Anita Douglas Community Acquired Pneumonia Shadow
Health (All Tabs) | GRADED A+
What general categories can increase the likelihood of CAP? - ANSWER
decreased mucociliary transport
decreased host immune response
decreased cough reflex (aspiration risk)
List factors that decrease mucociliary transport. - ANSWER smoking
COPD
CF
viral infection
elderly
List factors that decrease host immune response. - ANSWER ethanol abuse viral
infection
elderly hypoxemia
DM, AIDS, cancer pulmonary edema
malnutrition bacterial endotoxin
immunosuppressants
List factors that increase G- colonization. - ANSWER malnutrition
chronic ilness
elderly/nursing home resident
surgery or prolonged hospitalization
smoking
antacids, H2 blockers, PPIs
List factors that decrease cough reflex and thereby increase aspiration risk. -
ANSWER ethanol intoxication
stroke
general anesthesia
drugs that impair mental status
Explain the classic presentation of pneumococcal pneumonia. - ANSWER follows
respiratory viral illness
abrupt onset of severe chill
high fever
chest pain
productive cough
T/F: the classic presentation of CAP is seen in all age groups. - ANSWER False
young or middle aged
[elderly have mental status changes instead]
List lab test findings for CAP. - ANSWER increased WBC w/ left shift (15-40,000)
, CXR inflitrates
decreased PO2 on ABG
blood cultures of pneumonia causing bacteria
+- sputum culture and gram stain
Why is a sputum culture not always helpful in diagnosis of CAP? - ANSWER often
contaminated by natural flora of the mouth
List some bacteria that commonly cause CAP. - ANSWER strep pneumo
(pneumococcal pneumonia) - G+ diplococci
staph - G+ cocci in clusters
h. flu - small G- coccobacilli
klebsiella - short plump G- bacilli
mycoplasma - unremarkable
anaerobic - foul smelling, polymicrobial
How would mycoplasma CAP present? - ANSWER "walking pneumonia"
low grade fever, non-productive cough
Anaerobic pneumonia is often secondary to ________. - ANSWER Anaerobic
pneumonia is often secondary to *peridontal disease*.
How are patients evaluated for seriousness of pneumonia? - ANSWER CURB-65
scale
Confusion
Uremia (BUN>20)
Respiratory rate (>=30)
low Blood pressure (SBP<90 or DBP=<60)
65 y/o or greater
Using the CURB-65 scale, determine where a patient should be treated. - ANSWER
1 point for each letter/number
0-1: outpatient
2: inpatient, general ward
>=3: inpatient, ICU
How should a CAP be treated if outpatient and previously healthy, no ABx in past
3mos? - ANSWER *macrolide*
doxycyline
How should a CAP patient be treated if outpatient with comorbidities or ABx in past
3mos? - ANSWER respiratory FQ
B-lactam + macrolide
How should a CAP patient be treated if inpatient but non-ICU? - ANSWER
respiratory FQ
B-lactam + macrolide
How should a CAP patient be treated if inpatient ICU? - ANSWER B-lactam
(ceftriaxone, cefotaxime, or unasyn) *plus* either azithromycin or respiratory FQ
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
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 tutorsection1. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.