Session 8: Pneumonia Flashcards
Define pneumonia
A general term to describe the inflammation of parenchyma of the lung due to infection.
What is inflammation of the lung parenchyma called in the absence of infection?
Pneumonitis
Give examples of lower respiratory tract infections.
Pneumonia Bronchitis Bronchiolitis Empyema Bronchiectasis Lung abscess
Causes of pneumonitis
Chemical or physical damage for example
What is a common feature of pneumonia?
Cellular exudate in the alveolar spaces.
Pneumonia can be divided into classifications. Which?
Lobar pneumonia Broncho pneumonia
What is the difference between lobar pneumonia and bronchopneumonia?
Lobar pneumonia is when the pneumonia is restricted to a particular lobe/s of the lung. Bronchopneumonia is more diffuse and patchier. (Not restricted to lobes)
Pneumonia is also classified due to its source of infection. State the different classifications.
Community acquired pneumonia Nosocomial/Hospital acquired pneumonia Aspiration pneumonia Immuno-compromised pneumonia
Most common causative organisms of community acquired pneumonia.
Streptococcus pneumonia (most common) followed by Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, Staphylococcus aureus
What is atypical pneumonia?
A form of community acquired pneumonia caused by atypical organisms.
Give the most common causative organism of atypical pneumonia + some other
They are atypical because they lack a cell wall. Mycoplasma pneumoniae is the most common. Chlamydia pneumoniae and Legionella pneumophila also occurs.
How to diagnose CAP.
Clinical presentation - sputum sample, dyspnoea, fever, tachycardia, crackles. Imaging - consolidations, infiltrates and cavitation.
Antibiotic treatment of CAP.
Since it is mainly pneumococcal it is treated with amoxicillin. However it depends on the severity.
Antibiotic treatment of atypical pneumonia.
As they don’t have a cell wall and can survive intracellularly penicillins will not work. Instead antibiotics that act on protein synthesis such as macrolides (erythromycin/clarithromycin) or tetracyclines like doxycycline can be used. Doxycyclin or a macrolide can also be used in mild-moderate CAP.
What is the definition of nosocomial pneumonia?
Symptoms that arise 48 hours after hospital admission and was not incubating at the time of admission.
What are nosocomial pneumonia more associated with?
Impaired defence
Give examples of defences of the respiratory tract.
Muco-ciliary escalator Coughing Sneezing Respiratory mucosal immune system. Alveolar microbiota
Briefly explain the Respiratory mucosal immune system.
Lymphoid follicles of the pharynx and tonsils. Alveolar macrophages. Secretion of IgA and IgG.
Common causative organisms of nosocomial pneumonia.
Gram-negative bacteria but also Staph aureus and MRSA.
Antibiotic treatment of nosocomial pneumonia.
As it is most commonly gram-negative Co-amoxiclav is used.
In case of MRSA nosocomial pneumonia, what antibiotic should be used?
Vancomycin
What is aspiration pneumonia?
Aspiration of food, drink, saliva, vomit or any other foreign body can lead to pneumonia.
Give risk factors for aspiration pneumonia.
Patients with altered consciousness such as anaesthesia, alcohol, drug abuse. Neuromuscular problems or oesophageal disease as well.
