Pneumonia

Question 1

What is hospital-acquired pneumonia?

Answer 1

HAP develops after more than 48 hours in hospital

Question 2

What is the most common cause of CAP?

Answer 2

Streptococcus pneumoniae

Question 3

What are the other causes of CAP?

Answer 3

Haemophilus influenzae
Moraxella catarrhalis (immunocompromised patients)
Pseudomonas aeruginosa (CF or bronchiectasis)
Staphylococcus aureus (CF)

Question 4

What are the common bacterial causes of HAP?

Answer 4

Psueodomonas
E. coli
Stapyloccocus aureus
Klebsiella pneumoniae (aspiration pneumonia)

Question 5

What are the causes of atypical pneumonia?

Answer 5

Legionella pneumophilia
Mycoplasma pneumonia
Chamydophilia pnuemoniae

Question 6

What is the presentation of pneumonia?

Answer 6

Productive cough
Pleuritic chest pain
Dyspnoea
Fever
Reduced breath sounds
Coarse crepitations
Hypoxia
Tachycardia

Question 7

What are the initial investigations for pneumonia?

Answer 7

CXR
FBC - raised white cells
U&E
ABG - respiratory failure
Sputum culture
CRP

Question 8

What is CURB-65?

Answer 8

Confusion
Urea > 7mmol/L
Respiratory rate > 30
BP systolic < 90 OR diastolic < 60
> 65 years of age

Community based care is score is 0 or 1
Hospital based care for patients with a score of 2
Intensive care assessment if CURB65 is 3 or more

Question 9

What is the management of mild CAP?

Answer 9

Oral amoxicillin - 5 days
Oral doxycycline/ clarithromycin if penicillin allergic

Question 10

What is the management of moderate severity CAP?

Answer 10

Oral amoxicillin (5 days) + clarithromycin if atypical pathogen is suspected

Question 11

What is the management of high severity CAP?

Answer 11

IV co-amoxiclav and clarithromycin

Question 12

What are the complications of pneumonia?

Answer 12

Acute respiratory distress syndrome
Sepsis
Lung abscess
Pleural effusion
Empyema