pneumonia

Question 1

types of pneumonia?

Answer 1

Community acquired pneumonia (CAP)
Atypical pneumonia
Hospital acquired (Nosocomial) pneumonia
Aspiration and anaerobic pneumonia
Pneumonia in the immunocompromised host
Recurrent pneumonia

Question 2

most common pneumonia causing bacteria?

Answer 2

Strep pneumoniae 60-75%
Mycoplasma 5-10%
H.influenzae 2-4%
Legionella 2-5%
Viral causes 5-10%

Question 3

seasons for viruses?

Answer 3

Question 4

gram negative pneumo

Answer 4

Gram -ve rods
Klebsiella
Pseudomonas sp
E coli
Proteus sp
Staph aureus

Question 5

pnauemonia investigations?

Answer 5

Chest X ray
FBC establish white blood cell count
Liver function tests
Arterial gases ~ hypoxaemia to respiratory failure
Sputum ~ Gram smear, culture & sensitivities
Sputum ~ AAFB
Blood ~culture
Serology ~ legionella / mycoplasma / viruses
Blood &urine ~ pneumococcal antigen

Question 6

pneumonia screen?

Answer 6

CURB - 65

Confusion
Urea >7.0 mmol/l
Respiratory rate >30/min
Blood pressure diastolic <60 or systolic <90mmHg
65 >age 65

Score 1 for each option if present
0-1 low risk, 2 moderate risk, 3+ high risk

Question 7

pneumonia treatment?

Answer 7

Influenza ~ add in flucloxacillin
Atypicals ~ add in a macrolide

Supportive measures
Fluids IV
Oxygen, ventilation
Pain relief

Question 8

severity testing?

Answer 8

Clinical
>65 years, >30 breaths/min, diastolic BP <60mmHg

Laboratory
leucocytosis >20x109/L
leucopenia <4x109/L
albumin <35g/L
hypoxaemia PaO2 <8kPa
urea >7.0 mmol/l
multi-lobar involvement
bacteraemia

Question 9

pneumonia complications?

Answer 9

parapneumonic pleural effusion 30-50%
empyema/ lung abscess <1%
respiratory failure <5%