04-16 Pneumonia Flashcards Preview

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Flashcards in 04-16 Pneumonia Deck (14):
1

Describe the pathogens that cause different types of pneumonia and the drugs that treat them

COMMUNITY-ACQUIRED PNEUMONIA (CAP)
—Mycoplasma
— Strep pneumo
—Chlamydophiia
—Influenza
—Legionella (severe cases)

ASPIRATION PNEUMONIA (Think EtOH)
—Poly microbial w/ oral anaerobes

HEALTHCARE-ASSOC'D PNEUMONIA (HCAP)
—Staph
—GNRs

VENTILATOR-ACQUIRE PNEUMONIA
—Pseudomonas

2

Identify the geographic, behavioral and social factors that predispose to pneumonia

Review behavioral risk factors for pneumonia such as alcohol abuse

Worldwide problem; #8 cause of death aux É.U.

3

Recognize the clinical manifestations, diagnosis (and treatment, see other card) of pneumonia

MANIFESTATIONS
—cough, fever, dyspnea, tachypnea, even hypotension + tachy
—OnDoc P.E. findings: asymm crackles ("râles"), whispered pectoriloquy, egophony, incr. vocal fremitus, and asymm dullness to percussion
—INFILTRATE ON CHEST X-RAY is cardinal finding (super important; required for dx; critical, etc.)
—Neutrophilia
—Positive cultures

4

Review the role of vaccination and other preventive measures in the prevention of pneumonia

Vaccinate against:
—Pneumococcal
—Influenza

Prevent and Treat:
—TB
—HIV/AIDS

5

Identify the role of thoracentesis in the management of empyema

If pt is not getting better consider the possibility of an empyema which must be drained.

6

Discuss the role of the physician in the prevention of antibiotic misuse and consequent antibiotic resistance

Describe the importance of avoiding antibiotic misuse in the prevention of antibiotic resistance

Don't Rx for viral bronchitis!
—Use "smalllest gun" possible when tx'ing pneumonia.

7

Identify the major causes of URI and recognize which require treatment

See URI Card set

8

Identify viral illnesses which cause URI and which can be diagnosed using clinically-available molecular diagnostic tests

Influenza can be tested for

9

Community Acquired Pneumonia
—Bugs
—Drugs
—Back-Up Drugs

CAP
—Bugs: Strep pneumo and atypicals (mycoplasma, chlamydophiia, legionella); ALSO influenza
—Drugs: azithro
—2nd line: doxy

10

Community Acquired Pneumonia (Sicker)
—Bugs
—Drugs
—Back-Up Drugs

CAP (Sicker)
—Bugs: Strep pneumo (resistant) + atypicals
—Drugs: ceftriaxone + azithro
—2nd line: moxifloxacin or levofloxacin (more ADRs and otherwise too broad, but useful if pt allergic)

11

Comm-Acquired Pneumonia (wicked sick: home→ICU)
—Bugs
—Drugs
—Back-Up Drugs

CAP (wicked sick)
—Bugs: Strep pneumo (resistant) + GNRs
—Drugs: vanc + ceftriaxone
—2nd line: vanc + moxifloxacin

12

Healthcare-Acquired Pneumonia
—Bugs
—Drugs
—Back-Up Drugs

HCAP
—Bugs: Staph aureus, GNRs, atypicals
—Drugs*: vanc + ceftriaxone
—2nd line*: vanc + amp/sb (Unasyn)

*Add pip/tazo if high risk (Pseudomonas cvg)

13

Ventilatory-Acquire Pneumonia
—Bugs
—Drugs
—Back-Up Drugs

VAP
—Bugs: resistant GNRs, Staph
—Drugs: vanc + pip/tazo +/- quinolone
—2nd line: vanc + ceftriaxone +/- quinolone

14

Aspiration Pneumonia
—Bugs
—Drugs

—Bugs: anaerobes
—Drugs: CAP drugs (e.g. azithro) + metronidazole or clindamycin +/- β-lactamase inhibitor