Exam 6 - LRTI Flashcards
(81 cards)
What 3 things/areas does the lower respiratory tract involve?
1) Bronchi
2) Bronchioles and alveoli
3) Lungs
How do you get bacterial pneumonia?
1) Inhalation of contaminated air droplets
2) Aspiration
Name the 4 complications of bacterial pneumonia.
1) Pleuritis
2) Abscess
3) Bronchiectasis
4) Sepsis
Name frequent co-morbid conditions associated with bacterial pneumonia (7).
1) Asthma
2) COPD
3) DM
4) HF
5) Alzheimer’s
6) Influenza
7) COVID-19
Name the 3 classifications of bacterial pneumonia.
1) Hospital Acquired Pneumonia (HAP) - s/s after a minimum of 48 hours in the hospital
2) Ventilator Associated Pneumonia (VAP) - after 48-72 hours of intubation
3) Community Acquired Pneumonia (CAP) - none of the above, resides in the community
What it is primary bacteria in CAP?
Strep. pneumo
What are the 3 bacteria species/classes that present in CAP?
1) Strep pnemo
2) H. flu
3) Mycoplasma pneumoniae
Name the 5 total bacteria that can be seen in CAP.
1) Strep pneumo
2) H. flu
3) Mycoplasma pneumo
4) Legionella pneumophilia - uncommon
5) Klebsiella pneumo - alcoholism
Name the 7 types of bacteria that can be seen in HAP/VAP.
1) Strep pneumo
2) Legionella - atypical bacteria
3) Klebsiella
4) Pseudomonas aeruginosa
5) E. coli
6) Staph aureus
7) MRSA
Name the “Typical” s/s of bacterial pneumonia (5).
1) Cough with sputum production
2) Fever
3) Chills
4) Pleuritic chest pain - pain in side with deep inspiration
5) SOB
Name the “Atypical” s/s of bacterial pneumonia (3).
1) HA
2) Low-grade fever or afebrile
3) Dry, persistent cough
Name the physical findings of bacterial pneumonia (6).
1) Distant or coarse breath sounds
2) Rhales
3) Inspiratory crackles
4) Dullness to percussion
5) Tachypnea
6) Tachycardia
What is the GOLD STANDARD in diagnosis bacterial pneumonia?
Radiographic evidence
- Chest x-ray
- CT scan
When is a sputum culture obtained?
Severe infections
What is meant by “left shift” in WBC count?
Increase in bands
What does an elevated/positive PCT indicate?
Bacterial infection
Name three scenarios that can elevate PCT.
1) Thyroid cancer
2) COVID-19
3) Kidney failure
What is the name of the lab value that is a biomarker of bacterial infection?
PCT - procalcitonin
What value is indicative of a bacterial infection with PCT values?
> 0.25 ng/mL
What do you use PCT levels for in a patient with an infection?
Deciding to escalate or de-escalate antibiotics
T/F: PCT can be used to decide whether to start antibiotics or not.
FALSE - PCT should NOT be used to decide whether to start antibiotics or not
Streptococcus pneumoniae is gram _____.
Streptococcus pneumoniae is gram POSITIVE.
Name the 4 general approaches to management of bacterial pneumonia.
1) Oxygenate
- If O2 below 92%, then need supplemental oxygen
2) Hydrate
- Water is the best mucolytic
3) Analgestics/antipyretics
- IBU or APAP - caution with suppressing fever and using that as an indication for changing/stopping antibiotics
- Morphine, Percocet for pain so that patients can breath
4) Antibiotics
Why can you not use Daptomycin for MRSA pneumonia?
Because Daptomycin cannot be used in the lungs
-Broken down by enzymes in the lungs
