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21 Cards in this Set
- Front
- Back
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What are 3 defensive mechanisms the lungs normally have to protect themselves?
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Cough, MIcrociliary clearance, Immune Response
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What is the typical presentation of a pneumonia patient?
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Fever, fatigue, chills, productive cough with purulent sputums (rusty, yellow). Pt is tachypneic, tachycardic. Upon PE, altered transmission of breath sounds, crackles, egophony, increases tactile fremitus
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On a histological preparation how will strep pneumoniae look?
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gram positive lancet shaped diplococci.
"Strep - strips" |
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What pneumonia is associated with elderly patients?
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Strep pneumonia...just like in normal, young healthy individuals
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What pneumonia is associated with Hospitalized pts?
Diabetic patients? |
Staph aureus or pseudomonas
Klesiella pneumonia (same in alcoholics) |
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What pneumonia is associated with HIV pts?
What stain do you use to diagnose? |
Pneumocystis jiroveci (carinii).
This is an AIDS defining sickness Methylene silver or Giemsa stain |
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What pneumonia is associated with alcoholics?
How do you treat? |
Klesiella pneumonia (gram - )
3rd generation cephalosporin + aminoglycoside or fluoroquin |
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What is the differential dx for hospital acquired pneumonia?
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CHF, ARDS, PE, Drug Prescription
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How do you treat outpatient pneumonia?
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Macrolide or doxycycline (fluoroquinolone if others don't work)
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How do you treat an inpatient CAP pneumonia
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Macrolide, doxycycline PLUS a 3rd generation cephalosporin
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How would you treat a pt in the ICU with pneumonia?
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Macrolide, fluoroquinolone, + 4th generation cephalosporin
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How do you treat Hospital Acquired pneumonia?
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wide spread antibiotics, be sure to cover for pseudomonas (as well as staph aureus)
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What are the 4 "MUST Admit" rules?
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1. hemodynamic instability
2. hypoxemia less than 90% on room 3. unable to tolerate oral meds 4. coexisting condition |
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Atypical pneumonias...
cows, goats, sheep? |
Q fever - Coxielle burnetii
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Atypical pneumonias...
rodents? chicken/birds? |
hantavirus
psittacosis |
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What is a major complication that arises from pneumonia?
What is the clinical presentation? |
Pleural effusions
Dullness to percussion, decreased tactile fremitis, diminished breath sounds |
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Transudative pleural effusions arise d/t _.
Occurs in conditions such as _ |
an imbalance btwn hydrostatis and oncotic pressure
chf, cirrhosis, pulmonary embolism |
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Exudative pleural effusions occur d/t _
Occurs in conditions such as _ |
local factors influencing accumulation of fluid become altered
pneumonia, cancer, pe |
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What are the differences between transudative and exudative pleural effusions?
In fluid amount g protein appearance? |
E: greater than 200, greater than 3 g protein, and cloudy and viscous
T: less than 200, less than 3 g protein, clear and non clotting |
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To treat gram negative bacilli, what do you use?
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3rd generation cephalosporin, aminoglycoside or fluoroquinolone.
This is in the example of KIebsiella (diabetics, alcoholics), H flu, E Coli, and psudomonas (HAP, CF) |
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What is the most common bug involved in pneumonia of lung disease pts?
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S pneumonia - same as everyone else
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