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CR > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Symptoms of pneumonia

A 
cough
sputum
dyspnoea
chest pain: may be pleuritic
fever
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2
Q

Signs of pneumonia

A

fever, tachycardia, tachypnoea
reduced oxygen saturations
reduced breath sounds, bronchial breathing, dull to percuss, coarse crepitations

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3
Q

Legionella pneumonia presentation

A

dry cough, no fever, headache, confusion, diarrhoea, hyponatraemia

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4
Q

Mycoplasma pneumonia presentation

A

upper respiratory involvement, skin changes, encephalitis, uveitis, myocarditis, haemolytic anaemia

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5
Q

CRB-65 scoring

and CURB-65

A

Confusion
Respiratory rate of >=30 bpm
BP of <90/60
65 years old or more

0 = low risk of death
1-2 = intermediate
3-4 = high risk (>10%)

CURB-65 includes urea (>7 mmol/l)

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6
Q

Management of those with CRB-65 score of 0 vs others

A

If 0 –> home-based care

Other score –> hospital assessment

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7
Q

CURB-65 score of 2 or more management

A

Hospital-based care

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8
Q

CURB-65 score of 3 or more management

A

ICU assessment

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9
Q

CURB-65 score of 0 or 1 management

A

Home-based care

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10
Q

Management of low-severity community acquired pneumonia

A

amoxicillin (5 days)

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11
Q

Management of moderate severity community acquired pneumonia

A

amoxicillin + macrolide (7-10 days)

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12
Q

Management of high severity community acquired pneumonia

A

co-amoxiclav, ceftriaxone or piperacillin with tazobactam AND a macrolide

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13
Q

Investigations

A 
Pulse oximetry
CRP
CXR 
Blood + sputum cultures, pneumococcal and legionella urinary antigen tests if intermediate or high risk 
Bloods - FBC, U&amp;Es, CRP
ABG if low sats or has COPD
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14
Q

Typical bacterial causes

A 
Streptococcus pneumoniae = most common
Haemophilus influenzae
Staphylococcus aureus
Group A streptococci
Moraxella catarrhalis
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15
Q

Atypical bacteria causes

A

Mycoplasma pneumoniae, Chlamydia, and Legionella

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16
Q

Viral causes

A

Influenza A and B, respiratory syncytial virus, adenovirus, and some coronaviruses

17
Q

Indications for flu vaccine

A 
65 years old or over   
Pregnancy
Live in care home  
Carers for elderly/disabled 
Health staff 
Chronic conditions - asthma, COPD, chronic heart disease, CKD, chronic liver disease, chronic neuro conditions, diabetes, spleen issues 
Immunosuppressed 
BMI of 40 or above
18
Q

Indications for pneumococcus vaccine

A

Babies
65 and over
Occupational risk e.g. welders
Chronic conditions + immunosuppressed (same as flu)

19
Q

CXR findings

A

Consolidation
Lobar collapse
Pleural effusion

20
Q

Causes of hospital acquired pneumonia

A

Pseudomonas aeruginosa
MRSA
Other non-pseudomonal Gram-negative bacteria

21
Q

Causes of pneumonia in immunocompromised people

A

More atypical causes e.g. fungal, mycobacteria, viruses, pneumocystis jirovecii

CR (19 decks)

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