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Flashcards in Resp - Pneumonia Deck (10)
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1
Q

Anatomical classification

A
  • Bronchopneumonia: patchy consolidation of different loves

- Lobar pneumonia: fibrosupurative consolidation of a single lobe

2
Q

Bugs- HAP vs CAP

A
  • CAP: pneumococcus, mycoplasma, haemophilus, S aureus, moraxella, chlamydia, legionella, viruses (15%)
  • HAP: >48h after hospital admission, gram -ve enterobacteria, S aureus
3
Q

Bugs: immunodeficiency pts

A

-usually bugs + PCP, TB, fungi, CMV/HSV

4
Q

Symptoms

A

-Fever, rigours, malaise, anorexia, dyspnea, cough, haemoptysis, purulent sputum, pleuritic pain

5
Q

Signs

A
  • Raised RR and HR
  • Cyanosis
  • Confusion
  • Consolidation: decreased expansion, dull percussion, bronchial breathing, crackles, pleural rub
6
Q

Ix

A
  • Bloods: FBC, U+E, LFT, CRP, culture, ABG (if ↓SpO2)
  • Urine: Ag tests (Pneumococcal, Legionella)
  • Sputum: MC&S
  • Imaging: CXR —> infiltrates, cavities, effusion
  • Special: Paired sera Abs for atypicals (Mycoplasma, Chlamydia, Legionella)
7
Q

What score do you need to know?

A

CURB 65

  • Confusion
  • Urea >7mM
  • Resp rate >30/min
  • BP <90/60
  • > 65
0-1 = home rx 
2 = hospital rx
>3 = condition ITU
8
Q

What is the Mx?

A
  • ABX
  • O2: PaO2 >8kpa and SpO2 94-98%
  • Fluids
  • Analgesia
  • Chest physio
  • Consider ITU if shock, hyper apnea, hypoxia
  • F/U at 6 wks with CXR and check for underlying Ca
9
Q

ABX- CAP (mild-sev + atypical)

A

-Mild: amoxicillin 500mg TDS PO for 5d or clarithro 500mg BD PO for 7d
-Mod: amoxicillin 500mg TDS and clarithro 500mg BD PO/IV (clarithro alone if pen allergy) for 7d
-Sev: Co-amoxiclav 1.2g TDS IV / cefuroxime 1.5g TDS IV and clarithro 500mg BD IV for 7-10d (Add fluclox if staph suspected).
-Atyp Chlamydia: tetracycline PCP: Co-trimoxazole
Legionella: Clarithro + rifampic

10
Q

HAP ABX (mild and severe + aspiration)

A
  • Mild / <5d: Co-amoxiclav 625mg PO TDS for 7d
  • Severe / >5d: Tazocin ± vanc ± gent for 7d
  • Aspiration: Co-amoxiclav 625mg PO TDS for 7d

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