Pneumonia

Question 1

What is pneumonia?

Answer 1

A lower respiratory tract infection

Question 2

How does Pneumonia present?

Answer 2

Focal chest symptoms and new shadowing on CXR

Question 3

Symptoms of Pneumonia?

Answer 3

Fever
Malaise
Productive Cough
Anorexia
Sweating
Dyspnoea
Rigors

Question 4

Describe expansion in Pneumonia?

Answer 4

Diminished

Question 5

Describe percussion in pneumonia?

Answer 5

Dull

Question 6

Describe resonance in pneumonia?

Answer 6

Increased

Question 7

Describe the CXR

Answer 7

New shadowing

Question 8

Describe the breathing?

Answer 8

Bronchial Breathing (Due to consolidation)

Question 9

Investigations of Pneumonia?

Answer 9

FBC
CXR
ABGs
Urea
Sputum/Blood Cultures/Bronchial Lavage

Question 10

Results of Investigations?

Answer 10

CXR = New Shadowing
FBC = High WCC
ABGs = Type1/Type2 Respiratory Failure
Urea = Look for legionella
Blood Culture/Sputum/Bronchial Lavage = Identify causative agents

Question 11

Complications of pneumonia?

Answer 11

Respiratory Failure
Empyema
Pleural Effusion
Death

Question 12

How is Community Acquired Pneumonia assesed?

Answer 12

CURB 65

Question 13

What does CURB 65 stand for?

Answer 13

C = Confusion (New Onset)
U = Urea > 7
R = Respiratory Rate > 30
B = Blood Pressure

Question 14

Most common organism in Community Acquired Pneumonia?

Answer 14

Streptococcus Pneumonia

Question 15

Most common pneumonia causing agent in the young?

Answer 15

Mycoplasma Pneumonia

Question 16

Most common pneumonia causing agent in the old?

Answer 16

Streptococcus Pneumonia

Question 17

Most common pneumonia causing agent in bird owners?

Answer 17

Chlamydia Psittaci

Question 18

Most common pneumonia causing agent in Sheep Workers?

Answer 18

Coxiella Burnetti

Question 19

Most common pneumonia causing agent that causes red jelly sputum?

Answer 19

Klebsiella Pneumoniae

Question 20

Most common pneumonia causing agent that causes rusty sputum?

Answer 20

Pneumococcal Pneumonia?

Question 21

Most common pneumonia causing agents that causes COPD exacerbation?

Answer 21

Streptococcus Pneumonia

Haemophilus Influenzae

Question 22

Most common pneumonia causing agents in travellers?

Answer 22

Legionella Pneumophila

Question 23

Treatment in Mild Community Acquired Pneumonia? (0-2)

Answer 23

Amoxicillin IV

Question 24

Treatment in Mild Community Acquired Pneumonia (0-2) if pencillin allergy?

Answer 24

Doxycycline OR Clarithromycin

Question 25

Treatment in Severe Community Acquired Pneumonia (2+)

Answer 25

Co-amoxiclav + Clarithromycin OR Doxycycline

Question 26

Treatment in Severe Community Acquired Pneumonia if Pencillin allergic?

Answer 26

Levofloxacin

Question 27

Describe the risk factors for hospital acquired Pneumonia?

Answer 27

``` Malnutrition Age Chronic Disease Immunosuppression Mechanical Ventilation ```

Question 28

Early onset organisms of hospital acquired pneumonia? (less than 4 days)

Answer 28

Streptococcus Pneumoniae Haemophilus Influenza Staph Aureus

Question 29

Late onset organisms of hospital acquired pneumonia? (more than 4 days)

Answer 29

Streptoccous Pneumoniae Haemophilus Influenza Staph Aureus Klebsiella Pneumoniae

Question 30

Treatment for non severe Hospital Acquired Pneumonia?

Answer 30

Amoxicillin + Metronidazole

Question 31

Treatment for severe Hospital Acquired Pneumonia?

Answer 31

Amoxiciilin + Metronidazole + Gentamicin

Question 32

Treatment for Severe Hospital Acquired Pneumonia if penicillin allergic?

Answer 32

Co-trimoxazole + Metronidazole + Gentamicin

Question 33

Different between non severe and severe hospital acquired pneumonia treatment?

Answer 33

Gentamicin is given in severe

Question 34

Difference between severe and severe + penicillin allergy hospital acquired pneumonia?

Answer 34

Amoxiciilin in normal | Co-trimoxazole in penicillin allergy

Question 35

Patient comes in with mild community acquired pneumonia... Treatment?

Answer 35

Amoxicilin

Question 36

Patient comes in with mild community acquired pneumonia and they are penicllin allergic.. Treatment?

Answer 36

Doxycycline

Question 37

Patient comes in with severe community acquired pneumonia... Treatment?

Answer 37

Co-Amoxiclav + Clarithromycin or Doxycycline

Question 38

Patient comes in with severe community acquired pneumonia and pencillin allergy.. Treatment?

Answer 38

Levofloxacin

Question 39

Patient with mild hospital acquired pneumonia... Treatment?

Answer 39

Amoxicillin and Mentronidazole

Question 40

Patient with severe hospital acquired pneumonia... Treatment?

Answer 40

Amoxicillin + Metronidazole + Gentamicin

Question 41

Patient with hospital acquired pneumonia and pencillin allergy... Treatment?

Answer 41

Same as normal except replace Amoxicillin with Co-trimoxazole