Pneumonia

Question 1

How is pneumonia anatomically classified?

Answer 1

Bronchopneumonia= patchy consolidation of different lobes

Lobar pneumonia= consolidation of a single lobe

Question 2

Four signs of consolidation/pneumonia on clinical exam?

Answer 2

  ↓ expansion 
  Dull percussion 
  Bronchial breathing 
  ↓ air entry 
  Crackles 
  Pleural rub 
  ↑VR

Question 3

How can pneumonia be divided aetiologically?

Answer 3

Hospital acquired
Community acquired
Aspiration

Question 4

A CURB65 score of 3 advises what type of management?

Answer 4

intensive care

Question 5

Four investigations for pneumonia?

Answer 5

Bloods
Blood cultures
Urine cultures
Sputum cultures
CXR

Question 6

Which organisms would you test of in the urine of patient with pneumonia?

Answer 6

pneumococcal, legionella

Question 7

In which group of patients with suspected pneumonia may not show an inflammatory response and why?

Answer 7

immunocompromised, due to poor immune function and therefore will not mount a comparable immune response to non-immunocompromised people

Question 8

Antibiotic choice and course for mild pneumonia?

Answer 8

amoxicillin TDS 500mg 5 days

Question 9

Antibiotic choice for moderate- severe pneumonia and course?

Answer 9

Dual antibiotics:

Amox 500 mg TDS AND clarithromycin 500 mg BD for 7-10 days

Question 10

Three complications of pneumonia?

Answer 10

1. Sepsis
2. Pleural effusion
3. Empyema
4. Abscess
5. Death
6. Respiratory failure
7. Hypotension

Question 11

Which organisms associated with community acquired pneumonia are resistant to beta lactam therapy?

Answer 11

mycoplasma, legionella, chlamydia

Question 12

Name one drug can induce pneumonia?

Answer 12

amiodarone, methotrexate, cyclophosphamide, nitrofurantoin

Question 13

Which organism that causes pneumonia is associated with hyponatraemia?

Answer 13

legionella

Question 14

What is the treatment for atypical pneumonia?

Answer 14

clarithromycin/erythromycin

Question 15

Three signs/symptoms of atypical pneumonia?

Answer 15

Flu-like symptoms
Dry cough
Deranged LFTs

Question 16

Two signs of infection with legionella?

Answer 16

hyponatraemia

lymphopenia

Question 17

Two signs of pneumonia caused by mycoplasma?

Answer 17

haemolytic anaemia
GBS
myocarditis
erythema multiforme

Question 18

What is the FU for pneumonia?

Answer 18

Patient’s who are admitted and treated for pneumonia in hospital should have a chest X-ray 6-12 weeks after clinical resolution of symptoms. This is to ensure resolution of consolidation, and to detect any underlying lung pathology or scarring of lung parenchyma which may have been hidden by the consolidation.