Infectious lung disease

Question 1

What is pneumonia?

Answer 1

Swelling of the alveoli

Question 2

Stages of pneumonia pathophysiology?

Answer 2

Congestion - exudate into alveolar space
Red hepatisation - cells into alveolar space
Grey hepatisation - fibrin accumulation, destruction of cells
Resolution - resorption of exudate

Question 3

Pneumonia symptoms?

Answer 3

Fever
Productive cough
Chest pain
Dyspnoea

Question 4

Elderly pneumonia presentation?

Answer 4

Afebrile
Confused
Decompensation of other disease

Question 5

Most common cause of pneumonia?

Answer 5

Streptococcus pneumonia - vaccine available

Question 6

Other common bacterial causes of CAP?

Answer 6

Haemophilus influenza, Staphylococcus aureus,
Group A strep
Moraxella catarrhalis

Question 7

Hospital acquired pneumonia definition?

Answer 7

New infection more than 48 hours post admission

Question 8

Most common organisms of HAP?

Answer 8

Gram negative bacteria
Staph aureus
Legionella

Question 9

Atypical pneumonia agents?

Answer 9

Mycoplasma pneumonia
Chlamydia pneumonia
Legionella pneumophila

Question 10

Mycoplasma pneumonia course?

Answer 10

Slow onset
Constitutional upset
Fever
Headache
Dry cough

Question 11

Which cohort get klebsiella pneumoniae infection?

Answer 11

Alcoholics

Question 12

Legionella pneumonia cause?

Answer 12

Most severe, headache, myalgia and fever predominate early phase followed by respiratory symptoms

Question 13

When do patients get staph aureus pneumonia

Answer 13

Hospital or post influenza

Question 14

What is idiopathic interstitial pneumonia?

Answer 14

Non-infective pneumonia e.g. cryptogenic organising pneumonia

Question 15

What is cryptogenic organising pneumonia?

Answer 15

Bronchiolitis which develops secondary to rheumatoid or amiodarone therapy

Question 16

Signs of pneumonia?

Answer 16

Pleural rub
Increased vocal resonance
Dullness to percussion,Bronchial breathing

Question 17

Investigations for pneumonia?

Answer 17

CXR
FBC
U+Es
Blood culture
Sputum culture
Urinary antigen testing - legionella and pneumococcus
LFTs

Question 18

First line treatment for community acquired?

Answer 18

Macrolide or tetracycline

Question 19

Complications of pneumonia?

Answer 19

Sepsis
Heart failure
ACS
Arrhythmia
Necrotising pneumonia
Pleural effusion
Abscess
Empyema

Question 20

What is TB

Answer 20

Tuberculosis - infection caused by mycobacterium tuberculosis

Question 21

Symptoms of pulmonary TB?

Answer 21

Cough
Haemoptysis
Chest pain
Cachexia
Weight loss
Night sweats
Fever
Fatigue

Question 22

Symptoms of extra-pulmonary TB?

Answer 22

Haematuria
Meningitis
Hoarseness
Loss of appetite
Weight loss
Night sweats
Fever
Fatigue

Question 23

Tests for TB?

Answer 23

Tuberculin skin test

Quantiferon test - interferon gamma release assay

Question 24

Risk factors for developing tuberculosis?

Answer 24

Silicosis
Chronic renal failure
HIV 
Organ transplantation
IV drug use
Haematological malignancy
anti-TNF treatment
Previous gastrectomy
Underweight

Question 25

Treatment for TB?

Answer 25

RIPE
Rifampin
Isoniazid
Pyrazinaminde
Ethambutol

Question 26

Phases of TB treatment

Answer 26

Initial phase - RIPE - 2 month

Continuation fase - RI - 4-7 month

Question 27

When is continuation phase 7 months long?

Answer 27

Extensive disease, initial phase didn’t include pyrazinamide

Question 28

What is special about TB treatment?

Answer 28

Long + directly observed therapy