Pneumonia

Question 1

Most common cause of pneumonia?

Answer 1

Steptococcus pneumoniae

Question 2

Rheumatoid arthritis or amiodarone therapy can lead to what form of idiopathic pneumonia?

Answer 2

Cyptogenic organising pneumonia

Question 3

Which organism?

Accounts for 80% of cases
Most common cause of CAP
Particularly associated with:
-	high fever
-	rapid onset 
-	herpes labialis - cold sores
-	Pleuritic chest pain
- vaccine available

Answer 3

Streptococcus pneumoniae

Question 4

Common cause of pneumonia in COPD

Answer 4

Haemophilus influenzae

Question 5

What are two common atypical pneumonias?

Answer 5

Mycoplasma pneumonia

Legionella pneumophilia

Question 6

What symptoms do mycoplasma pneumonia and legionella pneumophilia share?

Answer 6

Atypical symptoms:

• Flu-like symptoms
• dry cough
• deranged LFTs

(treat both with macrolides e.g. erythromycin)

Question 7

How to differentiate legionella pneumonia and mycoplasma pneumonia?

Answer 7

Mycoplasma pneumonia = haemolytic anaemia, erthema mulitforme, encephalitis, GBS, Percarditis

Legionella pneumonia: hyponatraemia, lymphopenia

Question 8

What organism give pneumonia after a flu typically?

Answer 8

Staphylococcus aureus

Question 9

pnuemonia seen in alcoholics?

Answer 9

Klebsiella pneumoniae

Question 10

Causes Pneumonia in those with HIV?

Answer 10

Pneumocystis jiroveci/carcinni

Question 11

Features of PCP/PJP

Answer 11

Desaturation on exercise, dry cough

Question 12

CURB65 go!

Answer 12

Confusion (MMT ≤8/10)
Urea >7mmol/L
Resp rate≥30
SBP ≤90 &/or DBP ≤60
aged ≥65

0-1 mange at home
score ≥3 consider ICU assessment

Question 13

how to treat low-severity pneumonia (0-1)?

Answer 13

• Amoxicillin

- If penicillin allergic then macrolide or tetra cyclin

Question 14

Management of moderate to high severity pneumonia (2-5)

Answer 14

• Amoxicillin + macrolide (erythromycin/clarithromycin)

- Consider co-amoxiclav/ceftriaxone/piperacillin + tazobactam + macrolide if high severity