Pneumonia

Question 1

Organisms causing acute pneumonia in infants and children?

Answer 1

Usual viruses and bacteria

Question 2

Causes of acute pneumonia in school going children?

Answer 2

Mycoplasma pneumoniae

Chlamydia pneumoniae

Question 3

Commonest causes of bacterial pneumonia

Answer 3

Streptococcus pneumoniae
staphylococcus aureus
H influenza before vaccine

Question 4

Commonest cause of viral pneumonia

Answer 4

RSV
adenovirus
para influenza
influenza

Question 5

Commonest causes of pneumonia in immunocompromised children

Answer 5

Gram negative bacteria :klebsiella

In HIV positive infants : PJP , cytomegalovirus, TB

Question 6

Danger signs of pneumonia

Answer 6

Stridor
Altered level of consciousness
Severe malnutrition
HIV-positive not on antiretrovirals

Question 7

Who should be admitted for Pneumonia

Answer 7

Any danger signs
cyanosis
Difficulty feeding
Chest wall in drawing
Saturation less than 92
Infants Less than two months
Congenital heart disease
Chronic lung disease

Question 8

Causes of tissue breakdown in cavity formation on chest x-ray

Answer 8

Staphylococcus aureus
Klebsiella
Mycobacterium TB

Question 9

Why is adenovirus infection of concern

Answer 9

Causes a prolonged course with a high risk of developing long-term complications such as bronchiolitis Obliterans and bronchiectasis

Question 10

Supportive measures when managing an acute pneumonia

Answer 10

1. Supplemental oxygen:
   - nasal prongs oxygen
   - flow rate between 0.5 - 2 L
   - sats should be kept between 92 to 94%
   - change mode of O2 delivery if sats don’t improve.
2. feeding and fluids
   - Uncomplicated oral feeds
   - Severe and complicated IV fluids
   - Severe SIADH (decreased fluid secretion) 60 ml/kilogram/ day
3. Vitamin A and zinc
   Measles and HIV- vitamin a
   Zinc - decreases hospital stay

Question 11

Reasons for no response to treatment

Answer 11

Resistance
Incorrect antibiotics dose
TB 
Complicating factor with cause e.g foreign body
Complication
Wrong diagnosis

Question 12

Organisms causing acute pneumonia in neonates?

Answer 12

Gram negative bacilli
Streptococcus b
Chlamydia trachoma this