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clin med pulmonology > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What is the pathophys of pneumonia

A

inflammation of the alveoli and bronchioles

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2
Q

What is pneumonia caused by

A

infection
aspiration

*from bacteria, viruses, fungi

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3
Q

What is the #1most deadly hospital acquired infection

A

Pneumonia

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4
Q

What is the #1 cause of bacterial pneumonia

A

strep pneumonia

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5
Q

What is the second most common bacterial pneumonia

A

H. influenza B

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6
Q

How do typical community acquired pneumonia present

A

caused by bacteria
alveolar inflammation / exudate
Productive cough
High WBC

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7
Q

What will be seen on CXR with typical community acquired pneumonia

A

Lobar consolidation

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8
Q

How do atypical community acquired pneumonia present

A

organisms invade / destroy lung interstitium

Lack of alveolar exudate
dry cough
normal WBC

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9
Q

How does atypical community acquired pneumonia present on CXR

A

Patchy infiltrate

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10
Q

What are example of atypical community acquired pneumonia

A

mycoplasma
chlamydia
viral

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11
Q

Where is the antibody created for typical community acquired pneumonia

A

in the spleen

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12
Q

What symptoms will a patient have with typical community acquired pneumonia

A

Chest pain
absent lung sounds
productive cough
crackles

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13
Q

What are some criteria for hospitalization of typical community acquired pneumonia

A

RR>30BPM
Mechanical ventilation
septic shock
O2 sat<90%

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14
Q

What are some typical diagnostics for community acquired pneumonia

A

Crackles on exam
absent lung sounds
increased whispered pectoriloquy
Egophony
bronchophony
tactile remits
lobar consolidation

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15
Q

How do you treat outpatient adult community acquired pneumonia

A

Azythromycin (zpack)
Doxy
Levofloxacin

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16
Q

How do you treat pediatric outpatient community acquired infection

A

amoxicillin

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17
Q

How do you treat inpatient adults with community acquired infection

A

Ceftriaxone + Azithromycin
OR
Levofloxacin

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18
Q

How do you treat inpatient pediatric community acquired infection

A

ampicillin (If fully immunized)

Ceftriaxone otherwise

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19
Q

Which population is atypical community acquired pneumonia more common in

A

Children

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20
Q

What is bronchopneumonia known as on xray

A

Patchy infiltrate

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21
Q

How does mycoplasma effect the lungs

A

Damage the epithelium allowing bacteria to overgrow

22
Q

Where can chlamydia pneumonia come from

A

college
Koalas
Non-bullous myringitis

23
Q

What type of pneumonia is legionnaires disease

A

gram negative bronchopneumonia

24
Q

How is legionnaires disease transmitted

A

**NOT from person to person

Pathogen grows in water of vent systems

25
Q

What are some symptoms of legionnaires pneumonia

A

fever
chills
malaise
dry cough
diarrhea

26
Q

How do you test for legionnaires disease

A

urine antigen or sputum fluorescent antibody test

27
Q

How do you treat legionnaires pneumonia

A

Levofloxacin

*any delay in treatment increases risk of mortality

28
Q

When is pneumonia considered hospital acquired

A

Pneumonia present after 48 hours after admission

29
Q

What pathogen is most prevalent in hospital acquired pneumonia (In ICU)

A

Pseudamonas
*Highest mortality rate

30
Q

Which patients are at greatest risk for hospital acquired pneumonia

A

Intubation
tracheotomy
immunocompromised
chronic lung disease

31
Q

What treatment is used for aspiration pneumonia

A

clindamycin
or
Metronidazole + ceftriaxone

32
Q

Which drugs are commonly used in nosocomial pneumonia

A

Cefepime
Zosyn
Meopenem
Levofloxacin

33
Q

What was one of the first diseases seen in the AIDS pandemic

A

PJP

34
Q

How do HIV infected people acquire PJP

A

fungus found in soil

35
Q

What is the presentation of PJP

A

Foamy exudates and cysts in lungs
Cough, fever, weight loss
CD4 <200

36
Q

What is the leading cause of death for people with HIV world wide

A

pulmonary TB

37
Q

How do you treat PJP pneumonia

A

Predisone first
then
TMP-SMX

38
Q

Why are sickle cell disease patients prone to s. pneumoniae

A

from poor spleen function from infarct

39
Q

What are the phases of fungal pneumonia

A

1: mild flu-like illness
2: Creation of cavitary lesions?similar to TB
3:Hepatosplenomegaly, pancytopenia, septic shock/death

40
Q

Where does histoplasmosis come from

A

bird and bat droppings

41
Q

How is histoplasmosis confirmed

A

urine testing

42
Q

What is the treatment of choice for histoplasmosis

A

Itraconazole

43
Q

What is another name for coccidiomycosis

A

valley fever (southwest U.S)

44
Q

How is coccidiomycosis diagnosed

A

skin test

45
Q

How do you treat coccidiomycosis

A

Generally self limiting
can treat with 3-6 months diflucan

46
Q

How long can symptoms last with coccidiomycosis

A

months

47
Q

Where does cryptococcus come from

A

bird droppings

48
Q

What can cryptococcus cause

A

meningitis in HIV patients with CD4<50

49
Q

How do you detect cryptococcus

A

Serum antigen testing

50
Q

How do you treat cryptococcus

A

Fluconazole x10wks

51
Q

How does mortality change with cryptococcus in those without HIV compared to those with

A

Mortality increases without HIV

52
Q

How can you prevent pneumonia

A

PCV20
flu shot (over 6months of age)

clin med pulmonology (12 decks)

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