusion Cyanosis Tachypnoea Tachycardia Hypotention Cosolidation
Define the clinical signs of consolidation?
Plueral rub
Decreased chest expansion
DULL percussion note
Bronchial breathing
Describe the risk factors for pneumonia?
Age (extremities) Co-morbidities (diabetes/HIV/CKD) Smoking Alcohol Iatrogenic - via immuno-suppression therapy
How would you grade the severity of pneumonia?
CURB-65 score Confusion? Urea? Respiratory rate? Blood pressure? Age - >65
Which forms of investigation would be required in a mild case of pneumonia?
NO microbiological tests needed
CXR needed if symptoms do NOT improve in 24h
Clarithromycin and Amoxicillin (standard treatment)
What is the significance of CXR?
Highlights areas of lobar consolidation and distinguishes from multi-lobar infiltrates. Identifies cavitations and pleural effusions.
In a FBC - what is the normal range for WBC?
11.0-12.0 mmol
In a FBC - what is the normal range for neutrophils?
8.0 mmol
In a FBC - what is the normal range for Hb?
Male = 13.0 - 18.0 Female = 12.0 - 16.0
