This document discusses different types of pneumonia including definitions, classifications, symptoms, investigations, management, and complications. It covers community acquired pneumonia, hospital acquired pneumonia, pneumonia in immunocompromised patients, and specific types like lobar pneumonia, bronchopneumonia, suppurative pneumonia, and aspiration pneumonia. Pneumonia is defined as acute lung inflammation seen on imaging and is classified by location and cause of acquisition. Signs, testing, treatment, and prognosis vary depending on the type and severity of pneumonia.
Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With ...farah al souheil
criticism of the article "Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia The LEAP 2 Randomized Clinical Trial"
Pneumonia - Community Acquired Pneumonia (CAP)Arshia Nozari
An overview to Community Acquired Pneumonia; It's Pathophysiology, Etiology, Epidemiology, Diagnosis and Treatment according to Harrison's Internal Medicine, 20th Edition (2018).
Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With ...farah al souheil
criticism of the article "Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia The LEAP 2 Randomized Clinical Trial"
Pneumonia - Community Acquired Pneumonia (CAP)Arshia Nozari
An overview to Community Acquired Pneumonia; It's Pathophysiology, Etiology, Epidemiology, Diagnosis and Treatment according to Harrison's Internal Medicine, 20th Edition (2018).
Diagnosis & Mangement of Community-Acquired Pneumonia, Hospital Acquired Pneu...Riaz Rahman
Clinical overview of Community Acquired Pneumonia, Hospital Acquired Pneumonia, Aspiration Pneumonia. Covers pathophysiology, clinical management, prevention, risk stratification (pneumonia severity index), prognostic factors, complications. Includes case studies, comprehension questions. Given at Jackson Park Medical Center on 12/1/2013. Includes references.
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Community Acquired Pneumonia and other types of pneumonia
for medical students
Detailed information on pneumonia including the following
Definition
Classification
Aetiology
Pathogenesis
Pathological states
Investigations
Treatment & follow up
Complications
Medication
Hospital acquired pneumonia and it’s treatment and management and prevention
Other types of pneumonia
And pneumonia in immune compromised patients
Diagnosis & Mangement of Community-Acquired Pneumonia, Hospital Acquired Pneu...Riaz Rahman
Clinical overview of Community Acquired Pneumonia, Hospital Acquired Pneumonia, Aspiration Pneumonia. Covers pathophysiology, clinical management, prevention, risk stratification (pneumonia severity index), prognostic factors, complications. Includes case studies, comprehension questions. Given at Jackson Park Medical Center on 12/1/2013. Includes references.
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Community Acquired Pneumonia and other types of pneumonia
for medical students
Detailed information on pneumonia including the following
Definition
Classification
Aetiology
Pathogenesis
Pathological states
Investigations
Treatment & follow up
Complications
Medication
Hospital acquired pneumonia and it’s treatment and management and prevention
Other types of pneumonia
And pneumonia in immune compromised patients
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Pneumonia
1.
2.
Definition
Classification
Lobar pneumonia and Bronchopneumonia
Community acquired pneumonia
Hospital acquired pneumonia
Pneumonia in immunocompromised patient
Suppurative and aspiration pneumonia
Index
3.
Pneumonia is defined as an acute respiratory illness
associated with recently developed segmental, lobar or
multilobar radiological shadowing.
Definition
4.
It is classified as
1. Community-acquired pneumonia (CAP)
2. Hospital acquired (nosocomial) pneumonia (HAP)
3. Pneumonia occurring in immunocompromised hosts.
Classification
5.
Lobar pneumonia and
Bronchopneumonia
Lobar pneumonia is a
radiological and
pathological term referring
to homogeneous
consolidation of one or
more lung lobes, often with
pleural inflammation.
Bronchopneumonia refers
to patchy alveolar
consolidation with
bronchial and bronchiolar
inflammation, often
affecting both lower lobes.
6.
20% of childhood deaths worldwide are due to pneumonia.
Most patients may be safely managed at home but hospital
admission is necessary in 20–40%.
In hospital, death rates are typically 5–10%, rising to 50% in
severe illness.
The most common organism is Streptococcus pneumoniae,
Haemophilus influenzae should be considered in elderly
patients, while Mycoplasma and Chlamydia pneumoniae are
more often seen in the young.
Rarer causes of severe pneumonia include Legionella ,
Chlamydia Psittaci , Staph. aureus , Burkholderia pseudomallei
Community-acquired pneumonia
7.
Fever, rigors, shivering and vomiting.
Pleuritic chest pain is common and may be the presenting
feature.
Cough is followed by mucopurulent sputum
(rust-coloured sputum - Strep. pneumoniae infection).
Patients have poor appetite and headache.
Haemoptysis (occasionally).
Examination may reveal crepitations or bronchial
breathing, suggesting underlying consolidation.
Clinical features
8.
Chest X Ray: In lobar pneumonia, a homogeneous opacity
localised to the affected lobe or segment is seen.
It may also identify complications such as a
parapneumonic effusion, intrapulmonary abscess
formation, or empyema.
Investigations
10.
Sputum is sent for microscopy (Gram and Ziehl–Neelsen
stains), culture and sensitivity testing.
Blood culture is frequently positive in pneumococcal
pneumonia.
Acute and convalescent samples for Mycoplasma, Chlamydia,
Legionella and viral serology should be sent.
Legionella antigen can be detected in urine and pneumococcal
antigen can be detected in blood or sputum.
Throat/nasopharyngeal swabs may be helpful during an
influenza epidemic.
Many cases of CAP are managed successfully without
identification of the organism.
Microbiological investigations
11.
Arterial Blood gas should be done if SaO2 is < 93% or if
clinical features suggest severe pneumonia.
WBC count is often marginally raised or even normal in
patients with pneumonia caused by atypical organisms.
A very high (> 20 × 109/L) or low (< 4 × 109/L) WCC may
be seen in severe pneumonia.
U&Es and LFTs should be checked.
C reactive protein is typically elevated.
Blood investigations
12.
A scoring system to assess disease severity helps to
guide antibiotic and admission policies.
- CURB 65 Score
Management
13.
CURB SCORE
Defined as an abbreviated mental test score ≤ 8, or new disorientation
in person, place or time. (A urea of 7 mmol/L ≅ 20 mg/dL.)
15.
High concentrations (> 35%) of oxygen (preferably
humidified) should be administered to all patients with
tachypnoea, hypoxaemia, hypotension or acidosis, aiming to
keep PaO2 ≥ 8 kPa (60 mmHg) or SaO2 ≥ 92% .
IV fluids are given in severe disease, and in elderly or vomiting
patients.
If possible, take blood cultures prior to starting antibiotics but
do not delay treatment in severe pneumonia.
Consider analgesia for pleural pain, and physiotherapy if cough
issuppressed, e.g. due to pain.
16.
Refer to ICU for consideration of continuous positive
airways pressure (CPAP) or intubation if there is:
1. a CURB score of 4–5 and the patient is failing to respond
to treatment;
2. persistent hypoxia despite high inspired O2;
3. progressive hypercapnia;
4. severe acidosis;
5. shock;
6. depressed conscious level
18.
Review should be arranged at ~6 weeks
Chest X ray to be taken if there are persistent symptoms,
physical signs or reasons to suspect underlying
malignancy.
Influenza vaccination and pneumococcal vaccination are
recommended for selected high-risk patients.
Follow-up and prevention
19.
Hospital-acquired pneumonia (HAP) is defined as a new
episode of pneumonia occurring at least 2 days after
admission to hospital.
The most important distinction between HAP and CAP
lies in the spectrum of organisms, with the majority of
hospital-acquired infections caused by Gram-negative
bacteria, including Escherichia, Pseudomonas and
Klebsiella spp. Staph. aureus/MRSA are also common.
The clinical features and investigation of patients with
HAP are very similar to those of CAP.
Hospital-acquired pneumonia
20. Patients who have received no previous antibiotics can be treated
with co-amoxiclav or cefuroxime.
If the individual has received a course of recent antibiotics, then
piperacillin/tazobactam or a thirdgeneration cephalosporin should
be considered.
Antipseudomonal cover may be provided by meropenem or a
third-generation cephalosporin combined with anaminoglycoside.
MRSA cover may be provided using vancomycin or linezolid.
It is usual to start with broad-based cover, discontinuing less
appropriate antibiotics as culture results become available.
Physiotherapy is important to aid expectoration in the immobile
and elderly, and nutritional support is often required.
The mortality from HAP is high (~30%).
Management and Prognosis
21.
In suppurative pneumonia there is destruction of the lung
parenchyma by the inflammatory process.
Microabscess formation is a characteristic histological feature of
suppurative pneumonia; the term ‘pulmonary abscess’ refers to
large localised collections of pus.
Organisms include Staph. aureus and Klebsiella pneumoniae.
Suppurative pneumonia may be produced by primary infection,
inhalation of septic material from the oropharynx or
haematogenous spread
Bacterial infection of a pulmonary infarct or of a collapsed lobe
may also produce suppurative pneumonia or lung abscess.
Suppurative and aspiration
pneumonia
22.
Chest X Ray characteristically demonstrates a dense
opacity with cavitation and/or a fluid level.
Treatment with co-amoxiclav may be effective.
If anaerobes are suspected, oral metronidazole should be
added.
Prolonged treatment for 4–6 wks may be required.
23.
Pulmonary infection is common in patients receiving
immunosuppressive drugs and in diseases causing defects of
cellular or humoral immune mechanisms.
Most infections are caused by the same common pathogens
that cause CAP.
Gram-negative bacteria, especially Ps. aeruginosa, are more of
a problem than Gram-positive organisms, however, and unusual
organisms or those normally considered to be non-pathogenic
may become ‘opportunistic’ pathogens.
More than one organism may be present.
Pneumonia in the
immunocompromised patient
24.
Patients may have non-specific symptoms and the onset tends to
be less rapid in those with opportunistic organisms such as
Pneumocystis jirovecii and mycobacterial infections.
In P. jirovecii pneumonia, cough and breathlessness can precede
the appearance of CXR abnormality by several days.
At presentation the patient is usually pyrexial and hypoxic with
normal breath sounds.
Induced sputum or bronchoscopy with bronchoalveolar lavage
or bronchial brushings may help to establish a diagnosis.
Clinical features and investigations
25.
Whenever possible, treatment should be directed against
identified organism.
Frequently, the cause is not known and broadspectrum
antibiotic therapy is required (e.g. a third-generation
cephalosporin, or a quinolone, + an antistaphylococcal
antibiotic, or an antipseudomonal penicillin + an
aminoglycoside)
Treatment is thereafter tailored according to the results of
investigations and the clinical response.
Management