Pneumonia

Question 1

Mild community acquired pneumonia (CURB score of 0 or 1)

Answer 1

PO Amoxicillin (Doxycycline if penicillin allergic)

Question 2

Moderate community acquired pneumonia (CURB score of 2)

Answer 2

PO Amoxicillin and clarithromycin

Question 3

Severe community acquired pneumonia (CURB score of 3 or more)

Answer 3

IV Co-amoxiclav (and/or doxyclycline)

Question 4

Non-severe hospital acquired pneumonia

Answer 4

PO Amoxicillin and metronidazole

Question 5

Severe hospital acquired pneumonia

Answer 5

IV amoxicillin, metronidazole and gentamicin

Question 6

Common organisms of community acquired pneumonia

Answer 6

Strep. pneumoniae, Haemophilus influenzae (Mycoplasma pneumoniae)

Question 7

Common organsims of hospital acquired pneumonia

Answer 7

gram negative bacilli, pseudomonas, anaerobes

Question 8

Atypical pneumonias: Staph. aureus symptoms

Answer 8

bilateral cavitating bronchopneumonia

Question 9

Atypical pneumonias: Staph. aureus risk factors

Answer 9

PWID, leukaemia, lymphoma, CF

Question 10

Atypical pneumonias: Staph. aureus treatment

Answer 10

flucloxacillin and/or rifampicin (vancomycin if MRSA suspected)

Question 11

Atypical pneumonias: Klebsiella symptoms

Answer 11

aspiration, cavitiating pneumonia, often in the upper lobes, often drug resistant

Question 12

Atypical pneumonias: Klebsiella risk factors

Answer 12

alcoholic, elderly, diabetic

Question 13

Atypical pneumonias: Klebsiella treatment

Answer 13

Cefotaxime (or imipenem)

Question 14

Atypical pneumonias: Pseudomonas risk factors

Answer 14

common in patients with CF or bronchiectasis, can be hospital acquired

Question 15

Atypical pneumonias: Pseudomonas treatment

Answer 15

Ciprofloxacin and gentamicin

Question 16

Atypical pneumonias: Which organism causes epidemics every few years?

Answer 16

Mycoplasma pneumoniae

Question 17

Atypical pneumonias: What signs would you see on a CXR in Mycoplasma pneumoniae?

Answer 17

reticular nodular shadowing or patchy consolidation often in one lower lobe

Question 18

Atypical pneumonias: Mycoplasma pneumoniae treatment

Answer 18

clarithromycin, doxycycline or ciprofloxacin

Question 19

Atypical pneumonias: symptoms of legionnaires disease

Answer 19

Flu like symptoms, cough, dyspnoea, anorexia, D and V, hepatitis, renal failure, coma.
CXR shows bi-basal consolidation

Question 20

Atypical pneumonias: treatment of legionnaires disease

Answer 20

ciprofloxacin or clarithromycin

Question 21

Atypical pneumonias: Chlamydia treatment

Answer 21

doxyclycline or clarithromycin

Question 22

Atypical pneumonias: Pneumocystis symptoms

Answer 22

Dry cough, exertional dyspnea, decreased PaO2, fever, bilateral crepitations

Question 23

Atypical pneumonias: Pneumocystis risk factors

Answer 23

immunosuppresion

Question 24

Atypical pneumonias: Pneumocystis treatment

Answer 24

co-trimoxazole