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2a Resp > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Pneumonia is fluid e____ into alveoli due to ______ from infection

A

exudation
inflammation

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2
Q

Is pneumonia typically caused by a bacterial or viral infecton?

A

Bacterial

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3
Q

What does CAP stand for?

A

Community acquired pneumonia (in community or less than 48 hours in hospital)

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4
Q

What bacteria are most commonly responsible for CAP?

A

S. pneumoniae
H. influenzae
Mycoplasma pneumoniae

Also (can’t use beta lactam antibiotics):
S aureus
Legionella
Chlamydia pneumoniae

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5
Q

What is commonly the cause of Legionella?

A

Air conditioning, holidays to spain

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6
Q

For the infections that can’t be given beta lactam antibiotics, what should be given?

A

Macrolides instead like clarithromycin

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7
Q

How do beta lactam antibiotics work?

A

They inhibit bacterial cell wall biosynthesis.

However some bacteria are resistant to beta lactam antibiotics because they can make enzymes that hydrolyse the beta lactam ring, inactivating the antibiotic.

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8
Q

What does HAP stand for?

A

Hospital acquired pneumonia

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9
Q

What bacteria commonly cause HAP?

A

Gram negative aerobic bacilli:

P. aeruginosa
E. coli
Klebsiella

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10
Q

Why is HAP usually more severe?

A

Many of the bacteria causing HAP are multi drug resistant

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11
Q

What are 2 viral causes of pneumonia?

A

CMV
Haemophilus influenzae

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12
Q

What fungi can cause pneumocystis pneumonia (PCP) in immunocompromised patients?

A

Pneumocystis jirovecii

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13
Q

PCP is an ____ defining illness

A

AIDS

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14
Q

How is pneumonia caught?

A

Typically via inhaling or aspirating the pathogen

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15
Q

What are risk factors for pneumonia?

A

Immunocompromised (HIV/long term steroids)
IVDU (staph aureus)
Pre-existing respiratory disease
Extremes of age

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16
Q

In typical pneumonia, where does exudate form in response to the bacteria?

A

Inside alveoli lumen

Sputum present

17
Q

In atypical pneumonia where does the exudate form in response to the bacteria?

A

interstitium of alveoli

18
Q

Is sputum present in typical or atypical pneumonia?

A

Typical

In atypical there is a dry cough

19
Q

What are symptoms of pneumonia?

A

Productive cough with rusty coloured sputum (purulent)
Pyrexia (fever) due to infection
Pleuritic chest pain, worse with breathing/coughing
Tachypnoea
Dyspnoea
Tachycardia
Hypotension
Confusion in elderly

20
Q

How is pneumonia diagnosed?

A

1st line = Chest XR showing consolidation and an air bronchogram (can see the structure of the air-filled bronchioles as surrounded by opacified lung parenchyma)

Sputum sample and culture to 10 organism

21
Q

What does consolidation mean on a Chest XR?

A

The air in small airways of the lungs is filled with a fluid/solid/other material which shows up as dense and white

22
Q

Which bacteria may cause multilobar pneumonic lesions?

A

S. pneumoniae
S. aureus
Legionella

23
Q

Which bacteria may cause multiple abscesses seen in the lungs on a chest XR?

A

S. aureus

24
Q

On a Chest XR what may cause upper lobe pneumonic lesions?

A

TB
Klebsiella

25
Q

What tool is used to assess severity of CAP?

A

CURB65

26
Q

What does CURB65 stand for?

A

Confusion
Urea nitrogen greater than 7mmol/l
Respiratory rate greater than 30
Bp is lower than 90/60 mmHg (if either drops)
65+ y/o

27
Q

What is used to assess confusion in CURB65?

A

abbreviated mental test score (AMTS)
confusion = 8/10 or lower

28
Q

If only 1 of the CURB65 criteria applies to a patient what happens?

A

Given oral antibiotics and discharged. 3% mortality

29
Q

If 2 of the CURB65 criteria apply, what happens?

A

Consider short hospital stay and give antibiotics

30
Q

If 3 or more of the CURB65 criteria apply, what happens?

A

15% mortality rate
hospitalised in ICU
Given IV antibiotics

31
Q

How is pneumonia treated?

A

O2 (stats 94-98%)
Broad spec antibiotics
NSAIDs for pleuritic chest pain

32
Q

What antibiotic is given for CAP with a CURB65 score of 0-2?

A

Amoxicillin

33
Q

What antibiotics is given for CAP with CURB65 score of 3-5?

A

Co-amoxiclav and Clarithromycin

34
Q

Which organism causing pneumonia should be treated with clarithromycin as 1st line, irrespective of the CURB65 score?

A

Legionella

(also notifiable to PHE)

35
Q

What conditions can cause aspiration pneumonia?

A

Stroke
Bulbar palsy
Myasthenia Gravis

2a Resp (15 decks)

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