Pneumonia

Question 1

What is pneumonia? Give some key symptoms.

Answer 1

. Inflammation of the lung parenchyma, which mainly affects the alveoli
–> Empyema and consolidation
. Symptoms include coughing, chest pain, tachycardia, fever

Question 2

What causes pneumonia? What is the most common cause?

Answer 2

. Bacteria or viruses which infect the upper respiratory tract, then cause damage and inflammation in the alveoli
. Most commonly caused by streptococcus pneumonia bacteria

Question 3

Why does pneumonia cause breathlessness?

Answer 3

Consolidation occurs when the alveoli fill with fluid and white blood cells in order to try and clear the infection. This means less oxygen is able to diffuse from the alveoli into the bloodstream.

Question 4

How do alpha-blockers treat prostate enlargement?

Answer 4

They relax muscles in the bladder and prostate in order to start urine flow

Question 5

How could be a chest x-ray be used to test for pneumonia?

Answer 5

A chest x-ray would show consolidation in the lungs if a patient had pneumonia. This is visible as white patches on the lungs.

Question 6

How could blood and sputum tests help you determine if a patient had pneumonia?

Answer 6

From the blood and sputum samples, you can identify the bacteria present and their sensitivity to certain antibiotics.

Question 7

Why is a urine test done for suspected pneumonia patients?

Answer 7

To check for pneumococcal antigens

Question 8

Which organ produces c-reactive protein? What does this protein indicate?

Answer 8

The liver produces c-reactive protein to increase inflammation in the body in response to infection

Question 9

What is enoxaparin?

Answer 9

Anticoagulant used to treat angina

Question 10

What is blind/empiric antibiotic therapy?

Answer 10

When a patient is prescribed a general selection of antibiotics based on a clinical educated guess, when the doctor isn’t sure of the specific bacteria present (gram positive/negative) and when you don’t know which antibiotics will work or not. Used when there’s not a confirmed diagnosis.

Question 11

What is clarithromycin?

Answer 11

Antibiotic used to treat chest infections. Often used as replacement to penicillin (like amoxicillin) if recipient is allergic to penicillin.

Question 12

What are the active ingredients of co-amoxiclav?

Answer 12

Amoxicillin and clavulanic acid

Question 13

Name one enzyme that bacteria have that humans don’t have (the one targeted by antibiotics)

Answer 13

DNA gyrase

Question 14

What are gram positive bacteria? What colour do they stain?

Answer 14

. Have thick peptidoglycan cell wall
. Stained dark purple because their thick cell wall catches the stain after it is washed away from the rest of the sample

Question 15

What are gram negative bacteria? What colour do they stain?

Answer 15

. Thin cell wall sandwiched between inner and outer cell membrane
. Stain red-pink because they don’t retain the purple stain after the decolourisation step. The alcohol in this step degrades the outer membrane, which makes the cell wall too porous to retain the stain
. Take up the red/pink counterstain

Question 16

Which type of bacteria (gram positive or gram negative) are more affected by antibiotics?

Answer 16

Gram positive bacteria are more affected because they don’t have an outer membrane (even though they have a thicker cell wall)

Question 17

Give two examples of macrolides.

Answer 17

Erythromycin and clarithromycin

Question 18

Who is at increased risk of contracting community-acquired pneumonia (CAP)?

Answer 18

Children, the elderly, those with chronic conditions (e.g. COPD), or those with weakened immune systems

Question 19

What is the maximum dose of paracetamol?

Answer 19

4g in 24 hours

Question 20

What does 7/7 mean on a prescription?

Answer 20

Take every day for a week

Question 21

Why may antibiotic treatment for pneumonia not work?

Answer 21

The pneumonia may be caused by a virus, in which case antiviral treatment would be needed. Also, there could be antibiotic resistance. It is also difficult to treat pneumonia in people with COPD or chronic conditions like this.

Question 22

Where is the upper respiratory tract?

Answer 22

Above the vocal cords

Question 23

Where is the lower respiratory tract?

Answer 23

Below the vocal cords?

Question 24

Is pneumonia an upper or lower respiratory tract infection?

Answer 24

Lower respiratory tract infection

Question 25

Why is chest pain a symptom of pneumonia?

Answer 25

The pleura of the lungs have lots of nerve endings. When the pleura are inflamed, chest pain is felt.

Question 26

What is normal oxygen saturation in a healthy individual?

Answer 26

Above 95%. Below 92% is considered hypoxic.

Question 27

What is a CURB score? When is the score considered severe?

Answer 27

Shows severity of pneumonia. Score of 4 or 5 ( out of 5) is considered severe.

Question 28

Give one long term consequence of pneumonia?

Answer 28

Bronchiectasis affecting the previously infected regions

Question 29

What is bronchiectasis?

Answer 29

Scarred airways inflamed with thick mucus. Airways become widened and can’t clear properly, which means that mucus builds up and bacterial infections are more likely to occur.

Question 30

How is pneumonia clinically prevented?

Answer 30

Pneumonia vaccine