Pneumonia Flashcards
define pneumonia
a bacteria mediated infection of lung tissue that causes inflammation that leads to fluid, blood cells and microorganisms leaking into the alveoli
causes of community acquired pneumonia
streptococcus pneumonia
haemophilus influenzae
mycoplasma pneumoniae
causes of hospital acquired pneumonia
straphylococcal aureus
pseudomonas aeruginosa
enterobacteria
risk factors of pneumonia
extremes of age
chronic smoking/alcohol use
respiratory disease
immunosupression
clinical features of pneumonia
fever malaise rigors cough purulent sputum pleuritic chest pain haemoptysis
signs of pneumonia
tachypnoea tachycardia hypotension cyanosis dull percussion and increased vocal resonance
differentials of pneumonia
COPD exacerbation
pulmonary oedema
pleural effusion
bronchiectasis
investigations of pneumonia
assess patient with CURB-65 score carry out CXR measure pulse oximeter sputum culture pneumococcal and legionella urinary antigen
common blood tests of pneumonia
FBC, CRP, RNF, U+E, LFTs, cultures, ABG
how to score using CURB-65
point for each
confusion urea >7mmol/L respiratory rate >30/min BP <90mmHg systolic and/or <60mmHg diastolic >65 years
how CURB-65 scores are dealt with
1 = home treatment 2 = consider hospital 3-5 = hospital treatment and ITU referral
conservative pneumonia management
advise smoking cessation
advise rest and good fluid intake
utilise NSAIDs and paracetamol for pain
5 day course amoxicillin
hospital management of pneumonia
oxygen supplement to keep > 94% fluid management analgesia for chest pain antibiotics (oral or IV) follow up CXR in 6wks once discharged
who is most likely to be affected by aspiration pneumonia
patients with: stroke myasthenia gravis bulbar palsy alcoholics post-ictal state achalasia GORD
common organisms involved in aspiration pneumonia
strep pneumoniae straph aureus haemophilus influenzae enterobacteria pseuodomonas
