Lower Respiratory Tract Infection in Adults Flashcards Preview

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Flashcards in Lower Respiratory Tract Infection in Adults Deck (54)
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1

What is the UK incidence of pneumonia?

5-11/1000 adult population

2

What percentage of community acquired pneumonia requires hospitalisation?

Between 22 and 42%

3

What is the mortality of hospitalised patients with pneumonia?

6-12%

4

What are some symptoms of pneumonia?

Malaise

Myalgia

Fever

Chest pain

Cough

Purulent sputum

Dyspnoea

5

What are some signs of pneumonia?

Pyrexia

Tachypnoea

Central cyanosis

Dullness on percussion of affected lobe

Bronchial breath sounds

Inspiratory crepitations

Increased vocal resonance

6

What investigations are done for pneumonia?

Serum biochemistry, full blood count and C-reactive protein (CRP) test

Chest X-ray

Blood cultures

Throat swab

Urinary legionella antigen

Sputum microscopy and culture

HIV test

7

What microrganisms are the 3 three for causing pneumonia?

1) Strep pneumoniae (39%)

2) Chlamydophilia pneumoniae (13.1%)

3) All viruses (13.1%)

8

What is the severity of pneumonia measured by?

CURB 65

9

What does CURB 65 stand up for?

C confusion

U blood urea > 7

R respiratory rate > 30

B diastolic blood pressure < 60

10

What is each aspect of CURB 65 given a score of?

0 (low risk and could be treated in the community)

1-2 (hospital treatment usually required)

3 (high risk of death and need for ITU)

11

What is the treatment for a CURB score of 0-1?

Amoxycillin or clarithromycin/deoxycycline

 

12

What is the treatment for a CURB 65 score of 2?

Amoxycillin and clarithromycin or levoflaxacin

13

What is the treatment for a CURB 65 score of 3-5?

Co-amoxiclav and clarithromycin or levoflaxacin (if penicillin alergic)

14

What are some things that come before pneumonia?

Aspiration pneumonia

Haematological malignancy

Legionnaires disease

Influenza

Staph pneumonia including PVL toxin

MRSA

HIV

15

What treatment should be used for pneumonia caused by MRSA?

Vancomycin or linezolid

16

What are treatment for pneumonia other than antibiotics?

Oxygen

IV fluids

CPAP (continuous positive airway pressure, keeps airways open)

Intubation and ventilation

17

What does CPAP stand up for?

Continuous positive airway pressure

18

What are some possible complications of pneumonia treatment?

Septicaemia

Acute kidney injury

Empyema

Lung abscess

Metastatic infection

ARDS (acute respiratory distress syndrome)

19

What does ARDS stand up for?

Acute respiratory distress syndrome

20

What is acute respiratory distress syndrome?

Widespread inflammation of the lungs

21

What is differential diagnosis?

Process of differentiation between two or more conditions which share similar signs or symptoms

22

What is the process of differentiating between two or more conditions that share similar symptoms called?

Differential diagnosis

23

What does differential diagnosis of pneumonia exclude?

TB

Lung cancer

Pulmonary embolism

Pulmonary oedema

Pulmonary vasculitis

24

What is empyema?

Collection of pus in the pleural cavity caused by microorganisms

25

What is a collection of pus in the pleura cavity caused by microorganisms called?

Empyema

26

What may follow pneumonia?

Empyema

Lung abscess

Bronchiestasis

27

What are the top 3 organisms that cause empyema?

Steptococcus (52%)

Anarobes (20%)

Staph aureus (11%)

 

28

What is the prominant feature of empyema?

Chest pain

29

What symptoms is absent with empyema?

Cough

30

What is used to investigate empyema?

CT thorax and ultrasound