Respiratory medicine notes detailing lung and airwaypathologies and conditions for medical school examinations. Notes made from multiple resources such as oxford handbook, question banks, university lectures and UK guidelines.
Look at specialty section and content list for the summary contents o...
Pneumonia in General
Presentation Investigations
- General: Dyspnoea; Cough; Pleuritic chest pain - CXR: Consolidation; Cavitation; Effusion
- Infection: Purulent sputum ± haemoptysis - ABG: Perform if SpO2 <92 %
- Observations: ↑To; ↑ HR; ↑ RR; ↓ BP; ↓ SpO2 - Bloods: FBC; U+E; CRP; LFTs
- Exam: ↓ Percussion; ↑ Fremitus; ↓ Expansion - Culture: Blood; Sputum
- Auscultation: Pleural rub; Bronchial breathing - Urine: Legionella/Pneumococcal antigens
Causes - Pleural fluid: MC&S + Microscopy
- Infectious (common) - BAL: Consider if immunocompromised / ITU
o NB: See lung infection notes - CURB-65: See below
- Non-infectious (uncommon) Management
o Common: Lung cancer; ARDS - Antibiotics: See lung infection notes
o Uncommon: Eosinophilic pneumonia; Sarcoidosis - Supportive: Fluids; O2 therapy
o Rare: Cryptogenic organising pneumonia - VTE Prophylaxis: LMWH
o AID: Vasculitis; RA - CXR: Repeat for progression + follow up at 6 wks
o Iatrogenic: amiodarone; Radiation pneumonitis
Aspiration Pneumonia
Description Causes
- Path: Oral or gastric contents get into lung lobes - Risks: Poor dental hygiene; Dysphagia; ↓ GCS
- NB: Acidic aspirates lead to chemical pneumonitis - G+Ve: S. pneumoniae; S. aureus
- Location: Right middle-lower lobes usually affected - G-Ve: H. influenzae; P. aeruginosa
Severity Assessment
CURB-65 Interpretation
- Confusion (abbreviated mental test ≤8) - 0-1: Home prescription is possible
- Urea >7 mmol/L - 2: Hospital admission + therapy
- Respiratory rate ≥30 breaths/min - ≥3: Severe pneumonia + consider ITU
- BP <90 mmHg systolic or <60 mmHg diastolic Prognosis
- Age ≥65 YO - Px: Score of 4 carriers 30 % mortality at 30 days
Pneumonia Complications
Respiratory Failure Empyema
- T1RF: Common complication - Features: Pneumonia; Recurrent fever
- Mx: High flow 60 % O2 - Ix: pH <7.2; ↓ Glucose; ↑ LDH
- Ix: ↓ O2; ↑ CO2 - Mx: Guided chest drain
- NB: Monitor ABG for CO2 retention Atrial Fibrillation (AF)
Pleural Effusion - Paroxysmal: Usually resolves with pneumonia mx
- Exudate Effusion: Protein >25 g/L; ↑ LDH - Mx: Short-term β-blockers or digoxin
- Transudate Effusion: Protein <25 g/L; ↓ LDH - NB: More common in elderly patients
- Pleurocentesis: If large or symptomatic drain effusion Septicaemia
- Mx: Guided aspiration (1-1.5 L max) - Spread: Pneumonia source may metastasise
- Cc: Re-expansion oedema; ↓ BP; Shock - NB: IE; Meningitis; Hepatitis; Pericarditis
Description
The lungs are one of the most exposed internal organ within the body to the outside environment and so are one of
the most common entry points and sites of infection. One of the most common lung infections in pneumonia which is
most commonly caused by contagious bacteria. Factors that increase the risk of lung infections include comorbidities
such as asthma, COPD and CF, immunocompromised and old age.
Infectious Pneumonia
Causes
- Community-Acquired Pneumonia (CAP) - Aspiration Pneumonia
o Common: S. pneumoniae o G+Ve: S. pneumoniae; S. aureus
o Mild: S. pneumoniae; H. influenzae o G-Ve: H. influenzae; P. aeruginosa
o Mod: S. pneumoniae; H. influenzae; M. pneumoniae - Neutropenic Pneumonia
o Severe: Panton-Valentine Leucocidin S. aureus o G+Ve: G+Ve cocci (e.g. Staphylococcus)
o Atypical: Legionella pneumophilia; PJP o G-Ve: G-Ve bacilli (e.g. Pseudomonas)
- Hospital-Acquired Pneumonia (HAP) o Fungi: Aspergillus; Candida; PJP
o Timing: Occurs ≥48 hrs post-admission - Viral pneumonia
o G-Ve: Usually G-Ve anaerobic Bacilli o Virus: Influenza; RSV; Parainfluenza; Rhinovirus
o Common: Pseudomonas aeruginosa o Cc: Increases chance of 2o bacterial infx
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller sk25. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.38. You're not tied to anything after your purchase.
