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Disease II > Pneumonia > Flashcards

Pneumonia Flashcards

(67 cards)

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1
Q

Purpose of differential diagnosis

A

Eliminate potential diagnoses by systematically comparing and contrasting signs and symptoms

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2
Q

The three elements of problem statement

A

Who

When
Time Course

What

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3
Q

Define a problem representation

A

An evolving summary to organize the defining features of a patient presentation

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4
Q

Purpose of problem representation

A

To help form a focused differential diagnosis

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5
Q

What are key features?

A

Features present consistently and ideally exclusively in the condition

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6
Q

Differentiating features

A

Shared among other similar conditions but not present in many.

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7
Q

What is a diagnostic schema

A

Organizes cause of disease around a specific symptom

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8
Q

What is an illness script

A

A mental model with chunks of information

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9
Q

What is the illness script used for

A

To effectively collect and retrieve clinically information about a condition

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10
Q

Define pneumonia

A

An inflammatory disease the mostly affects the alveoli’s (usually infection)

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11
Q

Define community acquired Pneumonia

A

An acute infection of the parenchyma acquired outside of the hospital

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12
Q

Define nosocomial pneumonia

A

Acquired in the hospital up to or after 48 hours

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13
Q

What are the two types of Nosocomial pneumonia

A

Hospital acquired pneumonia

Ventilator associated pneumonia

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14
Q

Etiology of pneumonia

A

Two models

Targets lungs

Typical and Atypical microbes

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15
Q

Model “1” of pneumonia

A

Pathogens enter and multiples the alveoli’s

Macrophages produces cytokines

Polynucleic neutrophils enter the cell and cytokines enter systemic circulation

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16
Q

What is model “2” for pneumonia

A

Pathogens are expected

Infection caused by change in pH, nutrients and oxygen levels.

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17
Q

Name the three terms that place pneumonia by location

A

Bronchopneumonia (segmental)

Lobar pneumonia (results from severe ⬆️) one segment to the other.

Interstitial pneumonia (mycoplasma pneumonia or virus)

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18
Q

The four pathogens that can cause pneumonia

A

Bacteria
Viruses
Fungi
Parasites

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19
Q

What is the difference between typical bacteria and atypical bacteria

A

Typical:

High incidence
Detected through usual test
Readily cultured
Responds to beta lactam

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20
Q

What are typical bacteria

A

Streptococcus pneumoniae
Haemophilus influenza
Moraxella catarrhalis
Staphylococcus aureus
Group A streptococci

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21
Q

Gram negative typical bacteria

A

Klebsiella spp
Escherichia coli

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22
Q

What typical bacteria is associated with aspiration

A

Microaerophillic bacteria (anaerobic)

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23
Q

Which bacteria accounts for most bacterial pneumonia

A

Streptococcus pneumoniae

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24
Q

Is nonmotile streptococcus pneumoniae gram positive or negative

A

Gram positive

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25
Which patients usually have streptococcus pneumoniae in their sputum
Chronic bronchitis
26
How is streptococcus pneumoniae transmitted
Aerosol (cough or sneeze)
27
What is streptococcus pneumoniae sensitive to
Penicillin and its derivatives
28
What does staphylococcus look like
Grape clusters
29
Is staphylococcus bacteria gram positive or negative
Positive
30
What kind of bacteria is MARSA
Staphylococcal
31
Which bacteria is occasionally necrotizing pneumonia
Staphylococcus
32
Which bacteria is the cause of pneumonia in older people and cultured from CF and COPD patients
Haemophilus influenzae
33
Who does Klebsiella pneumoniae cause severe pneumonia in
COPD Diabetes Alcoholism(theoretically)
34
Atypical pneumonia
Legionella spp
35
Where does legionella multiply
Standing water
36
How is legionella spread
Aerosolized
37
Three types of aspiration pneumonia
Chemical pneumonitis Obstruction Infection
38
Causes of aspiration pneumonia
Gastroesphageal reflux disease Dysphasia
39
What is lung abscess made of
Air and fluid cavity Liquified WBC remains, proteins, tissues debris Encapsulated in fibrin, inflammatory cells, granulation tissue
40
What causes necrotizing PNA
Aspiration (polymicrobial) Infection with necrotizing bacteria (staph aureus, Klebsiella pneumoniae, aeruginosa Pseudomonas)
41
Define prevalence
The presence of cases in a population (chronic diseases)
42
Define incidence
Associated with discrete events The rate at which disease appear Measured as annual appearance per population
43
What rank is the lower respiratory tract infection in cause of death worldwide
5th
44
What is the mortality rate for patients with (CAP) that are hospitalized
7%
45
Mortality from (CAP) over 65 yrs old while hospitalized
12%
46
What percent of patients hospitalized with (CAP) will return to the hospital
Nearly 9%
47
What is need to diagnose someone with (CAP)
Infiltrates in CXR With clinical compatible syndrome (fever, dyspnea, cough, and sputum)
48
What do you do if a CXR is negative, but symptoms point highly to PNA
CT scan
49
History and physical development of PNA
Rapid onset Chills Rigors Body aches
50
What type of chest pain is associated with pneumonia
Pleuritic rather than pressure During inspiration (sometimes) Not radiating
51
What happens to volumes with pneumonia
All volumes either stay normal or decrease
52
What happens to the FEV1/FVC ratio when
Normal or raised
53
What causes air bronchograms
Infiltrates/consolidation outlining large Aws
54
Incidence v. prevalence
Incidence: How often/rate at which you get the flu in an amount of time. Prevalence: How many have it now within the population
55
How is incidence measured
How many cases over a set number of time with a set number of population
56
Organizations the guide diagnosis and management of Pneumonia
American thoracic society Infectious disease society of America
57
Pathophysiology of Pneumonia
Inflammation Leaky capillaries (serum, RBC) Mucous accumulation (toward end to clear)
58
Explain deriving a validated system
Gather (population) Derive (what information did you gather) Validate (test on later patients)
59
What does CURB-65 stand for
Confusion BUN RR BP Equal to or greater than 65yr
60
CURB-65 low severity points and mortality rate
Points: 0-1 Risk of death Equal to or less than 3%
61
CURB-65 moderate severity points and mortality rate
Points: 2 Risk of death: 9%
62
CURB-65 high severity points and mortality rate
Points: 3-5 Risk of Death: 15-40%
63
What is considered a high BUN
> 20mg/dL
64
Supportive care for pneumonia
O2 AW clearance Lung expansion Bronchospasm
65
Define sepsis
A dysregulated host immune response leads to organ damage
66
What are the two scoring systems for pneumonia
Pneumonia severity index CURB-65
67
How many risk classes does the pneumonia index offer
Five

Disease II (14 decks)

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