Pulmo: CAP

Question 1

CAP. Location?

Answer 1

Office –> Inpatient –> after a day of improvement can be discharged home

Question 2

CAP. exam? 5

Answer 2

Gen.
Chest - chief
heart
abdomen
HEENT

tik tiek, no skin, no limbs nieko

Question 3

CAP. tests non specific? 2
1 optional

Answer 3

CBC
BMP

1. Optional - Magnesium - bbz kodel jie cia speficiskai Mg minejo

Question 4

CAP. stabilizing? 1

Answer 4

pulse oximetry - kadangi complaining of respiratory symptoms

Question 5

CAP. Instrumental? 2

Answer 5

ECG - good to screen in febrile patient

chest xray - because of suspected pneumonia

Question 6

CAP. Infection status? Febrile patient
5

Answer 6

1. Urinalysis
2. Bacterial culture, urine
3. Bacterial culture - patient met SIRS
4. Bacterial culture, sputum - patient has CAP, need sputum culture
5. Atypicals = Antibody Legionella, urine or serum or sputum

Question 7

CAP. Tx stabilizing? 1

Answer 7

buvo low SpO2 on pulse oximetry –> GIVE OXYGEN

Question 8

CAP. Tx for fever? 2

Answer 8

Iv access
RINGER/SALINE - patient has fever, need to give fluids

Question 9

CAP. Tx specific? 1

Answer 9

ANTIBIOTICS

Macrolide + beta lactam.
Pvz ampicillin/sulbactam AND Azithromycin/Clarithromycin

Arba respiratory fluoroquinolone monotherapy (i.e. levofloxacin)

Question 10

CAP. Preventive? 5 non specific

Answer 10

1. Smoking cessation
2. Varicella (above 50yo)
3. Influenza vaccine (If >6 months old)
4. Tdap
5. Pneumococcal - to prevent further pneumonia infections

Question 11

CAP. S. pneumonia had to be high on the differential due to worsening PRODUCTIVE cough, SOB and Fever. Physical exam - findings consistent with consolidation.

Answer 11

.

Question 12

CAP. When based on findings pneumonia suspected –> do basic labs, blood cultures, sputum culture and stain, chest xray.

Answer 12

Next step: to decide where to Tx patient.

Yra ta lentele kur balus surinkti ir pagal tai nuspresti. Bet mintis buvo tokia, kad jos prisiminti nereikia, tiesiog jeigu concerning: febriliai karsciuoja, tachy, elderly ir abnormal labs —> inpatient.

Po gydymo 1 paros ivertinti - pacients will feel better, can be discharged HOME. Case will end.