Pneumonia

Question 1

Risk factors

Answer 1

Age
Underlying resp disease
Smoking
Immunocompromise
DM

Question 2

Symptoms

Answer 2

Productive cough (Green sputum)
Breathless

(Viral)
Fever
Fatigue
N/V

Question 3

Examination

Answer 3

Tar Staining
Tachycardia
Tachypnoea
Dullness
Inspiratory crackles
Reduced breath sounds (Over effected area)

Question 4

Investigations

Answer 4

CXR (Consolidation)
Routine bloods (FBC,CRP)
Sputum culture
Blood culture (If fevereish)
ABG if low sats

Question 5

CURB 65 Score

Answer 5

Indicator of 30 day mortality

confusion
urea > 7
resp rate > 30
bp < 90/60
65 years (older than)

Question 6

CAP Organisms

Answer 6

Strep Pneumoniae
Haemophillus influenzae
Moraxella Cattharalis

Question 7

HAP Organisms

Answer 7

E.Coli
MRSA
Pseudomonas

Question 8

Atypical Organisms

Answer 8

Mycoplasma Pneumoniae
Chlamidyae Pneumonia
Leigionella Pneumphila

Question 9

CAP Treatment

Answer 9

1. Amoxicillin 500mg TDS for 5 Days
2. Doxycycline 200mg OD for 5 Days If penicillin allergic or suspected Atypical.
3. Paractemol
4. Oxygen if required

Question 10

Follow up

Answer 10

1. HIV Screen
2. Immunoglobulin Screen
3. Pneumococcal IgG Serotypes
4. H. Influenzae b, IgG Serotype
5. Review in clinic in 6 weeks, repeat CXR

Question 11

Unresolved Causes

Answer 11

Complications - Empyema, Abcess
Host - Immunocompromise
Antibiotic - Type, Dose, Duration
Organism - Atypical
Secondary cause - PE, Ca