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Flashcards in HAC- EBM Deck (22):
1

Pneumonia

inflammation of lung due to microorganisms (bacteria, viruses, fungi, parasite)

2

pneumonitis

inflammation of lung due to factors other than microbial. (chemicals, bird feces, gastric contents, asbestos, silica)

3

Bronchitis

inflammation of bronchi or bronchial tubes
cough
green, clear, yellow sputum

4

community acquired pneumonia

CAP
- presumed to be infectious from contact within the community

5

healthcare associated pneumonia

HCAP

6

healthcare acquired pneumonia

pneumonia occurs 48 or more hours after admission which was not incubating at time of admission

7

ventilator associated pneumonia

arises more than 48-72 hrs after

8

Most common pathogen detected with pneumonia

1. Thinovirus
2. Influenza A/B
3. S. pneumoniae

9

Symptoms of pneumonia

cough, fever, SOB, fatigue, malaise

10

signs of pneumonia

- consolidation on CXR
- air bronchogram
- elevated WBC
- hypoxemia
- dullness to percussion
- tactile
- tachypnea
fever
rales
egophony and dullness to perfussion
hemoptysis

CXR- pleural effusion, abscess, broniial pbreath sounds

11

CURB-65

tool to decide of pt needs to be admitted

Confusion
BUN > 20
RR > 3- BP (SBP 65

0-1 = low risk (Outpt)
2==hospital admission
>2 assess for admission to ICU

in outpt BUN could be dropped and a score of 1 could suggest hospitalization

12

Which CURB criteria is lowest reason to admit

age

13

Decision making tools for pneumonia

CURB-65
SMART COP
PSI - stratifies adults into 5 categories for risk of death in 30 days from all causes

14

First lines of treatment for CAP in healthy

azithromycin
doxycycline (first line if macrolide resistance > 20%)

15

Treat CAP with pt with other comorbidities (heart dz, lung dz, liver, etc) WHAAAT

azithro PLUS beta
fluoroquinolone
beta lactam PLUS macrolide

16

Treatment for INPT ICU treatment

beta lactam plus either arithromycin or fluoroquinolone

17

If worried about pseudomonas

antipneumococcal, antipseudomonal beta lactam

(pip-tazo plus cipro or levo)

18

Lights criteria

- tells whether effusion fluid is transudate or exudate; if at least one of following three criteria filled, fluid = exudate

Protein Fluid/Protein Body > 0.5
LDH Fluid/ LDH Body > 0.6
LDA Fluid > 2/3 upper limit of normal

19

Parapneumonic effusion

effusion assd with pneumonia
- occur in 40% cases
- usually resolves w/antibiotics alone
- can do VATS or chest tube

20

most common cause of post-influenza pneumonia

complication of influenza

Strep pneumo most common but we worry about staph as well

21

Vaccines for pneumonia

Over 65, now everyone gets Prevnar then get pneumovax a year later

22

MONA criteria

Morphine
oxygen
nitroglycerin
aspirin
beta blocker