Flashcards in CAP Deck (12):
What is the MOST COMMON cause of CAP?
Patient presents with dypnea, cough with sputum, tachypnea, tachycardia, and a fever. What are you concerned about?
What do you expect to hear on PE?
focal crackles, bronchial breath sounds, increased tactile fremitus, vocal resonance
What diagnostics should you order?
CXR (PA and lateral view)
ABG if they are inpatient
Culture and GS esp if unsure of pathogen
**Urine antigen testing for pneumoccal and legionella
What do you expect to see on the CXR?
How do you decide if you should admit a patient or not?
PSI and CURB-65 are useful tools to see if patient can be admitted. If patient is normally healthy and fairly young with no pre-disposing factors, you will most likely treat outpatient.
How do you decide if they should go to the ICU or Gen ward?
Use the 1 major or 3 minor rule.
major=mechanical ventilation or pressors
minors: increased heart rate, increased breathing rate, hypothermia, hypotension, multilobar filtrates (etc)
If outpatient, how do you tx?
if inpatient, how do you treat?
gen ward:macrolide + beta-lactam and RFQ, if ICU then marcrolide + beta-lactam and RFQ + beta-lactam
What is the general discharge criteria?
no more than 1 of the following in a 24 hour period:
>100bpm, fever, 24 resp/min, >90mmHg systolic
What are GN risks?
elderly, smokers, COPD or heart disease