MSRA: Pneumonia

Question 1

What can we classify the severity of pneumonia?

Answer 1

Curb-65
Confusion, MMT 8 or less
Urea greater than 7mmol/L
Resp rate greater than 30
Blood pressure, systolic less than 90 or diastolic less than 60
Greater than 65 years old

0-1 home treatment is possible - mild
2 hospital therapy - moderate
3 or more, consider ITU of 4 or more - severe

Question 2

What are the key features of a Legionella infection?

Answer 2

Prodromal flu-like illness
Dry cough
Hyponatraemia, deranged LFTs

Question 3

What are the key features of a mycoplasma infection?

Answer 3

Crowded accommodation
Erythema multiforme
Haemolytic anaemia (Cold agglutin test)

Question 4

What are the key features of a Staph aureus infection

Answer 4

CAP after influenza
Cavity formation

Question 5

What are the key features of a Klebsiella infection?

Answer 5

Common in alcoholics/ with aspiration
Predisposition for the upper lobes
Red currant jelly sputum

Question 6

What is the treatment for the different severities of pneumonia?

Answer 6

Low - oral amoxicillin
Moderate - oral amoxicillin and oral macrolide (e.g. Clarithromycin)
Severe - IV co-amoxiclav and IV macrolide

Question 7

What are the features of an aspergilloma?

Answer 7

May arise in a pre-existing lung cavity
Causes haemoptysis
CXR: crescent sign

Question 8

What follow-up is needed for patient with pneumonia?

Answer 8

CXR at 6 weeks to check for resolution