PG Medical Entrance Exam | USMLE preparation|Pneumonia

Introduction :

•Infection of Pulmonary parenchyma
•Community acquired pneumonia, Hospital acquired pneumonia, Ventilator associated pneumonia
•Health Care associated pneumonia

Pathogenesis:

•Aspiration

Haematogenous spread

•Air

Host Defence :

•Nasal Hairs
•Mucociliary clearance
•Local antibacterial factors

Pathology:

•Phase 1 –  Oedema
•Phase 2-   Red Hepatization phase
•Phase 3-   Grey Hepatization Phase
•Phase 4-    Resolution

Organisms involved:

•Streptococcus
•Klebsiella
•H. influenzae
•Atypical organisms- Mycoplasma , C. pneumoniae
•MRSA
•Anaerobic organisms

Symptoms:

•Fever- moderate to high grade, rigors, chills
•Cough- Nonproductive or productive,
•Breathlessness
•Haemoptysis
•Chest pain- If pleura involved

Diagnosis:

•Clinical features
•Chest X-Ray
•Sputum analysis-Sputum sample > 25% Neutrophils and <10 % Squamous epithelial cells
•CT scan Chest
•Legionella and Pneumococcal urine antigen tests

Treatment:

•Pneumonia Severity index- 20 variables
•CURB-65 Criteria
•Not sensitive criteria

Reasons for failure to improve:

•Resistance to drugs
•Lung abscess or empyema
•Wrong drugs or wrong dosage of drugs
•Atypical microorganism or tuberculosis
•Nosocomial superinfections

Complications:

•Respiratory Failure
•Coagulopathy and DIC
•Shock and multiorgan failure

 

 

 

 

 

 

 

 

 

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