Pneumonia (CP1)

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  • Created by: NDumps97
  • Created on: 09-05-19 17:12
What symptoms would you see in patients with pneumonia? Name 5
Acute systemic illness, fever, rigors, vomiting, cough, dysponea, pleuritic chest pain (may refer to shoulder), acute confusion
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How would a cough be initially in pneumonia and how would it change as it progresses?
Initially short, dry and painful.
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What clinical signs would you see on examination of a patient with pneumonia?
Pyrexia, cyanosis, confusion, tachpnoea, tachycardia, signs of consolidation (dull percussion), increased tactile vocal fremitus, pleural rub, coarse crackles over affected area, brocnhial breathing
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What is tactile vocal fremitus and how do you examine it?
Get the patient to say 'blue balloons' as you put the stethoscope at different points of the lungs. Then assess increased or decreased resonance of the voice.
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What is pleural rub and what does it sound like?
Pleural friction rubs are the squeaking or grating sounds of the pleural linings rubbing together and can be described as the sound made by treading on fresh snow.
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What is bronchial breathing? Over what kind of airways will you hear them?
Bronchial breath sounds are tubular, hollow sounds which are heard when auscultating over the large airways (e.g. second and third intercostal spaces). They will be louder and higher-pitched than vesicular breath sounds.
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What tests should you do in suspected pneumonia?
O2 sats (<92% is not good); Bloods (LFTs, FBC, U&Es); CXR (definitely); urine samples (checking for legionella/pneumococcus)
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What would you see on a CXR with a pneumonia patient?
Pneumonia is the most common cause of consolidation. There are other signs too.
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Explain each bit of CURB65? (what scores a point?)
Confusion = 8 or less on mini mental exam. Urea = >7. Resp rate = >30. BP = systolic <90 or diastolic <60. 65+ years.
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What are the CURB65 ranges for mild, moderate and severe pneumonia?
mild = 0-1; moderate = 2; severe = 3+
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Define hospital acquired pneumonia (HAP)
pneumonia that develops at least 48 hours after admission
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What are the two main causes of CAP (60-80%) and which one of the bacteria is more common in those with COPD?
Streptococcus pneumonia and haemophilius influenzae (more common in COPD)
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Streptococcus pneumoniae (most common cause of CAP) gives classic _____ pneumonia and a ____ coloured sputum
Streptococcus pneumoniae (most common cause of CAP) gives classic lobar pneumonia and a rust coloured sputum
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In which group of people does mycoplasma pneumoniae cause >40% of cases.
M. pneumoniae is responsible for >40% of CAP in younger people (17-44 yrs)
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What infective organism may cause pneumonia as a complication of influenza infection.
Staph pneumonia commonly complicates influenzae infection - occurs during a influenza outbreak
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What causes consolidation on CXR in pneumonia?
Inflammatory exudate produced as inflammatory response.
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Does consolidation of the air spaces classically occur in bacterial or viral pneumonia?
Bacterial. Viral pneumonia often spares the air spaces and affects the interstitum, causing interstital pneumonia
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Describe the CXR consolidation findings of bronchopneumonia (compared to lobar pneumonia)
The primary infection is at the bronchi - spreading to nearby alveoli which show as consolidated. The intital consolidation is patchy (in lobules) but if untreated can become confluent (involve whole lobes)
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Where in the lung is the consolidation in bronchopneumonia? What ages is it most common in?
Normally occurs in infants and elderly due to retention of secretions which then affect the lower lobes (due to gravity)
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Describe lobar pneumonia
Organisms are present in distal air spaces rather than the bronchi, so there is rapid spread of infection through alveolar air spaces. Whole lobe = consolidated.
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What type of resp failure is relatively common with pneumonia?
Type 1 (PaO2= <8)
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What is the main causative organism of TB?
mycobacterium tuberculosis
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Other cards in this set

Card 2

Front

How would a cough be initially in pneumonia and how would it change as it progresses?

Back

Initially short, dry and painful.

Card 3

Front

What clinical signs would you see on examination of a patient with pneumonia?

Back

Preview of the front of card 3

Card 4

Front

What is tactile vocal fremitus and how do you examine it?

Back

Preview of the front of card 4

Card 5

Front

What is pleural rub and what does it sound like?

Back

Preview of the front of card 5
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