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Flashcards in Pneumonia Deck (37)
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1

Top 3 commonest pathogens causing CAP

1) strep pneumoniae
2) haemophilus influenzae
3) mycoplasma pneumoniae

2

Other common CAP pathogens x4

Staph aureus
Chlamydia
Legionella
Moraxella catarrhalis

3

What is HAP

Pneumonia acquired > 48hours after admission to hospital

4

Common HAP pathogens x2

Staph a or gram negative enterobacteria (salmonella, e.coli, shigella, y.pestis, klebsiella)

5

Other HAP pathogens

Pseudomonas
Bacteriodes
Clostridia

6

Symptoms of pneumonia

Fever, malaise, rigours, anorexia
Dyspnoea, cough, purulent (yellow/green/rust) sputum
Haemoptysis
Pleuritic pain

7

Signs of pneumonia

Pyrexia
Cyanosis
Confusion
Tachycardia and tachypnoea
Hypotension
Reduced expansion
dull percussion
Bronchial breathing
Increased tactile vocal fremitus
Pleural rub
Coarse creps

8

Severity score for pneumonia

CURB 65
Confusion (amts)
Urea - serum - >7mmol/L
Resp rate >30
Blood pressure systolic below 90 or diastolic below 60
Age over 65

9

Consequences of curb 65 score

0-1 - go home for treatment
2 - hospital therapy
>/= 3 - severe - may need ITU

10

General non-antibiotic management of Pneumonia

Fluids
VTE prophylaxis
Analgesia

11

Antibiotic management of mild CAP pneumonia (not previously treated)
(What are pathogens)

Strep p and haem.i

Amoxicillin
Or
Clarithromycin
Or doxi

12

Treatment of moderate CAP pneumonia and pathogens

Strep p, haem.i, mycoplasma.pn

Amoxicillin + clarithromycin
Or doxi

13

Treatment of severe CAP by the top 3 pathogens

Co-amoxiclav (augmentin)
Or cephalosporin
AND clarithromycin

14

Antibiotic if staph a

Flucoxacillin + rifampicin

15

Antibiotic if MRSA

Vancomycin

16

Legionella antibiotic

Fluoroquinolone
With clarithromycin or rifampicin if severe

17

Chlamydia antibiotic

Doxycycline

18

Pnemocystis jiroveci

Co-trimoxazole

19

HAP treatment

Gentamicin
Penicillin
Cephalosporin

20

Aspiration pneumonia treatment

Cephalosporin + metronidazole

21

Which pneumonia pathogen do you herpes labialis with?

Strep pneumoniae

22

What does klebsiella pneumonia cause?

Upper lobe cavitating pneumonia

23

How does mycoplasma pneumoniae occur?

In epidemics every 4years
Flu like symptoms (myalgia, arthralgia and headache)
Followed by dry cough
Shadowing or patchy consolidation of lower lobe (usually one)

24

How does chlamydia pneumoniae present?

Biphasal
Pharyngitis, hoarseness, otitis
Followed by pneumonia

25

Who in and how does pneumocystis pneumonia present?

In immunocompromised patient

Dry cough, exertional dyspnoea, fever
Bilateral creps
Bilateral perihilar shadowing

26

What is SARS?

Severe acute respiratory distress syndrome caused by SARS virus

27

How does SARS present?

Fever, chills, rigours
Myalgia
Dry cough and dyspnoea
Headache
Diarrhoea

28

Tests in SARS

Decreased WCC and abnormal CXR

29

Major complication of SARS

Respiratory failure

30

Management of SARS

Supportive
No druc dg been shown to be effective
Early isolation