Week 2 Pneumonia ✅ Flashcards
What factors about sputum do we need to know about?
Volume, colour, texture, smell
What is significant about bronchiactasis?
Affects older people
Lots of sputum
How can phlegm be measured?
Teaspoon, egg cup, cup
What causes a barking cough?
Increased pressure against vocal cords
What does whooping cough sound like?
Cough cough…… bark
What is stridor?
Harsh inspiratory sound
upper airway - trachea upwards e.g. mass against trachea
What is wheeze?
Episodic lower respiratory sound on expiration
Why do we get pleuritic pain?
Lungs have no pain fibres
Why do anaerobic bugs when pleuritic chest pain?
Not moving lungs to breathe so worse infection
What scale is breathlessness measured on?
MRC scale 1-5
What must you ask for in a respiratory drug history?
Inhalers
What is whispering pectoriloquy?
Whispered words are heard clearly in the presence of consolidation on auscultation
What is the GCS for AVPU?
A - 15
V - 12/13
P - 8-9
U - 3
What is pneumonia?
Consolidation from infection on x-ray
Pus/blood/fluid etc
Problems with diagnosing pneumonia in primary care? PoC testing?
No CXR!
PoC - COVID test, spirometry
What are the symptoms of pneumonia?
Cough + 1 other respiratory system + 1 systemic symptom
What types of pneumonia are there?
Community acquired
Hospital acquired
Nursing home acquired
Aspiration
Immunocompromised
Ventilated associated (as bypassed nose and throat)
Bacterial
Viral
Fungal
How do you get aspiration pneumonia?
Problems with larynx - food going into lungs when swallowing
What does viral pneumonia look like on CXR?
Lots of little bilateral changes
What must you do if fungal pneumonia is suspected?
Screen for HIV as it is longer growing pathogen
What is atypical pneumonia?
Pathogen hard to grow in lab - more uncommon pathogen
Which tool should be used if pneumonia is suspected?
CURB65 secondary care
CRB5 in GP
Where do aerobic and anaerobic pathogens grow in the lungs?
Aerobic - lung apex/top of lungs
Anaerobic - base of lungs
If CRP is not high, what type of pneumonia might the patient have?
Viral
If CRP is high, what type of pneumonia might the patient have?
Bacterial, fungal or even abscess
What is the first and second line treatment for pneumonia?
Amoxicillin
Doxycycline
How do you assess confusion?
AMTS (abbreviated mental test score)
If a patient complains of cough, how long should you advise it will take to resolve?
3-4 weeks
Why is pneumonia more likely in lung cancer?
Mass in lung blocks mucocillary staircase
If a cough has not resolved in 6 weeks what are the next steps?
CXR
What should you do if a smoker has a cough for >6 weeks?
CZE
Why does pulmonary embolism kill?
Causes the right side of the heart to beat faster but if it cant then die
What type of pain is pancoast tumour?
Persistent pain
What are symptoms of pancoast tumour?
Pain, wasting of hands/arm etc
How many mls of fluid is there normally in the pleural space?
5ml
