Lung infections

Question 1

What are the components of the CURB65 score?

Answer 1

Confusion
Urea >7mmol/L
Respiratory Rate > 30
Systolic BP < 90 mmHg
Over 65 years old

Question 2

0-2 CURB 65

CAP treatment?

Answer 2

Amoxicillin PO 1 g

Question 3

0-2 CURB 65
Penicillin Allergic
CAP treatment?

Answer 3

Doxycycline PO 200mg on day 1 then 100mg

Question 4

3-5 CURB65 CAP Treatment?

Answer 4

Co-Amoxiclav IV 1.2gs + Doxycycline PO 100mg

Question 5

ICU CAP treatment?

Answer 5

Co amoxiclav IV 1.2gs + Clarithromycin IV 500mg

Question 6

INTIAL treatment for severe hospital aquired pneumonia or aspiration pneumonia?

Answer 6

IV Amoxicilllin + Metronidazole + Gentamicin

Question 7

INTIAL treatment for severe hospital aquired pneumonia or aspiration pneumonia with PENICILLIN allergy?

Answer 7

IV Co-trimoxazole + Metronidazole +/- Gentamicin

Question 8

STEP DOWN treatment for severe hospital aquired pneumonia or aspiration pneumonia?

Answer 8

PO Co-trimoxazole + Metronidazole for 7 days

Question 9

INTIAL treatment for non-severe hospital aquired pneumonia?

Answer 9

PO Amoxicillin + Metronidazole for 5 days

Question 10

STEP DOWN treatment for ALL patients with community aquired pneumonia?

Answer 10

Doxycycline 100mg for 7 days

Question 11

Treatment for PENICILLIN ALLERGIC severe or ICU Community aquired pneumonia?

Answer 11

IV Levofloxacin 500mg

Question 12

Which organisms commonly cause mild community aquired pneumonia?

Answer 12

Streptococcus pneumoniae, followed by Haemophilus influenzae

Question 13

Which organism commonly causes pneumonia in the community following viral influenza infection?

Answer 13

Staphylococcus aureus

Question 14

Which organisms commonly cause exacerbation of COPD?

Answer 14

Streptococcus pneumoniae, followed by Haemophilus influenzae

Question 15

How useful is blood culture in pneumonia?

Answer 15

Not useful in community aquired pneumonia (only +ve in 5-15%)
Most useful in severe disease - aim to get cultures BEFORE giving antibiotic in severe pneumonia.

Question 16

Which bacteria groups can cause false positives in blood cultures?

Answer 16

Skin commensals such as staphyloccus epidermidis, corynebacterium species and bacillus species.

Question 17

What are the features of Heamophilus Influenza?

Answer 17

• gram negative (stains pink)
• coccibacillus
• aerobic
• will generally NOT grow on blood agar and requires chocolate agar media

Question 18

Mycoplasma pneumoniae generally infects?

Answer 18

Children and young adults

Question 19

How is mycoplasma pneumoniae spread?

Answer 19

person to person

Question 20

Which skin condition is characteristic of mycoplasma pneumoniae infection?

Answer 20

Erythema multiforme

Question 21

How is Coxiella burnetti spread?

Answer 21

Sheep and goats

Question 22

How is chlamydia pstiacci spread?

Answer 22

Infected birds

Question 23

Which organism can be detected via urine?

Answer 23

Legionella, by finding legionella antigen in the urine.

Question 24

When is urine culture indicated?

Answer 24

If complicated infection is suspected?

Question 25

Within what time frame should you aim for urine samples to reach the lab?

Answer 25

One hour