Pneumonia DSA and CIS I Flashcards
most common cause of infectious death in world
pneumonia
dx of pneumonia
fever, chills, leukocytosis
cough, sputum, dyspnea, chest pain, abnormal pulmonary exam
changes on CXR
population for pneumonia
65yo
typical pneumonia bugs
strep pneumonia
h flu
moraxella catarrhalis
atypical pneumonia bugs
legionella
mycoplasma
chlamydia pneumonia
viruses
fever, rigors, cough with sputum, lobar infiltrates on CXR
typical pneumonia
dry cough with diffuse patchy infiltrate on CXR
atypical pneumonia
elderly
only mental status changes
atypical coverage
macrolides
doxycycline
FQs
hospitalized CAP tx
resp FQ (moxi,levo)
OR
2,3 generation cephalosporin and macrolide
shock
need to be treated within an hour of developing hypotension
antibiotic treatment
health care associated pneumonia
MRSA and pseudomonas
criteria for health care associated pneumonia
hospitalized > 2 days previous 90 days
nursing home
home infusion therapy
hemodialysis
home wound care
fam member with MDR pathogen
immunosuppression
pneumonia specific criteria for health care associated pneumonia
hospitalization > 2 days
antibiotics previous 90 days
non-ambulatory
tube feeding
immunocompromised
gastric acid suppressive agent
MRSA
cavitary infiltrate pleural effusion gross hemoptysis concurrent influenza neutropenia erythematous rash skin pustules pneumonia during summer
legionella antigen
urinary
good sputum gram stain
less than 10 squamous and more than 25 leukocytes
thoracentesis
should be performed if greater 10mm pleural fluid
CURB-65
confusion uremia - BUN > 20 respirations >30 BP < 90/60 age 65
score >3 - hosp is appropriate
ICU admission
3 or more
-confusion, BUN, tachypnea, multiplbar infiltrates, hypoxemia, thrombocytopenia, hypotension, hypothermia, leukopenia, lactic acidosis, low pH, low albumin, tachycardia, elderly
smokers
strep pneumo
h flu
moraxella
legionella
COPD
strep pneumo
h flu
moraxella
legionella
alcoholism
drug resistant strep pneumo, anaerobe, TB
bird exposure
psittacosis
