Bacterial pneumonia

Question 1

define community acquired

Answer 1

pneumonia acquired outside of the hospital setting or within 48 hours of hospital admission

Question 2

define ventilator associated

Answer 2

HAP 48 hours post tracheal incubation

Question 3

define HAP

Answer 3

develops 48 hours or more post admission

Question 4

define atypical P

Answer 4

variable, caused by an atypical pathogen not detectable by gram stain and traditional culture

Question 5

which pneumonia causes the greatest mortality and morbidity worldwide?

Answer 5

CAP

Question 6

COMMON symptoms

Answer 6

dyspnoea
cough and fever
pain when breathing

Question 7

what’s pneumonia most common in

Answer 7

young and elderly

Question 8

2 common pathogens

Answer 8

strep pneumonia

haemophilus influenza

Question 9

shape and gram stain of strep p

Answer 9

coccus

gram positive

Question 10

is strep p commensal

Answer 10

yes

Question 11

why has the PCV vaccine stabilised resistance in strep p

Answer 11

decreased the incidence of penicillin resistant cases

Question 12

what makes strep p virulent

Answer 12

capsule to avoid immune system- avirulent without this

Question 13

what h.influenzae is most virulent

Answer 13

type b capsule

Question 14

what are h.influenzae commonly resistant to?

Answer 14

beta lactams- produce beta lactamases

Question 15

what vaccine has reduced the H.influenzae cases in children

Answer 15

Hib

Question 16

what do we look for in pneumonia diagnosis in the bloods?

Answer 16

biomarkers of infection

CRP, procalcitonin

Question 17

how is diagnosis confirmed in microbiology?

Answer 17

take a sputum sample

Question 18

why is it hard to find causative pathogen in microbiology?

Answer 18

can only find pathogens we look for

hard to detect atypical causes

Question 19

what imagine is essential to diagnose pneumonia

Answer 19

Thoratic images
chest Xray is good but CT is preferred
US

Question 20

chest X-ray is ______ over CT

Answer 20

not preferred

Question 21

disadvantages of CT?

Answer 21

cost and radiation exposure

Question 22

severity assessment is done using what?

Answer 22

CURB-65

Pneumonia severity index (1,2,3 are low, 4,5 are severe)

Question 23

what does CURB stand for? how does it work

Answer 23

confusion 
urea in blood 
RR
BP 
0-4, the lower the number the lower the risk

Question 24

if they score low on the PSI how do we treat?

Answer 24

want to keep out of hospital, monotherapy given

Question 25

if they score moderate on the PSI how do we treat?

Answer 25

want to do a micro check to determine causative organism

combination therapy given

Question 26

if they score high on the PSI how do we treat?

Answer 26

straight to ICU

combination therapy

Question 27

adjunctive therapy

Answer 27

corticosteroids- not sure

statins- inconclusive evidence

Question 28

effects of corticosteroids as an adjunctive treatment?

Answer 28

hinder breathing in some patients

reduce inflammation in others

Question 29

side effects of corticosteroids?

Answer 29

hyperglycaemia

superinfection- decrease in inflammation increases the infection