Page 226 - 2021 IDMT Digital

PNEUMONIA
Introduction:
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o PLOOLRQ FDVHV GLDJQRVHG DQQXDOO\ ZLWK RI WKRVH UHTXLULQJ KRVSLWDOL]DWLRQ
• 0RVW GHDGO\ LQIHFWLRXV GLVHDVH LQ WKH 86
WK
o OHDGLQJ FDXVH RI GHDWK
• 5LVN IDFWRUV
o 2OGHU DJH
o $OFRKROLVP RU WREDFFR XVH
o &RPRUELG PHGLFDO FRQGLWLRQV HVSHFLDOO\ DVWKPD RU &23' RU
LPPXQRVXSSUHVVLRQ
Subjective:
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o )HYHU FRXJK ZLWK RU ZLWKRXW VSXWXP SURGXFWLRQ WDFK\SQHD DQG G\VSQHD
o 0D\ DOVR LQFOXGH VZHDWV FKLOOV ULJRUV FKHVW GLVFRPIRUW SOHXULV\ KHPRSW\VLV
IDWLJXH P\DOJLDV DQRUH[LD KHDGDFKH DQG DEGRPLQDO SDLQ
• )RFXVHG +LVWRU\
o $W\SLFDO SQHXPRQLD PD\ EH DVVRFLDWHG ZLWK QDXVHD YRPLWLQJ RU DEGRPLQDO SDLQ
Objective:
• 3K\VLFDO ([DP
o &OLQLFDO HYDOXDWLRQ LV VHQVLWLYH FRPSDUHG WR FKHVW [ UD\ IRU WKH GLDJQRVLV RI
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o +((17 DQG IXOO UHVSLUDWRU\ H[DP
o 3QHXPRQLD 6HYHULW\ ,QGH[ LI FRQVLGHULQJ KRVSLWDOL]DWLRQ
• 7RROV
o ,PDJLQJ UHTXLUHG IRU GLDJQRVLV pXOPRQDU\ RSDFLW\ RQ FKHVW [ UD\ LV UHTXLUHG WR
HVWDEOLVK GLDJQRVLV
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Assessment:
• 'LIIHUHQWLDO
o 3OHXULV\ VKDUS RU EXUQLQJ SDLQ ZKHQ EUHDWKLQJ
o 3XOPRQDU\ ePEROLVP DFXWH RQVHW ZLWK G\VSQHD DQG SOHXULWLF FKHVW SDLQ
o %URQFKLWLV DXVFXOWDWLRQ RI DOO OREHV RI WKH OXQJ VKRXOG VWLOO EH SRVVLEOH
Plan:
• 0HGLFDWLRQV
o Antibiotic monotherapy is no longer recommended, contact preceptor
o 0DFUROLGH DQWLELRWLFV D]LWKURP\FLQ or clarithromycin
o 'R[\F\FOLQH
o Amoxicillin
• ,I SDWLHQWV DUH DW ULVN IRU GUXJ UHVLVWDQFH RU DUH KLJK ULVN
o )OXRURTXLQRORQH OHYRIOR[DFLQ

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