Pneumonia Flashcards
(24 cards)
Define pneumonia
Inflammation of lung tissue caused by infection leading to fluid and immune cells leaking into the alveoli, resulting in consolidation and impaired gas exchange.
What triggers the inflammatory response in pneumonia?
Microbe enters bronchioles of alveoli.
What fills the tissue during pneumonia?
White cells, proteins, fluid, and RBCs (if capillary damage occurs).
List common symptoms and signs of pneumonia.
- Fever
- Malaise
- Productive cough
- Pleuritic chest pain
- Shortness of breath (SOB)
- Haemoptysis
What are the main causes of pneumonia?
Bacterial, viral, or fungal infection invading through lung tissue.
What is aspiration pneumonia?
Occurs when a foreign object is breathed in, more common in patients with swallowing difficulties.
What is VAP?
Ventilator-associated pneumonia, occurring 48 hours after intubation.
Define atypical or interstitial pneumonia.
Occurs in the interstitium, does not show up on gram stains, and penicillin is ineffective.
What is lobar pneumonia caused by?
Streptococcus, resulting in whole lung consolidation.
What is the most common bacterial cause of pneumonia?
What is the bacteria associated with?
Streptococcus, associated with cold sores.
Name a bacterial cause of pneumonia associated with COPD.
Haemophilus influenza.
What is Staphylococcus aureus associated with in pneumonia?
Post-flu infections, children, or IV drug users, leading to bibasal pneumonia.
What is Klebsiella associated with?
Alcoholics and diabetes, causing cavitating pneumonia in upper lobes with red currant jelly sputum.
Name an atypical bacterial cause of pneumonia.
What is each associated with?
- Mycoplasma pneumoniae - autoimmune, erythema multiforme
- Chlamydiophila pneumoniae
- Legionella pneumophila - contaminated aerosol, poor hotel air conditioning
- Chlamydiophila psittaci - birds
- Coxiella burnetii - animals, farmers
What fungal cause of pneumonia is associated with immunocompromised patients?
Pneumocystis jiroveci.
Name two viral causes of pneumonia.
- Rhinovirus
- Coronavirus
What physical exam findings are indicative of pneumonia?
Bronchial breathing, coarse crackles, and dull percussion.
What does CURB 65 assess in pneumonia management?
- Confusion
- Urea > 7 mmol/L
- Respiratory rate equal to or over 30
- Blood pressure equal to or under 90 Systolic or 60 Diastolic
- Age 65 or over
What is the treatment for mild to moderate pneumonia (CURB 1-2)?
Oral amoxicillin and add clarithromycin/erythromycin if atypical pathogens suspected for 5 days.
What is the significance of conducting a sputum culture in pneumonia?
To confirm and guide appropriate antibiotic treatment.
What reasons might explain why consolidation is not seen on an X-ray?
- CXR done too early
- Ground glass shadowing
- Consolidation posterior to heart
- Consolidation on anterior/posterior aspect of diaphragm
Treatment of pneumonia in CURB over 3?
Admit
Co omoxiclav orally or IV for 5 days
If atypicals suspected -> add clairythro/erythromycin 7-10 days
For HAP - Co omoxiclav 3-5 days
Which pneumonia is common in cystic fibrosis patients
Pseudomonas aeruginosa
Haemophilius influenzae
How to tell the difference between right lower and right middle lobe pneumonia?
Right lower - beneath horizontal fissure, obscures diaphragm
