Review 1 Flashcards
(25 cards)
typical pneumonia
acute bacterial pneumonia
community acquired (CAP) or (HCAP)
hours to days
onset with fever and cough
lobar consoliation or segmental bronchopneumonia
pleuritis
micro-aspiration URT colonizing bacteria
MOST OFTERN S. PNEUMONIAE
etiology of CAP
- pneumococcus
- haemophilus (largely disappeared)
- G- like klebsiella
- viral pneumonia usually in children
Atypicial Pneumonia
disseminated, all treated the same although they are different bugs.
M. pneumoniae C. pneumoniae Legionella pneumophilia- water Coxiella burnetti chlamydia psittaci
aspiration pneumonia
stuppor, coma or seizures. FOCAL Oropharyngeal flora CAP: G+s, and up to 20% anaerobes HCAP: G-s like S. aureus
can be complicated by chronic pneumonia with *abscess formation
Atypicial Pneumonia
disseminated, all treated the same although they are different bugs.
M. pneumoniae C. pneumoniae L. pneumophilia- water Coxiella burnetti chlamydia psittaci
aspiration pneumonia
stuppor, coma or seizures. FOCAL Oropharyngeal flora CAP: G+s, and up to 20% anaerobes HCAP:
Hemophilus Flu
G- coccobacillus
Enterics
GNR
Treatment of CAP
beta lactams- strep, staph, klebsie
macrolides: atypicals
treatment of HCAP
resistant staph + GNB
Chronic Pneumonia
Patchy, weeks to months.
No empiric treatment.
requires bronchoscopy or lung biopsy
Chronic Pneumonia
Patchy, weeks to months.
No empiric treatment.
requires bronchoscopy or lung biopsy
Expectorated Sputum
Acceptable if: 25 PMNs
ratio GREATER than 5:1
Expectorated Sputum
Acceptable if: 25 PMNs
ratio GREATER than 5:1
Rapid antigen test
point of care testing- only flu and RSV
backup test for negatives
DFA
fast, stains most common viruses. less sensitive than culture
Culture
more sensitive but slower. not all viruses grow well
PCR
gold standard but expensive.
FAST
PCR
gold standard but expensive.
FAST
CXR reading
- patient’s name
- verify date of XR
- compare prior films
- evaluate quality
CXR ABCs
Airway Bones Cardiac Shadow Diaphragms effusions/empty spaces fields of lungs gastric bubble hilar region indwelling lines
CXR ABCs
Airway Bones Cardiac Shadow Diaphragms effusions/empty spaces fields of lungs gastric bubble hilar region indwelling lines
most common culprits of viral pneumonia
Picornavirus-Rhinovirus: common cold. susceptible to acid
Viral vs Bacterial
bacteria: high fever, prolonged symptoms,
