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Paeds - Resp > Pneumonia > Flashcards

Flashcards in Pneumonia Deck (11):
1

Where in the lungs does pneumonia start?

Alveoli

2

Complications of pneumonia

• parapneumonic effusion
• Empyema
• lung abscess
• necrotising pneumonia

3

Symptoms found in pneumonia

• persistent fever
• tachypnoea at rest
• Cough +/- chest pain
○ Remember - cough not necessary - alveoli don't have cough receptors!
• Vomiting +/- abdo pain
• increased work of breathing/respiratory distress
• lethargy/ unwell appearance / irritability
• Reduced appetite and dehydration

4

Exam findings in pneumonia

• hypoxaemia ( <92%) on pulse oximetry
• crackles and bronchial breathing on auscultation
• elevated respiratory rate for age
• chest wall indrawing, retractions, grunting, nasal flaring
• apnoea
• absent breath sounds and a dull percussion note suggest a pleural effusion  

5

What Ix could you do in pneumonia?

Ix are not recommended for routine use in Dx CAP - esp. in mild disease:
- UEC: hyponatraemia vs SIADH
- FBE
- microbio Ix
- CXR

6

Severe pneumonia - criteria

Clinical features of pneumonia and 2 or more of the following:
• Severe respiratory distress
• Severe hypoxaemia or cyanosis
• Marked tachycardia
• Altered mental state

OR
• Empyema

7

When to admit and d/c pneumonia?

Admit:
○ <1 yo
○ Nil by mouth + dehydration
○ Pleural effusion
○ Extensive consolidation
○ Severe breathing problems

- D/C when can maintain adequate oxygenation and oral intake

8

When O2 for pneumonia?

<92% sat

9

What abx for bacterial pneumonia?

○ Non-severe pneumonia: oral amoxicillin (7-10days) or IV benpen
- We don't really use augmentin, that would be if you think staph is likely

○ Severe: ceftriaxone or cefotxaime AND flucloxacillin
- Consider addition of vancomycin for MRSA
- If mycoplasma - roxythromycin 10 days

○ Consider neuraminidase inhibitors (oseltamivir) i.e. tamiflu if suspect to be complicated by/will be by influenza e.g. IC

10

Empyema:
- exam findings
- Mx

- stony dullness and pleuritic pain
- chest drain and fibrinolytics

11

What is the most common atypical organism in pneumonia? What are some cutaneous symptoms that you might see?

- Mycoplasma pneumoniae
- SJS/TEN
- Erythema multiforme
- Mucositis
- Rash: non-specific erythematous exanthem, might have vesicles/bullae associated