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Y1 - Respiratory > Pneumonia > Flashcards

Pneumonia Flashcards

(46 cards)

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1
Q

What is pneumonia?

A

Infection of the lung tissue causing inflammation and exudation (oedema)

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2
Q

What are the symptoms of pneumonia?

A 
Shortness of breath
Purulent cough
Haemoptysis
Pleuritic chest pain
Malaise
Rigors (spiking change in temperature)
Myalgia
Confusion
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3
Q

What are the signs of pneumonia?

A 
Fever
Tachypnoea
Tachycardia
Hypoxia 
Hypotension
Crackles
Bronchial breath sounds (harsh breath sounds on insp and exp)
Dullness to percussion
Pleural rub
Cyanosis
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4
Q

What investigations are done for pneumonia?

A 
CXR
Sputum culture
Viral PCR
Blood culture
Serology
ABGs
FBC
CRP
U&Es
LFTs
Legionella and pneumococcal urinary antigens
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5
Q

What is the assessment criteria for pneumonia?

A

CURB65

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6
Q

What is the most common cause of pneumonia?

A

Streptococcus pneumoniae

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7
Q

What is a common cause pneumonia in COPD patients?

A

Haemophilus influenzae

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8
Q

What is a common cause of pneumonia in PWIDs, the young or elderly, or often following influenza?

A

Staphylococcus aureus

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9
Q

Which atypical pneumonia organism is associated with birds?

A

Chlamydophila psittaci

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10
Q

Which atypical pneumonia organism is associated with sheep and goats, and farming?

A

Coxiella burnetti

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11
Q

Which atypical pneumonia organism is associated with water tanks/ air con and holiday to Spain?

A

Legionella pneumophilia

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12
Q

Which atypical pneumonia organism is associated with alcoholism and aspiration pneumonia?

A

Klebsiella/mixed anaerobbes

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13
Q

Which atypical pneumonia organism is associated with the immunocompromised?

A

Pneumocystis jiroveci

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14
Q

Which atypical pneumonia organism causes erythema multiforme (target lesions) and neurological symptoms in a young patient?

A

Mycoplasma pneumoniae

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15
Q

How does strep pneumonia appear on gram staining?

A

Gram positive (purple) cocci in strips

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16
Q

How does haemophilia influenzae appear on gram staining?

A

Gram negative (pink) coccobacilli

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17
Q

How does staph aureus appear on gram staining?

A

Gram positive coccus, ‘grape-like’ clusters

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18
Q

What is community acquired pneumonia?

A

Pneumonia acquired outside hospital or healthcare facilities

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19
Q

What is the pathology of pneumonia?

Study These Flashcards
A
  1. Organism reaches the lungs
  2. Immune activation and infiltration of neutrophils, macrophages
  3. Fluid and cellular build up in alveoli
  4. Impaired gas exchange
20
Q

What are risk factors for community acquired pneumonia?

Study These Flashcards
A 
Increasing age
Immunocompromised/suppressed patients
Smoking 
COPD
Alcohol abuse
Drugs that reduce stomach acid production - H2 antagonist, antacids
21
Q

In what way can atypical pathogens present differently to other pathogens?

Study These Flashcards
A

Can present sub-acutely with gradual onset of symptoms

22
Q

When should you suspect community acquired pneumonia?

Study These Flashcards
A

In patients with symptoms and signs of a lower respiratory tract infection, and when there is new radiographic consolidation for which there is no other explanation

23
Q

What are some differentials for pneumonia?

Study These Flashcards
A 
Acute bronchitis
Congestive heart failure
Bronchiectasis exacerbation
TB
Lung cancer
Pulmonary embolism
Pneumothorax
24
Q

How does the assessment criteria for pneumonia assess severity?

Study These Flashcards
A 
Confusion
Urea >7
Resp rate >30
BP <90 systolic or <60 diastolic 
65+
One point for each of the above that they exhibit
0 points is low risk
1-2 is moderate
3+ is high risk
25
What is the treatment for mild/moderate community acquired pneumonia?
Oral amoxicillin/doxycycline 5 days
26
What is the treatment for severe community acquired pneumonia?
Co-amoxiclav + doxycycline If penicillin allergic then levofloxacin only If high risk of atypical organism: co-amoxiclav + clarithromycin
27
What are the supportive measures used for pneumonia?
Oxygen if <94% IV fluids Bed rest
28
Who are pneumonia vaccines given to?
``` Over 65 year olds Patients with chronic chest or cardiac disease Patients with diabetes Immunocompromised Health care workers ```
29
What are some complications of pneumonia?
``` Septic shock ARDS C diff associated colitis (pseudomembranous) Heart failure Pleural effusion Empyema Lung abscess ```
30
What is hospital acquired pneumonia?
An acute lower respiratory tract infection that is acquired after at least 48 hours of admission to hospital
31
What is early onset hospital acquired pneumonia often caused by?
Strep pneumoniae
32
What are risk factors for hospital acquired pneumonia?
ICU Major surgery Patients who have been in hospital a long time Endotracheal intubation with mechanical ventilation Sedation Immunosuppression Head of the bead at <30 degree angle
33
What is the treatment for non-severe hospital acquired pnuemonia?
Amoxicillin/doxycycline PO 5 days
34
What is the treatment for severe hospital acquired pneumonia?
IV Amoxicillin + gentamicin | If penicillin allergic then co-trimoxazole + gentamicin
35
What are the most common organisms causing community acquired pneumonia?
Strep pneumoniae Atypicals Haemophilus influenza Staph aureus
36
What are the atypical bacteria causing pneumonia?
``` Legionella pneumophilia Mycoplasma Chlamydia pneumonia Coxiella burnetti Chlamydia psittaci ```
37
What fungus can cause pneumonia?
Pneumocystis jiroveci
38
How does pneumocystis jiroveci (pneumocystis pneumonia) present?
Subtly with dry cough without sputum, shortness of breath on exertion and night sweats
39
How is pneumocystis pneumonia treated?
Co-trimoxazole
40
What are the most common organisms causing hospital acquired pneumonia?
E. coli Klebsiella Pseudomonas aeruginosa
41
What is lobar pneumonia?
Consolidation involving a complete lobe
42
What is bronchopneumonia?
Infection starting int he airways and spreading to adjacent alveolar lung
43
What is the onset of pneumonia?
Subacute - days
44
What is the treatment for non-severe aspiration pneumonia?
Amoxicillin/doxycycline + metronidazole PO 5 days
45
What is the treatment for severe aspiration pneumonia?
IV amoxicillin/clarithromycin + metronidazole + gentamicin
46
What is the treatment for atypical pneumonia?
If it's not legionella - doxycycline | If it's legionella - clarithromycin/erythromycin or levofloxine

Y1 - Respiratory (12 decks)

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