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Flashcards in Pneumonia Deck (16):
1

What is the main treatment modality in Pneumonia?

Empiric Antibiotic Treatment.
Our diagnostic testing of etiology isn't effective and is expensive.

2

What are the 3 categories of Pneumonia?

Community Acquired Pneumonia
Atypical Pneumonia (no way to distinguish)
Healthcare assoc. pneumonia

3

Who is most likely to contract pneumonia?

Males
African Americans

4

What are predisposing factors for Community Acquired Pneumonia?

Altered Level of Conciousness (aspiration of mouth contents during unconciousness)
Smoking (dec cilia)
Alcohol (dec LOC)
Hypoxemia (decreases cilia)
Acidosis
Pulm Edema
Uremia
Malnutrition
Immunosupression
Age >65
Denture use while sleeping
CF, bronchiectaisis,
Kartagener's (dec cillia action)
Dysphagia
HIV

5

What are the most common Bacteria that cause Typical Pneumonia?

Strep Pneumo**,
Haemophilus Pneumonia
Staph Aureus
Group A strep
Moraxella Catarrhalis
Anaerobes
Aerobic G- Org

6

What are the most common bacteria that cause Atypical Pneumonia?

Mycoplasma Pneumonia**, Legionella**
Chlamidia pneumoniae
Chlamidia psittaci (rare from parrots)

7

What Bacteria is someone more likely to be infected by if they have influenza, previous Abtx or Lung disease?

Staph Aureus
Enterobacteriaceae
Pseudomonas

8

What are the risk factors for being infected with an anaerobic organism?

Aspiration associated with Altered LOC
causes lung abcesses and empyema
Less common Pts without teeth

9

How is pneumonia diagnosed?

Chest X-ray (infiltrates seen)
S and S of cough, FEVER, pleuritic chest pain (localized, extreme pain made worse with inspiration), dyspnia, sputum production

10

WHat is seen on CXR in pneumonia?

Lobar or interstitial Infiltrates or cavitation
film may be negative until Pt is well hydrated
Air/Fluid level charicteristic of a lung abcess

11

In what cases is ID of the specific organism considered critical?

Legionella
Influenza A/B and MERS
Community acquired MRSA
Agents of bioterrorism (Anthrax)

12

What are the diagnostic studies used for specific diagnosis of orgainisms in pneumonia?

Sputum and blood culture
Antigen detection for legionella and Strep Pneumo
PCR

13

In what cases is sputum gram stain and culture recommended?

ICU admission
Failure of Abtx
Cavitary changes on imaging
Immunocompromised host
Alcoholism
Severe COPD
Pleural Effusion
Epidemic Pneumonia
Epi data suggests resistance


Only usefu if an acceptable sample can be obtained

14

What is the difficulty of obtaining a blood culture?

Often contaminated with Staph normally found on skin

15

What is the Tx for pneumonia in low risk Pts?

Oral Macrolide
Azithromycin, Clindamycin, Erythromycin
OR
Doxycycline

16

What is the Tx for pneumonia in Pts with comorbidities?

Respiratory Fleuroquinolone OR beta Lactam PLUS a macrolide