Pneumonia

Question 1

Rust coloured sputum

Answer 1

Streptococcal

Question 2

Organisms which can cause lobar pneumonia?

Answer 2

Streptococcus
Klebsiella
Legionella

Question 3

Classical acute inflammatory response in lobar pneumonia?

Answer 3

Fibrin rich fluid exudate
Neutrophil
Macrophage infilitration
Resolution

Question 4

Staph/anaerobes/coliforms seen in which type of pneumonia?

Answer 4

Aspiration (so probably Bronchopneumonia)

Question 5

Organisms causing bronchopneumonia

Answer 5

More varied – Strep. Pneumoniae, Haemophilus influenza, Staphylococcus, anaerobes, coliforms
Clinical context may help. Staph/anaerobes/coliforms seen in aspiration

Question 6

Usually mild disease in young patient, cycles occur every 3-4 years
Usually prominent extra-pulmonary symptoms (headache, malaise, myalgia)
Complications: haemolytic anaemia, erythema multiforme, hepatitis, meningoencephalitis

Answer 6

Mycoplasma pneumoniae

Question 7

Pneumonia with neurological symptoms frequently seen, along with GI involvement and deranged liver enzymes, elevated creatinine kinase

Answer 7

Legionella

Question 8

More common in pre-existing structural lung disease (CF, bronchiectasis, COPD and the elderly)

Answer 8

Haemophilus influenza, Moraxella catarrhalis

Question 9

Pneumonia recognised as a cause of endocarditis?

Answer 9

Coxiella burnetti (Q fever)

Question 10

Pneumonia where cavitation and abscess are seen?

Answer 10

Pseudomonas areuginosa (this organism is gram negative)

Question 11

More common in those with history of excess alcohol (bacteraemia more likely), poor dental hygiene, diabetes and other co-morbidities

Answer 11

Klebsiella (this organism is gram negative)

Question 12

Chlamydophila psittaci

Answer 12

Acquired from birds

Question 13

Features of legionella pneumonia?

Answer 13

GI symptoms, neurological symptoms often seen

Deranged liver enzymes, elevated creatinine kinase