Pneumonia

Question 1

Pathophysiology of pneumonia?

Answer 1

Infection of lung tissue
Inflammation of alveolar space
Bacterial infection often (Streptococcus pneumonia (pneumococcus))

Question 2

Other causes of pneumonia?

Answer 2

Moraxella catarrhalis,
Pseudomonas aeruginosa,
Staphylococcus aureus,
Methicillin-resistantStaphylococcus aureus(MRSA),
Haemophilus influenzae

Question 3

3 types of classification for pneumonia?

Answer 3

CAP - Community-acquired
HAP - Hospital-acquired
VAP - Ventilator-acquired

Question 4

Presentation of pneumonia?

Answer 4

• Cough
• Sputum production
• Shortness of breath
• Fever
• Feeling generally unwell
• Haemoptysis (coughing up blood)
• Pleuritic chest pain (sharp chest pain, worse on inspiration)
• Delirium (acute confusion)

Question 5

Characteristic chest sign for pneumonia?

Answer 5

-Bronchial breath sounds(harsh inspiratory and expiratory breath sounds) due to consolidation around the airways
Focal coarse crackles -caused by air passing through sputum in the airways
Dullness to percussion - due to lung tissue filled with sputum or collapsed

Question 6

What are atypical pnemonias?

Answer 6

Caused by organisms that cannot be cultured in a normal way or detected with a gram stain.

Question 7

4 examples of a-typical pnemonias?

Answer 7

Legionella pneumophila
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Chlamydia psittaci

Question 8

How does Legionella pneumophila typically present?

Answer 8

inhaling infected water system (air con units)
can cause hyponatraemia

Question 9

How does Mycoplasma pneumoniae typically present?

Answer 9

milder pneumonia
rash = erythema multiforme
neurological symptoms in young patients

Question 10

How does Chlamydophila pneumoniae typically present?

Answer 10

mild to moderate chronic pneumonia and wheezing in school-age children

Question 11

How does Chlamydia psittaci typically present?

Answer 11

from infected birds (parrot owners typically)

Question 12

How to assess if a pneumonia pt should be admitted or treated in community?

Answer 12

• C–Confusion (new disorientation in person, place or time)
• U–Urea > 7 mmol/L
• R–Respiratory rate ≥ 30
• B–Blood pressure < 90 systolic or ≤ 60 diastolic.]
• 65– Age ≥65

Score <2 = consider community
Score = 2 = inpatient
>3 = severe pneumonia

Question 13

Investigations for pneumonia?

Answer 13

often clinical diagnosis
CXR
FBC - raised WCC
U and Es
CRP
Sputum
Bloods
PneumococcalandLegionella urinary antigen tests

Question 14

Management of pneumonia?

Answer 14

follow local abx guidelines

mild CAP = 5 days oral abx (Amoxicillin/Doxycycline/Clarithromycin)

moderate/ severe = Iv abx, step down to oral when able. Resp support (O2)

Question 15

Complication of Pneumonia?

Answer 15

• Sepsis
• Acute respiratory distress syndrome
• Pleural effusion
• Empyema
• Lung abscess
• Death