Term
| 2 general types of pneumonia: |
|
Definition
| community acquired & Hospital acquired |
|
|
Term
| average mortality rate for community acquired pneumonia: |
|
Definition
|
|
Term
| major differences btwn CAP and HAP: |
|
Definition
| predisposing factors and organisms |
|
|
Term
| most common cause of pneumonia: |
|
Definition
| aspiration of oropharyngeal secretions |
|
|
Term
| which organisms infect healthy people and which are involved with debilitated and hospitalized pts? |
|
Definition
| S. pneumoniae infect healthy people and gram negatives are involved with debilitated and nosocomial infections |
|
|
Term
| how long after hospital admission does it have to be before it can be considered HAP? |
|
Definition
|
|
Term
| why are ICU pts especially susceptable? |
|
Definition
|
|
Term
| what is the hallmark for pneumonia upon physical exam? |
|
Definition
| dull percussion sounds on chest wall |
|
|
Term
| 2 most common presenting Sx in pneumonia: |
|
Definition
|
|
Term
| 5 physical findings assoc w increased mortality: |
|
Definition
1. Resp >30bpm
2. Diastole <60 Systole <90
3. pulse >125
4. T <95 or >104
5. confusion or Decreased LOC |
|
|
Term
| what accounts for the decreased BP in severely ill pts? |
|
Definition
| immune mediated response; vasodilation |
|
|
Term
|
Definition
| tactile vibrations felt on phsical exam of the chest |
|
|
Term
| what would be found upon percussion of the chest in pneumonia? |
|
Definition
| dull chest sounds over infected protion of lung |
|
|
Term
| which breath sounds are assoc w pneumonia? |
|
Definition
|
|
Term
| what is the most common PRESENTING sign of pneumonia? |
|
Definition
|
|
Term
| what is the gold standard for Dx of pneumonia? |
|
Definition
|
|
Term
| when might false negative CXR be a problem? |
|
Definition
| sever dehydration or too early in course of infection |
|
|
Term
| what are 4 common patterns of pneumonia seen in CXR? |
|
Definition
1. brochopneumonia
2. lobar consolidation
3. interstitial infiltrates
4. miliary (multiple descrete lesions) |
|
|
Term
| which is the most frequent form of pneumonia? |
|
Definition
|
|
Term
| which pneumonia: complete lobe or lobes affected & more severe presentation and outcome |
|
Definition
|
|
Term
| 4 stages of lobar pneumonia: |
|
Definition
1. congestion (multiplying bacteria)
2. Red hepatization (lobe is firm, airless, pain on breathing)
3. Grey hepatization (begins slow healing phase)
4. resolution |
|
|
Term
| type of pneumonia with patchy or diffuse inflammation: |
|
Definition
|
|
Term
| interstitial pneumonia affects: |
|
Definition
| interstitial spaces leading to thickening and stifness of elastic tissue results in shallow rapid breathing |
|
|
Term
| which type of pneumonia is a result of a spread of previous infection through the blood? |
|
Definition
|
|
Term
| what type of organism is usually reponsible for the multiple descrete lesions in miliary pneumonia? |
|
Definition
|
|
Term
| which suspected pneumonia patients would you work up with labs? |
|
Definition
1. considering admit
2. >65yo
3. Co-existing illness |
|
|
Term
| which labs would you order? |
|
Definition
|
|
Term
| what is the admit protocol for pneumonia? |
|
Definition
|
|
Term
|
Definition
C: confusino
U: urea >20
R: resp >30
B: BP <
>65 yo
more than 3 of these = high risk of mortality |
|
|
Term
| which patients are at risk for penicillin resistance in pneumococcal infections? |
|
Definition
1. >65yo
2. <5yo
3. alcoholic
4. beta lactam wn last 3mo
5. immunosupressed pts |
|
|
Term
| 4 risk factors for enteric gram neg pneumonia: |
|
Definition
1. nursing home
2. underlying cardiopulmonary disease
3. multiple medical comorbidities
4. recent antibiotic therapy |
|
|
Term
| 5 risk factors for pseudomonas pneumonia: |
|
Definition
1. structural lung disease
2. corticosteroid therapy
3. broad spectrum ab for 7d wn last mo
4. malnutrition
5. leukopenic immune supression |
|
|
Term
| which antibiotics for outpatient pnsumonia? |
|
Definition
| macrolides: azithro, clarithromycin, doxycycline also 3g-cephalosporin, augmentin and high dose amoxicillin |
|
|
Term
| which antibiotics for inpatient pneumonia? |
|
Definition
| beta lactam + macrolide OR doxycycline |
|
|
Term
| which inpatients are at risk for pseudomonas infection? |
|
Definition
| patients of vent or underlying lung conditions |
|
|
Term
| Tx for pts at risk for pseudomonas: |
|
Definition
| IV anti-pseudomonas beta lactam; imprenem, mepropenem, + IV anti-pseudomonas fluroquinalone |
|
|
Term
| 3 predisposing factors for streptococcal pneumonia: |
|
Definition
1. URI
2. Malignancy
3. Chronic bronchitis |
|
|
Term
| what type sputum is characteristic of strep pneumonia |
|
Definition
| rusty color spututm or blood streaked |
|
|
Term
| what does CBC show in pneumonia? |
|
Definition
| lekocytosis with left shift |
|
|
Term
| second most common bug in pneumonia: |
|
Definition
|
|
Term
|
Definition
| elderly and non-vaccinated children |
|
|
Term
|
Definition
| may have rales wo signs of consolidation |
|
|
Term
| WBC is frequently normal in: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Klebsiella pneumonia sputum |
|
Definition
| Red "current jelly" sputum, dark/brown/occasionally blood stained |
|
|
Term
| what is the only type of pneumonia w a dry cough? |
|
Definition
|
|
Term
| what season is s. pneumo prevalent? |
|
Definition
|
|
Term
| what season is mycoplasm prevalent? |
|
Definition
|
|
Term
| 3 predisposing factors for mycolplasm pneumonia: |
|
Definition
1. otitis media
2. myringitis
3. pharyngitis |
|
|
Term
| transmitted through airconditioning vents: |
|
Definition
|
|
Term
| S/Sx of prodromal legionaire's |
|
Definition
|
|
Term
|
Definition
|
|
Term
| pneumonia: most common among 65-79yo, does not vary by season, seen with arthritis asthma and alzheimers |
|
Definition
|
|
Term
|
Definition
|
|
