Flashcards in Lecture 7 Pneumonia (missed lecture) Deck (20):
gold standard for diagnosis of pneumonia?
Chest X ray (although may be normal in up to 7% of patients)
3 classes of initial clinical classification of pneumonia
major immunodefeciency, Tb, normal hosts
4 classes of aquired pneumonia in normal hosts
Community, hospital acquired;
ventilator, health-care associated
suspect Tb in patients with 2 of more of the classic symptoms:
hemoptysis, cough more than 2 weeks, night sweats, weight loss.
order airbone isolation and CXR
CXR characteristics in patients with Tb:
____ lobe infilitrates, ____ pattern, ____ lesions , ____ infiltrate
upper, milliary, cavitary, nodular
the _____ and the pneumonia severity index are used to determine weather treatment should be ____ or ____
CURB-65, in vs outpatient
CURB65 is what?
scores above ____ should be considered for hospital stay
urea ( greater than 7 mmol/L),
respiratory rate greater than 30,
BP less than 90 systolic or 60 diastolic;
greater than 65 years of age;
scores above 1 (2 = short hospital stay, 3 = hospital)
major criteria (2) designating need for ICU admission:
invasive mechanical ventilation or septic shock (need just one)
minor criteria (need 3, see notes)
what somewhat new test helps indicate presence of bacterial infection?
PCT (pro-calcitonin) - indicates severe infection
increased risk of pseudomonas is seen in patients with structural lung disease such as ______; extended _____ therapy, broad-spectrum Ab use, or malnutrition
is it better to wait for results of culture/sputum sample before treating or to treat right away?
treat ASAP as possible,
2 vaccines patients should get to prevent pneumonia
Lobar pneumonia is characterized by a ____ exudate which causes ____ of a lobar or the entire lung
according to FA, what 3 bacteria cause lobar pneumonia?
S. pneumo by far, legionalla, klebsiella
bronchopneumonia is characterized by acute inflammatory infiltrates from the ____ into adjacent ____; distribution is characteriszed as ____
patchy (or multifocal)
4 organisms listed in FA that cause bronchopneumonia
S. pneumo, S. aureus, H influenza, klebsiella;
interstitial/atypical pneumonia is characterized by ____ ____ inflammation localized to interstitial areas at alveolar walls. there is an increase in "lung ____"
in addition to viruses, what bacteria can cause atypical pneumonia, according to FA
mycoplasma, legionella, chlamydia, coxiella
what is empyema? What bacteria usually causes it?
pus in the alveolar space, s aureus