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Flashcards in 4 - CAP Deck (12)
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1
Q

definition of pneumonia? spectrum of pathology?

A

inflammation of lung, usually of infectious etiology. bronchitis, bronchiolitis, bronchopneumonia, pneumonia aka pneumonia.

2
Q

classification of pneumonia

A

can be typical or atypical. lobar, segmental, sub segmental, or interstitial. community, hospital or health care acquired.

3
Q

pneumonia: what happens?

A

lung parenchyma inflammation/injury +/- filling of alveolar spaces with inflammatory gunk aka consoldiation

4
Q

pathogenesis of pneumonia

A

upper airways constantly exposed to pathogens: can get micro or macro aspiration = they enter the lower resp tract. could also have hematogenous spread.

5
Q

lower airways are usually ____? development of CAP means?

A

sterile: indicates a defect in host defenses, exposure to an overwhelming inoculum or a particularly virulent microorganism

6
Q

symptoms and signs

A

fever, dyspnea, cough, sputum, pleuritic chest pain, mental status changes, toxic appearance, high resp rate/heart rate, maybe resp. failure or septic shock.

7
Q

physical exam findings

A

asymmetric mvt of chest wall, dullness to percussion, increased tactile fremitus, bronchial breath sounds on auscultation, crackles, wheezes, egophony, whispering pectoriloquay

8
Q

diagnosis of pneumonia?

A

chest radiograph essential: do PA and lateral views, if there is pleural effusion then do lateral decubitus view. CT imaging has higher sensitivity, specificity though = gold standard.

9
Q

management of pneumonia?

A

cABC, O2 to keep SpO2 >90%. IV fluids. then work up: sputum, blood, urine, CXRs, and CT/bronchoscopy as needed. antibiotics (usually empiric selection)

10
Q

outpatient antibiotics?

A

macrolide (azithromycin, other “mycins”) OR doxycycline. if there are comorbidities: then fluoroquinoline (floxacins) or beta lactam + macrolide

11
Q

pts under 50 with CAPs should be? xrays?

A

screened for HIV infections and IgG deficiency. follow up chest xrays if smoker or over 40

12
Q

non resolving pneumonia: causes?

A

wrong antibiotic or drug. lung abcess. parapneumonic effusion - empyema. hydrostatic pulmonary edema. inflamamtory disorders. occult cancer. PE. etc.