Flashcards in Week 118 Bronchial sepsis Deck (138)
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1
What is pleuritic chest pain?
Sharp pain on inhalation/movement like a bad stitch
2
What are rigors?
Feeling cold with a temperature/sweats and vice a versa
3
If a pt has recently been on holiday, what is this significance of this?
TB
Certain pathogens
4
What is palmar erythema and what is it significant of?
Red palms
Vasodilation because of shock with low bp
5
What are causes of low bp?
Bleeding
Shock- sepsis or anaphylactic
Endotoxic shock
Pump failure
Tablets
(hypovolemia)
6
If a pt had a haemorrhage, how might their palms appear?
White and clammy
7
What do crackles sounds like?
Velcro
8
What does pleural rub sound like?
Someone walking on snow
9
How do you know if RLZ is affected? (CXR)
Can't see diaphragm border
10
How do you know if right middle zone (lingular) is affected (CXR)?
Can't see right heart border
11
What is a white-ish shadow potentially on a CXR?
Consolidation
12
How many ribs should be seen on a CXR?
8 anterior
6 posterior
13
What are signs of type 1 respiratory failure?
Low o2 low co2
14
What are signs of type 2 resp failure?
Low o2 high co2
15
What is CRP?
Protein made in liver, over 100 indicates infection/inflammation
16
What type of resp failure is pneumonia?
Type 1
17
What is high d-dimer indicative of in blood results?
Blood losing ability to clot so bruising and bleeding occurs e.g. overdose, kidney/liver failure
18
What is the average tidal volume?
500ml
19
How much air is processed in the lungs a day?
10-20,000 L
20
Describe features of typical pneumonia
-Abrupt onset
-High fever
-Purulent sputum (green)
-Focal consolidation
21
Describe features of atypical pneumonia
Gradual onset
Dry cough
Myalgias
Headache
22
When do you see helminths/protozoa infecting people?
Africa (sub-saharan), Asia
Immune deficient
23
What colour do gram +ve bacteria stain?
Blue
24
Describe features of streptococcus pneumonia
•Gm +ve
•Lives in resp tract
•Rapid multiplication •Abrupt onset
•Very ill
•Medical emergency
community acquired/aspiration
mild- amoxicillin
moderate- am and clarithromycin
aspiration- CephalosporinIV+metronidazoleIV
25
What presents on a CXR differentiating pneumonia from cancer?
black dots (bronchal...? research)
26
Describe features of haemophilus influenza
BACTERIA
heamophilus lives in mouth, nose, doesnt cause massive infection- weak bug that grows over a few days
•URTI common
•Usually encapsulated (typeable forms)
•Small pleural effusions can occur
•Empyema / cavitation rare
community acquired- clarithromycin
27
Where does staphylococcus normally grow?
Hands
28
Describe features of Staphylococcus aureus
-common in anyone with breakage in skin e.g. drug addict- look for needle marks
•Gram +ve
•Spread via airways (viral) or •Bacteraemia (e.g. endocarditis)
•Lung tissue lysis leads to cavitation
•Septicaemia, empyema, abscesses are common
29
Describe features of Klebsiella
•Gram –ve (not blue)
•Colonise oropharynx •Nosocomial
nosocomial= nursing home
old people cant fight this off and have comorbidity
•Comorbidity common
•Very ill
•Haemoptysis
•Poor prognosis
not dark blue stain
lives in stomach, intestines, oropharynx
30
