I can't breathe Week 3

Question 1

What is community acquired pneumonia?

Answer 1

pneumonia acquired in the community or within 48 hours of admission to hospital

Question 2

Why is the different classifications of pneumonia important?

Answer 2

different pathogens from CAP and HAP

therefore different treatment

Question 3

How do you diagnose CAP?

Answer 3

acute illness with cough
and at least on of the following: new focal chest signs, fever, dyspnoea/tachypnoae
and radiographic evidence of new lung infiltrates

Question 4

Typical presentation of pneumonia

Answer 4

green sputum
crackles heard on chest
high respiratory rate
chest pains on breathing
pyrexia at 39 degrees
confusion - hypoxia/systemic infection

Question 5

How is BP affected in a p with pneumonia?

Answer 5

low BP
sepsis
systemic response to infection - vasodilatation

Question 6

What would be heard upon percussion?

Answer 6

dull - fluid in alveoli, pleural space

Question 7

How to differentiate between pneumonia and GORD, airway inflammation and post-nasal dip?

Answer 7

pneumonia is acute

others are chronic eg. persistent cough

Question 8

How to differentiate between pneumonia and pulmonary fibrosis, bronchiectasis, lung cancer and heart failure?

Answer 8

radiology - chest x-ray

Question 9

Why is a blood sample taken?

Answer 9

may contain bacteria
which made lead to sepsis
markers of infection: WBC (high neutrophil and C-reactive protein if bac)

Question 10

Why are urine samples taken?

Answer 10

test for pneumococcal antigens

severity

Question 11

Difference between CXR of pneumonia and pulmonary oedema

Answer 11

pneumonia: unilateral consolidation
pulmonary oedema: in lower lobe
blunting bilaterally of costophrenic angle
bigger heart
more white lines near the top of the lungs

Question 12

What is consolidation?

Answer 12

lungs response to bacteria there

fluid/pus filled in alveoli

Question 13

Why is a p given 60% oxygen not 100%?

Answer 13

amount of O2 to maintain saturation

Question 14

What is the CURB 65 score?

Answer 14

C onfusion
U rea >7
R espiratory rate >30
BP <90
>65
score one point for each

Question 15

Why is the CURB 65 score used?

Answer 15

kind of mortality

streamline if you can treat at home and what antibiotics are needed

Question 16

Why might a p with pneumonia be given an iv?

Answer 16

patient is severely unwell and rapid response is needed

swallowing may be difficult

Question 17

What complications are associated with penumonia?

Answer 17

ST: empyema (infected fluid in pleural space), parapneumonic effusion, lung abscess

bronchiectasis