Term
| inflammation fo the lung parenchyma caused by an infection (bacteria, virusesm, fungi) |
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Definition
|
|
Term
| An abnormal infiltrate is required on ______ ______. This is required for diagnosis of pneumonia |
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Definition
|
|
Term
|
Definition
cough
dyspnea
fever
tachypnea
hemoptysis
pleuritic chest pain
myalgia
gi symptoms
rales rhonchi weezing
egophony
sensitivity of clinical criteria is no greater than 50 percent. |
|
|
Term
|
Definition
community acquired pneumonia (non health care)
nosocomial mneumonia (health care)
aspiration pneumonia (usually anerobes or a mix) |
|
|
Term
| Pneumonia is the _____ leading cause of death in the USA |
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Definition
|
|
Term
| Rates of dath have increased by ___ percent in the last 20 years. |
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Definition
|
|
Term
| Annually greater than 5 million cases of pneumonia inthe us result in |
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Definition
| more than one million hospitalization 80 thousand deaths. |
|
|
Term
| What is the most common cause of death in teh united states? What is the most common infectious disease cause of hospitalization and death? |
|
Definition
1) heart disease
2) penumonia |
|
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Term
|
Definition
| caused by pneumococcus and staphylococcus |
|
|
Term
|
Definition
caused by
legionella
mycoplasma
chlamyophilia |
|
|
Term
|
Definition
caused by
legionella
mycoplasma
chlamyophilia
mycobacterial
anaerobes
viral
fungal(coccidioides)
parasitic |
|
|
Term
| What percent of community aquired pneumonias have unknown etiology |
|
Definition
|
|
Term
| The most common cause of pneumoniae? |
|
Definition
|
|
Term
|
Definition
chlamidyophilic pneumonia
legionella
mycoplasma pneumonia |
|
|
Term
| other causes of pneumonia |
|
Definition
h. influenzae
moraxella catarhallis
staph aureus
gram negative rods
mycobacter
anaerobes |
|
|
Term
|
Definition
|
|
Term
|
Definition
gram + slightly
acid fast bacillus staining |
|
|
Term
| pathogenesis of pneumonia |
|
Definition
lung parencyma are usually sterile
pneumonia develops if host defenses are absent or overwhlmed |
|
|
Term
| Microaspiration of oropharyngeal secretion colonized with pathogens |
|
Definition
| the most common route of getting pneumonia |
|
|
Term
| gross aspiration of gastric contents with_______ or__________. This can be caused by damage to _________. |
|
Definition
enteric gram - rods
anaerobes
CNS |
|
|
Term
| _______ is a viable very transmisable route of spreading pneumonia especially m. tuberculosis, legionella |
|
Definition
|
|
Term
| Staph aureus during endocarditis is an example of heamtogenous spread. |
|
Definition
| if you have a heart valve, bacteria lodges elsewhere. |
|
|
Term
| Congiguous spread from another site example |
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Definition
| Liver abscess, penetrating trauma. |
|
|
Term
|
Definition
bacteria enter the cell
bacterial defenses allow it to survive
multiply
tissue injury
vascular permeability
increases
akveolar macrophages recruited to teh area of inflmation
large groups of alveolifileld with inflamatory exudates appear as pacities or consolidation on chest radiographs. |
|
|
Term
| Risk factors for pneumonia |
|
Definition
age
dentition
smoking
heavy alcohol intake
contact with children
copd
congestive hear gailure
diabetes mellitus
malnutrition
malignancy |
|
|
Term
| risk factors for getting drug resistant spneumoniae |
|
Definition
greater than 65 less than 5
recent antibiotics or hospitalization
alcoholism
immune suppression
cardiopulmonary
exposure to child |
|
|
Term
| risk factors for enteric gram negative rods (klebsiella) |
|
Definition
nursing home resident
comorbid cardiopulmonary disease
recent antibiotics |
|
|
Term
| risk factors for p aurigunosa |
|
Definition
structural lung diseases
steroid use
recent antibiotics
malnutrition |
|
|
Term
| staph aureus risk factors |
|
Definition
recent influenza
co morbid cardiopulmonary diseases |
|
|
Term
| asplenia you are at risk for |
|
Definition
|
|
Term
| cystic fibrosis you are at risk for |
|
Definition
pseudonomas
burkholderia cepacia |
|
|
Term
| influenza outbreak you are at risk for |
|
Definition
staph aureus
strep pneumonia |
|
|
Term
|
Definition
treatment involves a combination of iv antibiotics 1-2 weeks
-beta lactam
-fluoroquinolne
-macrolide |
|
|
Term
| what covers methicillin resistant s. aureus? |
|
Definition
|
|
Term
|
Definition
ventilation
supplemental oxygen
blood pressure support
cardiovascular monitoring |
|
|
Term
| complications of pneumonia |
|
Definition
bacteremia and sepsis
pleural effusion
empysema
lung abscesses |
|
|
Term
| parapneumonic effusion occurs is ___ percent of pneumonia. Usually resolve with antibiotic treatment What percent of s. pyogenes? S pneumonia? |
|
Definition
40 percent.
90 percent in strep pyogenes
10 percent in s.pneumonia |
|
|
Term
| THoracentessis may be needed |
|
Definition
small amount for diagnosis on parapneumonic effusion
large amoutn for treatment. |
|
|
Term
|
Definition
| colelction of pus in the collected space. |
|
|
Term
| How do you diagnose an empynema? |
|
Definition
| you need to see a visible yellow pus with a high WBC count of greater than 50000. |
|
|
Term
| How do you heal an empynema? |
|
Definition
|
|
Term
| Pulmonary abscesses cause by |
|
Definition
complication of pneumonia due to
anaerobic/mixed flora or bactremia.
right middle lobe or lower lobe |
|
|
Term
| in young healthy patient, mild case of pneumonia. more common cause |
|
Definition
|
|
Term
| Why do we call something atypical |
|
Definition
not normally cultured
cannot be treated with penicillin
a typical cxr findings
cxr can't be used to distinguish the ytype of pneumonia |
|
|
Term
| treatment of mild cap (walking penumonia) |
|
Definition
floriquinine
macrolides
tetracyclines |
|
|
Term
| How do we diagnosespneumonia pathogen |
|
Definition
sputum gram staina nd culture
pleural fluid culture
blood cultures
pneumococcal and legionella urine
consider HIV testingafb stain if you consider mycobacter
antibidy titer |
|
|
Term
|
Definition
crystal violent
idodine
decolor with alochol
counterstain |
|
|
Term
|
Definition
sputum gram stain revelaing a single prdominant organizim can help establish the etiolgoy and guide therapy.
should be deep cough
should be obtaiend prior to antibiotic treatment
less than ten epithelial cells greater than 25 pmns per low power field
cant use if greater htan 10 epithelial cells |
|
|
Term
|
Definition
sputum gram stain revelaing a single prdominant organizim can help establish the etiolgoy and guide therapy.
should be deep cough
should be obtaiend prior to antibiotic treatment
less than ten epithelial cells greater than 25 pmns per low power field
cant use if greater htan 10 epithelial cells |
|
|
Term
| Which bugs can you do a urine antigen test? |
|
Definition
|
|
Term
s. pneumonia gram stan
staph aureus |
|
Definition
gram positive lacet chapped
cocci in groups |
|
|
Term
| blood and sputum cultures are recommended for all patients with pneumonia (true/false) |
|
Definition
false
recommeded only in cases of failed antibiotics
immunosupression chronic liver or lung disease
asplenia
recent travel
pleural effusion |
|
|
Term
| chest x ray is recommended for all patients with sspected pneumonia |
|
Definition
| true posterior and lateral view |
|
|
Term
| radiography lags clinical improvment by |
|
Definition
|
|
Term
| possible false negative xray |
|
Definition
netropenia
dehydrated
pneumocystic jirovesi |
|
|
Term
| CT has better resolution than xray (true/false) |
|
Definition
|
|
Term
| In ER how many blood vials are drawn |
|
Definition
| 4 1aerobic 1 anaerobic frome ach of two viens sent to micro |
|
|
Term
| microdilution can test for susceptibility to various antibiotics |
|
Definition
| you can see which drugs it is resistant to |
|
|
Term
| when should you administer antibiotic therapy? |
|
Definition
| within 4-8 hours of diagnosis. |
|
|
Term
| What is the basic treatment question when managing a case of CAP |
|
Definition
| should i start with foriquinone or a macrolide along with Beta lactam or not? |
|
|
Term
|
Definition
| It predicts mortality and need for hospitalization int he case of pneumonia |
|
|
Term
|
Definition
|
|
Term
| non-ICU patient CAP what do you treat? |
|
Definition
| FQ or ML plus 3rd gen cephalosporin |
|
|
Term
| ICU patient with CAP treatment |
|
Definition
| anti psudomonal cephalosporin pplus FQ or ML |
|
|
Term
|
Definition
macrolide
azithromycin
clarithromycin |
|
|
Term
|
Definition
FQ
moxifloxican
levofloxican |
|
|
Term
|
Definition
90 types ofpneumonia
two vaccines
polysaccharide 23 valent
reduces risk by 50-60 percent
85-90 percent of invasive serotypes covered
doesn't work against non bacteria
but reduces mortality by 40 percent
23 valent polysaccharide
recommended over 65
cardiomyopathy
7 valent is for kids reduces rosk to kids by 90 percent
2,4,6
alcoholism
immunocompromsed
long term facility |
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|
