21.4 Emergencies- Pneumonia

Question 1

What are common organsims that cause pneumonia?

Answer 1

Streptococcus pneumniae
Heamophillus influenzae
Mycoplasma pneumoniae
Legionella and chlamydia psittaci

Question 2

What organism is commonly found in ICU patients?

Answer 2

Staphylococcus aureus

Question 3

Whar group of individuals typically get gram negative bacilli

Answer 3

Hospital acquires
Immunocomprimised
COPD

Question 4

What are the symptoms of pneumonia?

Answer 4

Fever, rigors, malaise
Anorexia, dyspnoea, cough, purulent sputum
Heamoptysis, pleuretic chest pain

Question 5

What are the signs of pneumonia?

Answer 5

Fever, caynosis, herpes labialis, confusion
tachypnoea, tachycardia, hypotension,
signs of consolidation, pleural rub

Question 6

What is the management of pneumonia

Answer 6

Treat hypoxia
Treat hypotension
Treat dehydration
Antibiotics and investigations
Speak to ICU if not improving despite CPAP

Question 7

What investigations should be carried out in those with pneumonia?

Answer 7

CXR
Oxygen sats
FBC,U&E’s. LFT,CRP
Blood cultures
Sputum cultures
Urine pneumococcal and legionella antigen
Bronchoscopy/bronchoalveolar lavage if patient is immunocompromised or on ICU

Question 8

What features indicate increasing risk of death in pneumonia

Answer 8

Coexisting disease
Bilateral/multiple infiltrates
PaO2<8kpa, sats<92%

Question 9

What are the complications of pneumonia?

Answer 9

Pleural effusion
Empyema
Lung abscess
Respiratory fialure
Septiceaemia
Pericarditis
Myocarditis
Chloestatic jaundice
AKI