Lung

Question 1

What are the common causative organisms of mild/moderate CAP?

Answer 1

Pneumococcus

Haemophilus influenzae

Question 2

Describe the gram stain of pneumococcus

Answer 2

Gram +ve diplococci

Alpha haemolytic

Question 3

Describe the gram stain of haemophilus influenzae

Answer 3

Gram -ve coccobacillus

Question 4

What testing should be done in pneumonia?

Answer 4

Blood cultures
Clotted blood for atypicals
Throat swab in viral transport medium
Sputum for bacterial culture
BAL or tracheal aspirates if no sputum
Urine
Legionells antigen serogroup 1

Question 5

What is the treatment for mild/moderate CAP?

Answer 5

Amoxicillin IV/PO (5 days)

If penicillin allergic: doxycycline PO or IV clarithromycin

Question 6

What are the commonest causative organisms of severe CAP?

Answer 6

Pneumococcus
Haemophilus Influenzae
Legionella
Mycoplasma
Chlamydia Pneumoniae
Coxiella
Staph aureus

Question 7

Describe the gram stain of legionella

Answer 7

Gram -ve pleomorphic

Question 8

Describe the gram stain of mycoplasma

Answer 8

derived from gram +ve

Question 9

What is the treatment for severe CAP?

Answer 9

Co-amoxiclav IV & doxycycline PO

if penicillin allergic: IV levofloxacin

Question 10

Describe the gram stain of chlamydia pneumonia

Answer 10

Gram -ve atypical

Question 11

Describe the gram stain of coxiella

Answer 11

Gram -ve coccobacilli

Question 12

Describe the gram stain of staph aureus

Answer 12

Gram +ve cocci in clusters

Question 13

What are the common causative organisms of acute exacerbation of COPD?

Answer 13

Pneumococcus

Haemophilus influenzae

Question 14

What is the treatment for severe CAP if patient is in ICU/HDU or NBM

Answer 14

Co-amoxiclav IV & clarthromycin IV
(if penicillin allergic; IV levofloxacin)

Step down to doxycycline

Question 15

What is the treatment for acute exacerbation of COPD?

Answer 15

1st line- amoxicillin
2nd line- doxycycline

(5 days)

Question 16

What are the common causes of HAP?

Answer 16

Pneumococcus
Haemophilus influenzae
Coliforms
Legionella

Question 17

Describe the gram stain of Coliforms

Answer 17

Gram negative rods

Question 18

What is the treatment for non-severe HAP?

Answer 18

PO amoxicillin 5 days

If penicillin allergic doxycycline

Question 19

What is the treatment for Severe HAP?

Answer 19

IV amoxicillin + gentamicin

If penicillin allergic IV co-trimoxazole and gentamicin

Question 20

What are the commonest causal organism of aspiration pneumonia

Answer 20

Streptococcus pneumoniae
Staphylococcus aureus 
H influenzae 
Pseudomonas aeruginosa
Klebsiella 

Anaerobes; bacteroides, prevotella

Question 21

Describe the gram stain of pseudomonas aeruginosa?

Answer 21

Gram -ve rod

Question 22

Describe the gram stain of klebsiella

Answer 22

Gram -ve rod

Question 23

Describe the gram stain of bacteroides

Answer 23

Gram -ve rod

Question 24

What is the treatment of non severe aspiration pneumonia?

Answer 24

PO Amoxicillin & metronidazole (5 days)

if penicillin allergic IV doxycycline and metronidazole

Question 25

What is the treatment of severe aspiration pneumonia?

Answer 25

IV Amoxicillin, Metronidazole and gentamicin
(If penicillin allergic; replace amoxicillin with PO doxycycline or IV clarithromycin)

Step down: PO amoxicillin + metronidazole

(if penicillin allergic doxycycline)