Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Anatomical classification of pneumonia
|
- bronchopneumonia: patchy consolidation of different lobes - lobar pneumonia: consolidation of a single lobe |
2 |
|
|
Aetiology of pneumonia |
- aspirational: stroke, bulbar palsy, decreased GCS, GORD, achalasia (anaerobes) - immunocompromised: PCP, TB, fungi, CMV, HSV - CAP - hospital-acquired pneumonia: >48hrs after admission |
4 |
|
|
Clinical features of pneumonia |
- fevers - rigors - malaise - anorexia - dyspnoea - cough - purulent sputum - haemoptysis - pleuritic pain - tachypnoea - tachycardia - cyanosis - confusion |
11 |
|
|
Signs of consolidation |
- decreased chest wall expansion - stony dullness on percussion - bronchial breathing - decreased air entry - crackles - pleural rub - vocal/tactile fremitus |
7 |
|
|
Assessing severity of pneumonia |
CURB-65 (if x-ray changes) - confusion - urea > 7mm - RR > 30/min - BP < 90/60mmHg - >65yrs old |
5 |
|
|
Management according to severity |
Score - 0-1: treat at home - 2: treat in hospital - 3+: consider ICU |
3 |
|
|
Management principles in pneumonia |
- ABx: empiric, then narrow spectrum - supplemental O2: >94% - fluids - analgesia - chest physio - follow up: CXR @ 6wks - consider ICU if: hypercapnoea, hypoxia |
7 |
|
|
Aetiology of CAP |
- pneumococcus: 35%, flu, smoking/alcohol, COPD, asthma, immunocompromise - mycoplasma: 6% - haemophilus: 40% - staph. aureus - moraxella: 13% - chlamydia - klebsiella - legionella - viruses: 15%, rhinovirus, influenza, parainfluenza |
9 |
|
|
Management of CAP |
- mild: amoxicillin 500mg TDS PO for 5days/clarithromycin 500mg BD PO for 7days - moderate: both for 7days (just clarithromycin if penicillin allergy) - severe: co-amoxiclav 1.2g TDS IV/cefuroxime 1.5g TDS IV and clarithromycin for 7-10days |
3 |
|
|
Management of atypicals |
- chlamydia: tetracycline - PCP: co-trimoxazole - legionella: ciprofloxacin/clarithromycin and rifampicin - pneumococcal: benzylpenicillin and ceftriaxone |
4 |
|
|
Aetiology of hospital-acquired pneumonia |
- staph. aureus: 27% - haemophilus influenza: 19% - pseudomonas aeruginosa: 17% - e. coli: 13% - strep. pneumonia: 10% |
5 |
|
|
Management of hospital-acquired pneumonia |
- mild/<5days: co-amoxiclav 625mg PO TDS for 7days - severe/>5days: tazocin +/- amikacin +/- vancomicin (aztreonam +/- vancomycin if penicillin allergy) |
2 |
|
|
Pneumovax |
- 23 valent - >65yrs, every 6yrs - indicated in: chronic heart, lung, liver, or renal failure or immunosuppression (DM, hyposplenism, chemo, HIV) |
|
|
|
Complications of pneumonia |
- respiratory failure - hypotension - AF - empyema |
5 |
