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Y4 Acute Care > LTRI: Pneumonia > Flashcards

LTRI: Pneumonia Flashcards

1
Q

What is Pneumonia? (3 things)

A
  1. Infection of lung tissue
  2. Inflamm of lung tissue + Sputum filling airways + alveoli
  3. Seen as consolidation on CXR
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2
Q

What are the classifications of Pneumonia? (3 things)

A
  1. Community Acquired Pneumonia
  2. Hospital Acquired Pneumonia (Nosocomial)
  3. Aspiration Pneumonia (after inhaling foreign material e.g food)
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3
Q

Why is it important to distinguish between Community vs Hospital acquired pneumonias?

A

Causative organisms different –> abx treatments will be different

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4
Q

What are the Risk Factors for Pneumonia? (6 things)

A
  1. Age (under 5 / over 65)
  2. Low immunity (obv)
  3. Smoking
  4. Alcohol abuse
  5. Malnutrition
  6. Chronic lung disease (COPD / CF)
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5
Q

What are the causes of Community vs Hospital Acquired Pneumonias? (2 + 3 things)

A

CAP: Strep pneumoniae / H influenzae

HAP: Gram -ve enterobacteria / Staph aureus / Pseudomonas

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6
Q

What are the pathophysiological steps of Pneumonia? (5 things)

A
  1. Bac aspirated
  2. Bac proliferate in Alveolar space
  3. Immune response thru Alveolar MACs
  4. Capillary leak + Alveolar infiltration
  5. Pneumonia signs + symptoms
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7
Q

What are the CF of Pneumonia? (9 things)

A
  1. Fever
  2. Delirium (might be only sign in elderly)
  3. SOB / Tachypnoea
  4. Productive Cough (purulent / bloody sputum)
  5. Pleuritic chest pain

@ exam

  1. Tactile fremitus (louder 99) (consolidation) (solid vocals)
  2. Dullness to percussion (consolidation)
  3. Bronchial breath sounds (consolidation)
  4. Crackles

(Bold ones distinguish Pneumonia from Bronchitis)

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8
Q

What severity score should you do to assess if a sus Pneumonia pt needs further investigation / hospitalisation?

A

CURB-65

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9
Q

What is the CURB-65 score?

A
  • Confusion (disorientated in person / place / time)
  • Urea (over 7)
  • Resp Rate (over 30)
  • BP under 90/60
  • 65+ yrs old

1 point for each

  • 0 - 1 = Home treatment / Abx (don’t need investigations)
  • 2 = Hospital
  • 3+ = ITU
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10
Q

What investigations should you do for CURB-65 score 2 (aka hospitalized) Pneumonia patients? (4 things)

A
  1. CXR
  2. FBC (high WCC)
  3. UnE (high urea)
  4. CRP (raised in inflamm / infection)
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11
Q

What further investigations should you do for CURB-65 score 3+ (aka ITU) Pneumonia patients? (3 things)

A
  1. Sputum Culture
  2. Blood Culture
  3. Urine sample (to check for Legionella + Pneumococcal Urinary Antigens)
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12
Q

What will a CXR show in Pneumonia? (2 things)

A
  1. Interstitial infiltrates (idk)
  2. Consolidation
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13
Q

What are the management options for Pneumonia? (5 things)

A
  1. Abx
  2. Oxygen (keep sats over 94%)
  3. Fluids
  4. Analgesia (if pleuritic chest pain)
  5. ITU (if shock / hypercapnia / remaining hypoxic)
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14
Q

What is the NICE Abx recommendations for LOW grade COMMUNITY Acquired Pneumonia?

A

FIRST LINE: Amoxicillin (5 day course)

If allergic: Macrolide / Tetracycline

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15
Q

What is the NICE Abx recommendations for MODERATE - HIGH grade COMMUNITY Acquired Pneumonia?

A

DUAL Abx Therapy: Amoxicillin + Macrolide (7-10 day course)

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16
Q

Why is it important to check local guidelines for Abx for Pneumonia, esp for HAP? (2 things)

A
  1. Guidelines developed according to popular causative bacteria in the specific area
  2. They also take into account specific Abx resistance in area
17
Q

How do you monitor Pneumonia to see if Abx treatment working? (2 things)

A
  1. WCC
  2. CRP
18
Q

What are the complications of Pneumonia? (4 things)

A
  1. Pleural effusion (Empyema (pus build up))
  2. Lung abscess
  3. Sepsis
  4. Death

Y4 Acute Care (31 decks)

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