Ana de Luca
CLINICAL CASE REVIEWS Consolidation :inflamedinfiltrates. Radiopacity in
whichhistoryand physicalexaminationmadeit suspect Smoking load of 30 maços/year. From 20 maços/year
CLINICAL CASE 1 - PNEUMONIA infiltrator. starttodevelop COPD.
- More common in right lobe, because the trachea divides
rapidly to the right. Therewasno digital drumming → (hypertrophy) of the
Highest Fever: Think of bacterial.
distal phalanges of the fingers and nails ofthebody. Dilated
The date thechildrencaughtthe infection is important fingertips, joins with your nails. It happens in COPD. As he
Reduced vesicular murmur at the left base:
because the autumn and winter months arethe most didnothave, it shows that his COPDwasnotserious.
lungiscompromisedin that area, airis notentering right into
the alvisolo. susceptibletopulmonary infectionsin general.
Pleural friction → the consolidationisthenext ofthepleura
Flu-like condition opensthe door tobacterial infections. It that is scraping the visceral pleura in the parietal → it looks
Fever +m úrburio + phlegm = thinkof infectious condition.
can evolveinto bacterialsituation. like a leaf scraping on the other. It happens for two reasons:
either pleural effusionor consolidate theverycloseofthe
Frisan increasedraco-vocal myth, because the
Flu and viral pneumonia don't consolidate! pleura.
regionisreadtransmits sound better than air. If it has
filteredinflames, thevibrationis more transmitted than Consolidation is a sign of bacterial pneumonia!
Egofonia → sound anasalado when you speak 33. It
where thereis air.
Bronchiectasia: brônquio who hasalready been infected consolidatesthenextofthe tisalv rmicoisolos.
Crackle:alvisologlued by mucus. It haslí quido by bactisria eestá destruído. When youhave already
caughttheciliary infection,you do nothave more cílios X-ray:v is radiopacity.
inflamatoriono alvéolo.
(mucus accommodates more easy)+loses muscles of the
wall → the4th noquio is flooded and full of mucus. Community pneumoniais→ out of the hospital.
The X-ray has to compare one side with the other. The dark
part is the aenada part. The white part is where the x-ray
Ask for x-rays because thecost ofbenefit is good. Pain tortothe scar ventilatório dependent on → pain when
doesnotpenetrate it properly.
1. Otima relaçãoascusto effectiveness. breathing → pain when shaving a pleura on the other →
2. Low radiationdose. shows pleural involvement.
It is important toaskfor different profiles tosee retrosternal,
retrocardiac, costo frênicos breasts,posterior tothecostal 3. Wide availability.
4. Limited usefulness inthe predictionofthe causative agent Elderly and immunosuppressed haveinfection without fever
arches. Helps to see thelocation ofthe anteroposterior of
– típicox atípico. , unlikethe children.
thechangesseen inthe PA.
Starttreatmentbefore leaving the result of the culture.
Ask for a profile wheneverpossible. Thepatient Agent atthatpeak cannotseet clearlyonthe X-ray.
isnotbedridden or severely conditioned that does not
CURB 65: patient more than 65 years.
allowthe X-ray to be profiled. Blood count shows increased leucócito.
1. C -Levelof information;
PCR shows how severetheinfectionis.
2. U - Urea > 50 mg/dl;
The normal profile usually has anterocardiac aerate zone, Viral panel shows the influenza, or not,to see ifit is flu or
3. R - Frequencyrespirat iria ≥ 30 ipm;
retrocardiac and where the aorta passes is usually aerate. passed to something else.
4. B – Pressis bloodpressure: PAS < 90 mmHg and/or
DBP ≤ 60 mmHg.
Streptococus came negative on the test, because this testis CLINICAL CASE 2 - PNEUMONIA COMUNITARIA 5. 65 - Age over 65 years.
not legal to be done in thefirst aid. Even coming in
negative, treat as pneumonia, because it is the main Youdidn'thave a fever!
Expectoraçãthe normal is white, when it arrives with Each pairof metersis worth1 point. sum.
causative agent of pneumonia.
If it's positive, okay. If it'snegative, itdoesn't mean anything. expectoração withchange of color → think of bactisria.
Vírusdoesnot change the colorof expectoração.
CLINICAL CASE REVIEWS Consolidation :inflamedinfiltrates. Radiopacity in
whichhistoryand physicalexaminationmadeit suspect Smoking load of 30 maços/year. From 20 maços/year
CLINICAL CASE 1 - PNEUMONIA infiltrator. starttodevelop COPD.
- More common in right lobe, because the trachea divides
rapidly to the right. Therewasno digital drumming → (hypertrophy) of the
Highest Fever: Think of bacterial.
distal phalanges of the fingers and nails ofthebody. Dilated
The date thechildrencaughtthe infection is important fingertips, joins with your nails. It happens in COPD. As he
Reduced vesicular murmur at the left base:
because the autumn and winter months arethe most didnothave, it shows that his COPDwasnotserious.
lungiscompromisedin that area, airis notentering right into
the alvisolo. susceptibletopulmonary infectionsin general.
Pleural friction → the consolidationisthenext ofthepleura
Flu-like condition opensthe door tobacterial infections. It that is scraping the visceral pleura in the parietal → it looks
Fever +m úrburio + phlegm = thinkof infectious condition.
can evolveinto bacterialsituation. like a leaf scraping on the other. It happens for two reasons:
either pleural effusionor consolidate theverycloseofthe
Frisan increasedraco-vocal myth, because the
Flu and viral pneumonia don't consolidate! pleura.
regionisreadtransmits sound better than air. If it has
filteredinflames, thevibrationis more transmitted than Consolidation is a sign of bacterial pneumonia!
Egofonia → sound anasalado when you speak 33. It
where thereis air.
Bronchiectasia: brônquio who hasalready been infected consolidatesthenextofthe tisalv rmicoisolos.
Crackle:alvisologlued by mucus. It haslí quido by bactisria eestá destruído. When youhave already
caughttheciliary infection,you do nothave more cílios X-ray:v is radiopacity.
inflamatoriono alvéolo.
(mucus accommodates more easy)+loses muscles of the
wall → the4th noquio is flooded and full of mucus. Community pneumoniais→ out of the hospital.
The X-ray has to compare one side with the other. The dark
part is the aenada part. The white part is where the x-ray
Ask for x-rays because thecost ofbenefit is good. Pain tortothe scar ventilatório dependent on → pain when
doesnotpenetrate it properly.
1. Otima relaçãoascusto effectiveness. breathing → pain when shaving a pleura on the other →
2. Low radiationdose. shows pleural involvement.
It is important toaskfor different profiles tosee retrosternal,
retrocardiac, costo frênicos breasts,posterior tothecostal 3. Wide availability.
4. Limited usefulness inthe predictionofthe causative agent Elderly and immunosuppressed haveinfection without fever
arches. Helps to see thelocation ofthe anteroposterior of
– típicox atípico. , unlikethe children.
thechangesseen inthe PA.
Starttreatmentbefore leaving the result of the culture.
Ask for a profile wheneverpossible. Thepatient Agent atthatpeak cannotseet clearlyonthe X-ray.
isnotbedridden or severely conditioned that does not
CURB 65: patient more than 65 years.
allowthe X-ray to be profiled. Blood count shows increased leucócito.
1. C -Levelof information;
PCR shows how severetheinfectionis.
2. U - Urea > 50 mg/dl;
The normal profile usually has anterocardiac aerate zone, Viral panel shows the influenza, or not,to see ifit is flu or
3. R - Frequencyrespirat iria ≥ 30 ipm;
retrocardiac and where the aorta passes is usually aerate. passed to something else.
4. B – Pressis bloodpressure: PAS < 90 mmHg and/or
DBP ≤ 60 mmHg.
Streptococus came negative on the test, because this testis CLINICAL CASE 2 - PNEUMONIA COMUNITARIA 5. 65 - Age over 65 years.
not legal to be done in thefirst aid. Even coming in
negative, treat as pneumonia, because it is the main Youdidn'thave a fever!
Expectoraçãthe normal is white, when it arrives with Each pairof metersis worth1 point. sum.
causative agent of pneumonia.
If it's positive, okay. If it'snegative, itdoesn't mean anything. expectoração withchange of color → think of bactisria.
Vírusdoesnot change the colorof expectoração.
