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Flashcards in Pneumonia Deck (28):
0

What antibiotic would you give for atypical pneumonia?

Macrolide or doxycycline

2

Drug induced pneumonitis?? What about pneumonia in an immunocompromised patient?

Chemotherapy toxicity reaction can cause a pneumonitis effect. Immunocompromise in chemotherapy patients is also considered like klebsiella etc

3

what are some 'typical' organisms that cause pneumonia?

Strep pneumoniae, haemophillus influenza, staph aureus, mycoplasma pneumoniae

4

What are some 'atypical' organisms that can cause pneumonia?

legionella, chlamydophillia, mycoplasma tuberculosis

5

What organisms usually cause hospital acquired pneumonia?

pseudomonas, klebsiella (gram negative rods), staph aureus

6

What is a classic bug that causes pneumonia in immunocompromised patients?

pneumocystis jiroveci = PCP

7

What are some fungi that can cause pneumonia?

cryptococcus, aspergillosus

8

what are some clinical symptoms of pneumonia?

fever, rigor, cough, dyspnoea, purulent sputum, anorexia, haemoptesis, pleuritic chest pain

9

What are some clinical SIGNs of pneumonia?

tachycardia, pyrexia, cyanosis, confusion in elderly, decreased percussion note over consolidation, pleural rub

10

Are breath sounds increased or decreased with consolidation?

INCREASED (bronchial breathing)

11

What are some tests you would do to confirm pneumonia?

Sputum culture, gram stain, transtracheal aspirate, CXR, FBE, blood cultures (performed before antibiotics)

12

How would we treat pneumonia?

Antibiotics depending on the organism, O2 supply if sat is low, paracetamol for pleuritic chest pain

13

what are some complications of pneumonia?

empyema, AF, pleural effusion, abscess, septicemia, respiratory failure

14

what are the 3 main categories of pneumonia

1. Community acquired; 2. hospital acquired; 3. immunocompromised patient

15

what other things would you want to watch out for in mycoplasma pneumonia?

pericarditis, myocarditis and skin rashes

16

what is a rare association with legionella pneumonia?

hepatitis

17

what is the commonest cause of CAP?

strep pneumoniae

18

what are the standard antibiotics for CAP?

amoxicillin or clarithromycin for those with a history of penicillin allergy

19

how do we assess the severity of pneumonia?

CURB 65 score
C : confusion present (abbreviated mental test score 7 mmol/L
R : respiratory rate >30/min
B : systolic BP 65
Give each 1 point. If 2= admit to hospital; 4-5= ICU care

20

what are some investigations you'd want to do if you suspect pneumonia?

Sputum culture
Bloods – FBC ( high WCC) / CRP( high ) / U&E / Blood culture
ABG – is the patient hypoxic
CXR

21

general management of pneumonia?

1. Oxygen
2. IV fluids if hypotensive
3. Antibiotics
4. Physiotherapy for sputum if sputum retention
5. clexane
6. analgesia for pleuritic chest pain

22

what would we use to cover atypical organisms that cause pneumonia?

erythromycin and tetracycline bc they do not have a cell wall

23

what organisms would predispose a cavitating pneumonia and cause a lung abscess?

staph aureus and klebsiella

24

what is first line treatment for PCP

high-dose co-trimoxazole (bactrim)

25

what are some risk factors of legionella pneumonia?

chronic lung disease, smoking, diabetes, immunosuppression, malignancy, chronic corticosteroid use and end-stage kidney disease

26

what are some extra investigations you might consider in serious pneumonia?

• Urinary antigen assay for pneumoccal and legionella
• Nose and throat swabs for nucleic acid testing
• IgM serology for M. pneumoniae
• Last resort- bronchoalveolar lavage

27

what are some signs of a staphylococcal pneumonia?

-a short clinical course before requiring intensive care support
-haemoptysis
-early multilobar involvement on chest X-ray
-progression to pulmonary cavitation
-disseminated intravascular coagulation

28

what are some complications of bacterial pneumonia

abscesses
pleural adhesions
empyema
infarct