Pneumonia

Question 1

What are the common examination findings?

Answer 1

Inspection - May look unwell - hot, sweaty, have a cough. May be sputum around the bed

Hands - Tachypnoea, tachycardia

Chest:

• Reduced chest expansion
• Increased TVF
• Dull percussion
• crackles and bronchial breathing with reduced breathe sounds. May have wheeze

Question 2

What are the investigations?

Answer 2

By the bed - History, obs, peak flow, spirometry and sputum. CURB 65 screen to determine treatment plan, cardiovascular exam

Bloods - FBC, CRP, U/E cultures, Urine for atypical, LFTS for atypical

Other - CXR, ECG, ABG for respiratory failure, also sputum culture

May want to initiate sepsis 6 protocol

Question 3

What are the key investigation findings?

Answer 3

CXR- Consolidation

ABG - T1RF

FBC - Raised WCC

Question 4

What is the treatment?

Answer 4

Conservative - Explain what is is going on and the need for regular obs

Medical - Abx due to local guidelines depending on CAP or HAP

CURB 65 will guide

MDT if serious enough
SEPSIS 6

Question 5

What are the causes

Answer 5

Many pathogens

S.Pneumoae

H.Influenzae

S.aureus

Legionella

Mycoplasma