Clinical Case Studies - Pneumonia Flashcards
1
Q
What is pneumonia?
A
Inflammation of the lung parenchyma caused by lower respiratory tract infection.
2
Q
What is the pathophysiology of pneumonia?
A
- Presence of bacteria
- Inhibition of IgA
- Pneumolysins - inhibit ciliary beating
- Damage to cilia by previous infection
- Hijacking platelet aggregation factor receptors to get to alveoli
3
Q
State the four histopathological stages of lobar pneumonia?
A
- Consolidation
- Red hepatisation (neutrophilia)
- Grey hepatisation (fibrosis)
- Resolution
4
Q
What are symptoms of pneumonia?
A
- Cough with purulent sputum
- Fever
- Dyspnoea
- Pleuritic chest pain
5
Q
What are signs of pneumonia?
A
- Tachypnoea
- Cyanosis
- Hypoxia
- Crackles and bronchial breathing
- Dull percussion
6
Q
Why does pneumonia cause these symptoms?
A
Inflammation and swelling of the airways
Mucus secretion
Pulmonary effusions
Obstruction of small airways and alveoli - poor gas exchange
7
Q
What is the severity staging for pneumonia?
A
CURB-65
- Confusion
- Urea >7 mmol/L
- Resp rate >30/min
- BP <90/<60
- >65 years old
8
Q
What microbes can cause pneumonia?
A
TYPICAL:
- Streptococcus pneumoniae
- Haemophilus Influenzae
- Staphylococcus aureus
- Moraxella catarrhalis
ATYPICAL:
- Legionella pneumophila
- Coxiella Burnetti
- Chlamydia psittaci
- Mycoplasma pneumoniae
9
Q
How would you investigate pneumonia?
A
- Bloods - can see haemolytic anaemia in mycoplasma, hypoNa in legionella
- Blood gas
- Serology
- Sputum and blood cultures - Ziehl Neelsen stain
- Urine samples - pneumococcal and legionella antigen
- Aspirate pleural effusion
- CXR
- Pleural tap
- Bronchoscopy
10
Q
What are the complications of pneumonia?
A
- Respiratory failure
- Empyema
- Lung Abscess
- Pleural effusion
