1 / 20

Pneumonia

Pneumonia. Esmaeli , A.; Francisco U.; Golpeo, K. A. G. 75 year old Male Single From Sta. Mesa, Manila Unemployed CC: progressive and productive cough, 3 days duration. TEMPORAL PROFILE. Past Medical History

betha
Télécharger la présentation

Pneumonia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Pneumonia Esmaeli, A.; Francisco U.; Golpeo, K.

  2. A. G. • 75 year old • Male • Single • From Sta. Mesa, Manila • Unemployed • CC: progressive and productive cough, 3 days duration

  3. TEMPORAL PROFILE

  4. Past Medical History • PTB (2002) – sputum AFB (+); 6 months quad-tab treatment completed; Chest X-ray after treatment – resolved • S/P Cataract surgery (2002) • COPD (2011) – Symbicort 2 puffs BID  1 puff BID (2012) • Allergy to seafood and chicken • (-) HTN, (-) DM • Family History • (+) HTN (father and younger brother) • (+) stroke (father) • (+) Lung CA (brother)

  5. Social and Environmental History • Smoker (51 pack years); started 14 years old, stopped 2002, 1 pack per day • Occasional alcohol drinker (1960 -1970); Last drink was 1985, 1 small bottle of pale pilsen per week • Denies illicit drug use

  6. Review of Systems • (-) anorexia • (-) vomiting • (-) diarrhea • (-) blood in sputum • (+) exertional dyspnea • (+) sputum production • Weight loss

  7. Physical Examination Awake, weak-looking, alert, ambulatory, febrile VS: 110/60 > 72 > 32 > 39 degrees celsius AS, PPC, (-) TPC, (-) CLADS ECE, (+) crackles in L lower lung AP, NRRR, distinct S1 and S2, (-) murmur Flat abdomen, NABS FEP, (-) cyanosis, (-) edema

  8. Primary Impression Community Acquired Pneumonia, Moderate Risk (CAP, MR); Chronic Obstructive Pulmonary Disease (COPD)

  9. Laboratories Ordered • CBC • UA • Blood CS • Sputum GS/CS • Na, K, Crea, BUN • Chest Xray

  10. CBC

  11. Chest Xray Impression: • Pneumonitis/ Bronchitis Right Lower Lung • Pneumonia Left Lower Lung • Residual Fibrosis Right Upper Lung

  12. Urinalysis

  13. Blood Chemistries

  14. Cultures • Sputum GS – Gram (+) cocci in pairs with neutrophils • Sputum CS – • Blood CS, 2 sites –

  15. IV FLUID: 1 liter D5NSS to run to 10 hours (100 cc/hr) • DIET: 2100 kcal/day • TFR

  16. Antibiotic started upon admission • Ceftriaxone 2 gm IV Q24 • Levofloxacin 750mg/tab, 1 tab Q48 (Azithromycin)

  17. COPD • Symbicort 2 puffs BID

  18. Hypokalemia • KaliumDurule, 1 durule TID

  19. Pneumonia

  20. Plan

More Related