How to Diagnose Pneumonia Flashcards Preview

Respiratory 2 > How to Diagnose Pneumonia > Flashcards

Flashcards in How to Diagnose Pneumonia Deck (15):
1

Classic hx of pneumonia

Retrocardiac airspace with air bronchograms

2

Pneumonia dx

Sx of LRT infection
Means of 6 days
Radiographic infiltrate

Criteria are not 100% specifc

X-rays can be negative but CT scans should not

3

Sx

COugh and fatigue are common

Fever not in all

Consolidation (egophony) in less than 1/3

A lot have sputum production

4

Pneumo vs. bronchitis

Both have cough, sputum production, hemoptysis, dyspnea, and rhonchi

Penumo only - true fever, pleuritic pain, consolidation, hypoxemia

5

Influenza

Infects resp epithelium and is explosive in onset

Fever, chills, myalgia, etc.

Retrosternal pain (vs. lateral in bacterial pneumonia)

6

S pneumo

Lobar classic

Gram-positive bullet cshaped diplococci

Most common pathogen in almost every scenario

Urine antigen is a rule in test

7

Croup

vs. bronchiolitis and epiglottitis

Croup - barking cough, low grade fever and stridor (parainfluenza)

bonrchiolitis - upper airway findings but not aggressive coguh...will have weheezes and crackles

Epiglottitis - high fever, drooling, muffled voice and leaned forward

8

Bact vs. virsues, vs. pneumocystis

Bact - high fever, true rigor, purulent phlegm, and streaky hemoptysis

Viruses - dry cough, except influenza

Pneumo - rarely pleghm or prominant airway sx due to lack of inflammation

9

S aureus

Cocci in clusters

Tendency to cavitate

Anti staph - vanc, linezolid, ceftrarolin

10

Hib

vs. legionella

Gram neg short bacilli

More in patients with chronic bronchitis

Copious sputum

Cannot ID by gram stain (legionella)

11

How to determine empyema

How to cover legionella

Is costophrenic angle there?

Add azirthromycin

12

Legionnaires

Longer prodrome and dry cough

Elderly, smokers, immunocomp

Clinical findings may point away from lung

Dx with urinary antigen or culture

13

COP vs. bac penumonia

Bacterial - think 6 days

COP - think 4-6 weeks

14

Empyema

Begins as pneumonia but spreads through the visceral pleura and into the pleural space producing a closed- space infection

Drainage AND antibiotics are rquired for resolution of the process

15

Provisional
Confirmed
PAth dx

Risk-benefit favors AB tx

Pt's condition improves ofr resolves with ABs +/- mico testing

Lung biopsy/autopsy confirms clinical impresion