Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics > W22 - Pneumonia > Flashcards

W22 - Pneumonia Flashcards

1
Q

what is pneumonia

A

inflmmation of the lung parenchyma of infective origin characterized by consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how can pneumonia be prevented

A

immunization

adequate nutrition and addressing environmental factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

if caused by bacteria what can it be treated by

A

antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the difference between primary and secondary pneumonia by aetiology

A

Primary has no apparent pre existing conditions that may predispose to pneumonia

Secondary pneumonia risk factors predisposing for pneumoniaare present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three forms of pneumonia by affected lung area

A

bronchopneumonia

lobar

interstitial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is bronchopneuomonia

A

acute inflammation of the wallers of the smaller bronchial tubes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is lobar

A

severe infection of one or more of the 5 major lobes of the lungs that if untreated eventually results in consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is interstitial

A

a condition of diffuse, chronic inflammation of the lungs beyond the terminal bronchioles, characterized by fibrosis and collagen formation in the alveolar walls and by the presence of large mononuclear cells in the alveolar spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the 2 locations catagories for pneumonia

A

community

hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the 3 classifications

A

Aetiology
Lung Affected
Location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what risk factors exist for community acquired (CAP)

A

Age <2 or >65

Living or working with in nursing home or in contact with children

smoking

preexisting pathologicla conditions e.g. COPD

influenza

Hospitilization in the past 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a common cause of pneumoniae

A

streptococcus pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some other common causes

A

gram positive bacteria

Viruses e.g. influenza

gram negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are symptoms of CAP

A 
cough
Temp >38
Sputum production
Breathlessness
Feeling generally unwell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the four stages of pneumonia

A

Consolidation
Red hepatization
Grey hepatization
Resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when does consolidation occur

A

first 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what happens during consolidation

A

cellular exudates containing neutrophils,lymphocytes and fibrin replaces the alveolar air

capillaries in the surrounding alveolar walls become congested and the infection spread to the hilum and pleura fairly rapidly

Pleurisy occurs marked by coughing and deep breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when does red heaptization occur

A

2-3 after consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what happens in red hepatization

A

consistency of lungs resembles liver as they become hypeamic

alveolar capillaries are engorged with blood

fibrinous exudates fill the alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is red hepatization characterized by

A

presence of many erythrocytes, neutrophils, desquamated epithelial cells and fibrin within alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when dose grey hepatization occur

A

2-3 days after red hepatization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what happens in gray hepatization

A

avascular stage where the lungs go gray brown to yellow because of fibrinopurulents exudates and disintegration of red cells and hemosiderin.

Pressure of exudates in the alveoli causes compression of the capillaries, leukocytes migrate into the congested alveoli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when does resolution occur

A

8-9 days after infection

24
Q

what occurs during resolution

A

large number of macrophages enter the alveolar spaces

Phagocytosis of the bacteria-laden leucocytes occur

consolidation tissue re aerates and the fluid infiltrate causes sputum

25
Q

what is resolution characterized by

A

resorption and restoration of the pulmonary architecture

26
Q

How can we make a diagnosis in primary care

A

acute illnes <21 days
cough
at least one symptom of lower respiratory tract infections

27
Q

how do we rank severity

A

we use CRB65 score to rank the mortality risk

28
Q

what should be done if there was no score

A

home based treatment 1% risk of death

29
Q

what should be done if there was 1 or 2 scored

A

hospitilization required as there is a moderate 1-10% risk of death

30
Q

what should be done if there is a 3 or 4 scored

A

hospitilization required as there is a larger than 10% chance of mortality

31
Q

how do you get scored on the CRB65

A

Confusion < 8 points

Respiratory rate > 30BPM

Low Blood Pressure

  • Sys <90
  • Diast <60

Age >65

32
Q

how can we differentiate bacterial pnumonia from covid 19 pneumonia

A

Its covid if:

  • History of typical symptoms of covid 19 for about a week
  • loss sense of smell
  • breathless but no pleuritic pain
  • history of exposure to known or suspected covid 19

its bacterial if
- becomes rapidly unwell after only a few days of symptoms
- does not have a history of typical covid symptoms
- has pleuritic pain
has purulent sputum

33
Q

what is pleuritic pain

A

pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing

34
Q

How do we determine severity in primary care

A

CRB65

Oxygen saturation level

Signs and symptoms

35
Q

how do we treat low severity community aquired pneumonia

A

5 day course of antibiotic e.g.

Doxycycline or amoxicillin

36
Q

what is the preferred first line treatment of CAP

A

Doxycycline 200mg 1st day then 100mg 4days

37
Q

what is the second line treatment of CAP

A

Amoxicillin 500 mg x3 x5 days

38
Q

what can be used in place of penicillin or amoxicillin

A

Clarithromycin 500mg x 3 x 5

Erythromycin 500mg x4 x 5

39
Q

what can we use to form a diagnossi in hospital

A

Chest X Ray

Oxygen saturation - measuring the haemoglobin binding site in the bloodstream occupied by oxygen

CURB65 score - urea and electrolytes for mortality risk assessment in hospital

C-reactive protein

Microbiological test

Full blood count

Liver function tests

40
Q

Since covid what new tests do we do to distinguish the pneumonia and covid.

A

SARS - CoV2 polymerase chain reaction assay

Legionella and pneumococcal antigen tests

41
Q

what are two penicillins that we use

A

amoxicillin, ampicillin

42
Q

what are two macrolides we use

A

erythromycin, chlarithromycin

43
Q

what are two teracyclins we use

A

tetracylin doxycyclin

44
Q

What should we do with a diagnosis of pneumonia or sepsis

A

start empiric treatment with antibiotic
within 1-4 hours of presentation to hospital max
do not wait for microbiological test results

45
Q

what should we treat moderate CAP

A

coamoxiclav with clarithromycin

cefuroxime with clarithromycin (second line)

46
Q

what should we treat severe CAP with

A

levofloxacin

47
Q

what happens as a result of therapeutic failure

A

increase of lung infiltration is indication of therapeutic failure

48
Q

what are some possible causes of therapeutic failure

A 
Wrong diagnosis
Unexpected pathogen 
Pathogens not covered by selected antibiotic
Antibiotic resistance
Inadequate dose
Non-compliant patient
Complicating condition
Impaired local or systemic defences
Local or distant complications of CAP
Overwhelming infection
49
Q

What is hospital acquired Pneumonia

A

defined as pneumonia that occurs 48 hours or more after hospital admission and is not incubating at hospital

50
Q

What are the risk factors HAP

A 
stroke 
chronic lung disease 
mechanical ventilation
recent surgery 
previous antibiotic treatment
51
Q

what are the causes HAP

A

bacteria and virus
resistant pathogens
may need treatment with extended spectrum antibiotics

52
Q

what is a diagnosis often confirmed by HAP

A

confirmed by chest X ray

53
Q

are there any validated tools to assess severity of HAP in context of covid 19 `

A

Nop

54
Q

what should be given in low risk HAP

A

oral 5 day single of

doxycycline
co amoxiclav
co trimoxazole
levofloxacin

55
Q

what should be given in high risk HAP

A

intravenous piperacillin with tazobactam

ceftazidime

levofloxacin if other options unsuitable

Therapeutics (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions