Pneumonia

Question 1

CAP

Answer 1

step.pneumonia, haemophilia influenzae, mycoplasma pnuemoniae

Question 2

Hospital acquired

Answer 2

gram -ve enterobacteria, pseudomonas

Question 3

Aspiration

Answer 3

stroke, decrease consciousness–> risk of aspiring oropharyngeal anaerobes

Question 4

First 5 micro-organisms

Answer 4

1. pneumococcal
2. staphylococcal
3. klebsiella
4. pseudomonas
5. mycoplasma

Question 5

Next 6 micro-organisms

Answer 5

6. legionella pneumophila
7. chlamydia pneumoniae
8. chlamydia psittaci
9. viral pneumonia
10. pneumococytis pneumoniae (PCP)
11. haemophilus influenzae

Question 6

symptoms of pneumococcal (strep)

Answer 6

rapid onset, fever, pleuritic chest pain, herpes labioles

Question 7

sputum of pneumococcal

Answer 7

rusty sputum

Question 8

CXR of pneumococcal

Answer 8

lobar consolidation

Question 9

Treatment of pneumococcal

Answer 9

ABC (amoxicillin, benzypenicillin, cephlasporin)

Question 10

complications of staphylococcal

Answer 10

influenza virus, IV drug users, leukaemia, lymphoma, CF

Question 11

CXR of staphylococcal

Answer 11

bilateral bronchopneumonia

Question 12

treatment of staphylococcal

Answer 12

FV (fluloxacillin, Vancomycin)

Question 13

Klebsiella found in…

Answer 13

alcoholics, diabetics

Question 14

sputum of klebsiella

Answer 14

jelly red

Question 15

treatment of klebsiella

Answer 15

CI (cefuroximine, imipenem)

Question 16

pseudomonas common in…

Answer 16

bronchiectasis and CF

Question 17

treatment for pseudomonas

Answer 17

anti-pseudomal penicillin

Question 18

symptoms of mycoplasma

Answer 18

flu-like symptoms (headaches, myalgia, arthralgia) followed by dry cough, erthyema maliforme

Question 19

CXR of mycoplasma

Answer 19

reticular nodular shadowing or patchy consolidation of 1 lower lobe

Question 20

diagnosis of mycoplasma

Answer 20

serology

Question 21

complications of mycoplasma

Answer 21

erythema maliforme

Question 22

treatment of mycoplasma

Answer 22

clarithromycin, tetracycline

Question 23

legionella

Answer 23

holiday- water

Question 24

symptoms of legionella

Answer 24

flu-like symptoms then dry cough and dyspnoea, anorexia, hepatitis, renal failure

Question 25

CXR of legionella

Answer 25

bi-basal consolidation

Question 26

bloods of legionella

Answer 26

lymphopenia, hyponatraemia (decrease Na+)

Question 27

diagnosis of legionella

Answer 27

urinary antigen

Question 28

treatment of legionella

Answer 28

fluoroquinolone 2-3 weeks

Question 29

chlamydophila pneumoniae spread

Answer 29

person-person

Question 30

diagnosis of chlamydophila pneumoniae

Answer 30

serology

Question 31

treatment of chlamydophila pneumoniae

Answer 31

tetracycline

Question 32

chlamydia psittaci

Answer 32

birds

Question 33

symptoms of chlamydia psittaci

Answer 33

fever, dry cough, lethargy, arthralgia, anorexia

Question 34

chlamydia psittaci sputum

Answer 34

mucoid

Question 35

CXR of chlamydia psittaci

Answer 35

patchy consoliation

Question 36

treatment of chlamydia psittaci

Answer 36

doxycycline

Question 37

commonest cause of viral pneumonia

Answer 37

influenza

Question 38

PCP organism

Answer 38

pneumocystis carinu/jiroveci

Question 39

symptoms of PCP

Answer 39

fever, dry cough, extertional dyspnoea, decrease PaCO2, bilateral crepitations

Question 40

CXR PCP

Answer 40

normal/bilateral perihilar interstitial shadow

Question 41

diagnosis of PCP

Answer 41

sputum, lung biopsy

Question 42

treatment of PCP

Answer 42

high dose co-trimoxazole

Question 43

complications of pneumonia

Answer 43

1. pleural effusion
2. empyema
3. resp failure
4. hypotension
5. lung abcess
6. septicaemia (blood poisoning)

Question 44

CURB-65

Answer 44

Confusion (new)
Urea ≤ 7mmol/L
Resp rate ≥ 30/min
BP