Respiratory Infections Flashcards
pneumonia, (17 cards)
What is pneumonia?
infection of lung tissue, causing inflammation in alveolar space
How does pneumonia appear on CXR?
consolidation, usually in lower lobes
List the classifications of pneumonia
community acquired (CAP)
hospital acquired (HAP)
ventilator acquired (VAP)
aspiration
What is aspiration pneumonia?
this is where the infection develops due to aspiration of food or fluids, usually in patients with impaired swallowing e.g., stroke pts
List the presenting symptoms of pneumonia
cough
sputum production
SOB
fever
feeling generally unwell
haemoptysis
pleuritic chest pain
acute confusion/delirium
What are the signs of pneumonia likely to be found O/E?
bronchial breath sounds
focal coarse crackles
dullness to percussion
What tool is used to assess pneumonia severity?
CURB-65
this predicts mortality
What does the CURB-65 acronym mean?
confusion
urea >7
respiratory rate >30
BP <90 systolic
age > 65
What are the top causes of typical bacterial pneumonia?
strep. pneumoniae
haemophilus influenzae
What is atypical pneumonia?
this is caused by organisms that cannot be cultured normally or detected using a gram stain
How should atypical pneumonia be treated?
penicillin is ineffective
treated with macrolides, fluoroquinolones and tetracyclines
List the 5 causes of atypical pneumonia
‘lesions of psittaci MCQ’s’:
Legionella pneumophila
Chlamydia psittaci
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Q fever (coxiella burnetii)
What is PCP?
pneumocystis jirovecii pneumonia
occurs in immunocompromised patients e.g., with HIV or low CD4 count
presents subtly with a dry cough, SOB and night sweats
What investigations should be carried out for patients admitted with suspected pneumonia?
CXR
FBC
U+E’s for CURB-65 score
CRP and WBCs for infection/inflammation markers
sputum and blood cultures in severe cases
How is mild CAP managed?
5 days of oral abx e.g.,: amoxicillin, doxycycline, clarithromycin
(depends on local guidelines)
How is moderate-severe pneumonia managed?
IV abx, stepped down to oral abx when appropriate
respiratory support e.g., oxygen or ventilation
List the possible complications of pneumonia
sepsis
acute respiratory distress syndrome
pleural effusion
empyema
lung abscess
death
