Community Acquired Pneumonia, D Kinder, DSA Flashcards Preview

Year 2 Resp Exam 2 > Community Acquired Pneumonia, D Kinder, DSA > Flashcards

Flashcards in Community Acquired Pneumonia, D Kinder, DSA Deck (23):
1

Dx of CAP

evidence infection: fever chills leuocytes
signs or Sx
new or changed infiltrate on CXR

2

DDX for abnormal CXR

CHF, viral infection, aspiration pneumonitis, pulmonary infarction, acute exacerbation of pulmonary fibrosis, acute exacerbation bronchiectasis, acute eosinophlic pneumonia, HS pneumonitis, pulmonary vasculitis, cocaine induced lung injury

3

Ddx for CAP Sx but normal CXR

acute exacerbation COPD, influenza, acute bronchitis, pertussis, asthma with viral syndrome

4

typical microbes causing pneumonia

S pnuemoniae, H influenzae, M catarrhalis

5

atypical pneumonia microbes

Legionella
Mycoplasma
C pneumoniae and viruses

6

Sx atypical pneumonia

dry cough, diffuse patchy infiltrate on CXR

7

Tx for actypical bacteria causing pneumonia

macrolides, doxy and FQ

8

first line Tx HAP

resp FQ
or 2nd/3rd cephalosporin and macrolide

9

exception to starting antibiotics ASAP for pneumonia

shock

10

microbes causing HAP or VAP

MRSA and multi drug R gram - bacteria
pseudomonas

11

Helath care assoc pneumonia criteria

-hospitalization for >2 days during previous 90 days
- Residence in nursing home
- home infusion therapy
-hemodialysis during previous 30 days
-home wound care
-family member with multidrug R pathogen
-immunosuppressive disease or therapy

12

Pneumonia specific criteria for health care associated pneumonia

- hospitalizaiton >2 days during previous 90 days
-antibiotics previous 90 days
-non-ambulatory
-tube feedings
-immnocompromised
-gastric acid suppressive agent

13

MRSA criteria

cavitary infiltrate
rapid pleural effusion
gross hemoptysis
concurrent influenza
neutropenia
erythematous rash
skin pustules
young previously healthy patient
severe pneumonia during summer

14

Testing for HAP and VAP

blood culture, resp tract culture, influenza testing, urinary pneumococcal Ag, urinary legionella Ag, pleurl fluit culture

15

viruses that cause pneumonia

RSV, influenza and para influenza

16

When should you perform thoracentesis

>10mm pleural fluid or loculated fluid

17

CURB 65

to assess if hospitalization needed
Confusion
BUN >20
RR >30
BP S65
>3 total need to hospitalize

18

what is PSI

pneumonia severity index used to assess mortality risk

19

What are criteria for ICU admission from pneumonia

confusion, BUN, tachypnea, multilobular infiltrates, hypoxemia, thrombocytopenia, hypotension, hypothermia, leukopenia, lactic acidosis, low pH, low albumin, hyponatermia, leukocytosis, tachycardia, >65

20

special populations at risk for pneumonia

smoking or COPD
alcholism :drug R s pneumonia, anaerobes and TB
bird exposure: psittacosis
bird droppings: histoplasmosis
Bats: histoplasmosis
rabbits:tularemia
farm animals: q fever
bioterrosism: B anthracis, tularemia, yersinia pestis

21

Central US exposure (ohio rivers)

histoplasmosis

22

southwest US (arizona

coccidiomycosis

23

northern central US

blastomycosis