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Flashcards in Important other Deck (16)
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1
Q

What is penumonia

A

Inflammation of lung parenchyma caused by a lower respiratory tract infection.
It often occurs after a viral infection of the upper respiratory tract. It is uncertain how the bacteria reach the lower respiratory tract after attaching to disaccharide receptors on pharyngeal epithelial cells.

2
Q

Pathophysiology of pneumonia

A

Debatable methods of invasion include:

  • Inhibition of IgA
  • Pneumolysins, which inhibit ciliary beating
  • Damage of epithelial cells by prior infection
  • Hijacking the platelet aggregating factor receptor pathway to reach the alveoli
3
Q

Symptoms of pneumonia

A

Fever
Cough with purulent sputum
Dyspnoea
Pleuritic pain

4
Q

Signs of pneumonia

A

Percussion: dull
Auscultation: crackles, bronchial breathing
Respiratory failure: cyanosis, tachypnoea
Septicaemia: rigors

5
Q

Treatment of pneumonia

A
BAPP
Breathing (maintain oxygen saturation levels)
Antibiotics (treat the underlying cause)
Pain (give analgesics)
Pneumococcal vaccines for those at risk
6
Q

Which at risk patients (for pneumonia) are given pneumococcal vaccines

A

Diabetics
Immunosuppressed
>65 years old

7
Q

Complications of pneumonia

A
Respiratory failure
Septic shock
Pleural effusion
Empyema
Lung abscess
Hypotension
8
Q

How does pneumonia cause respiratory failure

A

By causing acute respiratory distress syndrome (ARDS)

9
Q

How does pneumonia cause septic shock

A

Causative agent enters the patient’s bloodstream, releasing cytokines

10
Q

Underlying cause of hypotension in pneumonia

A

Sepsis

Dehydration

11
Q

Investigations of pneumonia

A

CXR - look for infiltrates
Identify the causative organism by assessing a sputum sample
Monitor oxygen saturation
Bloods - look for raised WCC and raised inflammatory markers
Urinary antigen test - for Pneumococcal or Legionella antigen
ABG

Assess severity using CURB-65

12
Q

Describe how you would use CURB-65 to assess severity of pneumonia

A
Confusion
Urea >7mmol/L
Respiratory rate >30/min
BP<90/<60mmHg
>65 years old

Each section of the CURB-65 is worth 1 point:
1 = outpatient care
2 = admission
>3 = requires ICU aadmission

13
Q

Causative organisms in community acquired pneumonia

A
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Viruses
(main ones)
14
Q

Causative organisms in hospital acquired pneumoniae

A
Gram-negative bacteria
Staphylococcus aureus
Streptococcus aureus
Streptococcus pneumoniae
Anaerobes
Fungi
Legionella pneumophila
15
Q

Causative organisms in children pneumonia

A

Viruses
Pneumococcus
Mycoplasma

16
Q

Causative organisms of pneumonia in immunocompromised patients

A
Pneumocystis jirovecii
Cytomegalovirus
Adenovirus
Herpes simplex virus
Mycobacterium tuberculosis
Bacterial infection e.g. Staphylococcus aureus