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Flashcards in PNA Deck (17)
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1
Q

What is Hospital Acquired Pneumonia (HAP)?

A

PNA ≧48Hrs after hospital admission!

2
Q

Risk Factors of Pneumonia (PNA)? (name 3)

A

Age, chronic comorbidities, viral respiratory infection, impaired airway protection, smoking, EtOH, crowded living conditions, residence in low-income settings, toxins!

3
Q

Name three Typical Bacteria that cause Pneumonia (PNA)?

A
  • Streptococcus pneumonias- 65%, most common, rust color sputum
  • Haemophilus influenzae- 2nd most common, COPD, smoker, EtOH
  • Moraxella catarrhalis- COPD
  • Staphylococcus aureus- often seen after viral illness (flu)
  • Group A streptococci
  • Aerobic gram-negative bacteria
  • Microaerophilic bacteria and anaerobes (associated with aspiration)
4
Q

Name three Atypical Bacteria that cause Pneumonia (PNA)?

A

-Legionella species- contaminated water, air
conditioner (aerosolized), hot tubs, cruise, travel, GI sx
-Mycoplasma pneumoniae- walking pneumonia,
young, college students, bullous myringitis
-Chlamydia pneumoniae
-Chlamydia psittaci- bird exposure
-Coxiella burnetii- exposure to farm animals (sheep), Q fever

5
Q

What are symptoms of Pneumonia (PNA)? (name 4)

A
  • Fever/ Chills
  • Cough
  • Pleuritic chest Pain
  • Hemoptysis
  • Headache
  • -Myalgias
  • Nausea
  • Infants/children-poorfeeding, restless
  • Nightsweats
6
Q

What lung sound is most suggestive of Pneumonia (PNA)?

A

-Rales (crackles)

7
Q

What is the main cause of viral Respiratory Pneumonia (PNA) in adults?

A

-Influenza A and B viruses- main cause in adults

8
Q

What are the findings on Chest X-Ray for Pneumonia (PNA)? Describe both typical and atypical pneumonia

A
  • isolated Lobar consolidation (typical)

- multilobar Interstitial infiltrates (atypical)

9
Q

Which medications are typically used for outpatient Treatment of Pneumonia (PNA)? (name 3)

A

Azithryomycin, Doxycycline, less likely Levofloxacin

10
Q

What medication is used to treat Inpatient Pneumonia (PNA)?

A

Levofloxacin

11
Q

What type of organism should be considered in aspiration pneumonia?

A

Anearobic organisms

12
Q

What is the best antibiotic Treatment for Aspiration Pneumonia?

A

Ampicillin-sulbactam (IV Unasyn), Amoxicillin-clavulanate (Oral Augmentin)

13
Q

What is the most common opportunistic infection associated with HIV/AIDS

A

Pneumocystis pneumonia (PCP)

14
Q

What tool (scoring system) is available to determine if a patient ought to be hospitalized for pneumonia? And what are the features of the scoring system?

A

CURB-65 (admit pts with score >70) (>90 ICU)
Confusion
Urea >7 (BUN >19)
RR >30
BP less than 90 systolic or less than 60 diastolic
Age 65 or older

15
Q

What is the main risk factors for MRSA pneumonia?

A

*Recent ICU admission/intubation (especially if known to have MRSA exposure)

16
Q

What are conditions that predispose patient to aspiration (4)

A
  1. Altered consciousness
  2. Dysphagia
  3. Neurologic disorder
  4. Mechanical disruption of the usual defense barrier (NGT, ETT, trach, EGD, bronch)
17
Q

What is used for prevention of PCP pneumonia in an immunocompromised patient?

A

Trimethoprim-sulfamethoxole (TMP-SMX) (Bactrim)

-SS daily or DS 3x/week