Pneumonia

Question 1

Pneumonia?

Answer 1

Infection of distal lung parenchyma, can be CAP, HAP, aspiration pneumonia, pneumonia in the immunocompromised

Question 2

What are parenchyma?

Answer 2

the portion of the lung involved in gas transfer - the alveoli, alveolar ducts and respiratory bronchioles.

Question 3

Pneumonia risk factors?

Answer 3

Age Smoking Alcohol Pre-existing lung disease (e.g. COPD) Immunodeficiency Contact with patients with pneumonia

Question 4

Pneumonia aetiology?

Answer 4

CAP; streptococcus pneumoniae

HAP; gram negative enterobacteria

Question 5

Pneumonia epidemiology?

Answer 5

5-11/1000 Community-acquired pneumonia is responsible for > 60,000 deaths per year in the UK

Question 6

Pneumonia symptoms?

Answer 6

fever, rigors, sweating, malaise, cough, sputum, breathlessness, pleuritic chest pain, confusion.

Question 7

Pneumonia signs?

Answer 7

Pyrexia, respiratory distress, tachypnoea, tachycardia, hypotension, cyanosis, decreased chest expansion, dull to percuss over affected area, increased tactile vocal fremitus over affected area, bronchial breathing over affected area, coarse crepitations on affected side.

Question 8

Pneumonia investigations?

Answer 8

FBC (raised WCC) U&Es, LFT, ABG, CXR, blood cultures.

Question 9

Pneumonia investigations CXR?

Answer 9

Lobar or patchy shadowing Pleural effusion

Question 10

Pneumonia management?

Answer 10

empirical antiobiotics (amoxicillin, erythromycin)

supportive; O2 and fluids. supportive treatment; O2, IV fluids, CPAP

Question 11

Pneumonia complications (7)?

Answer 11

Pleural effusion,

empyema,

localised suppuration (e.g. abscess),

symptoms of abscesses (Swinging fever, persistent pneumonia, copious/foul-smelling sputum),

septic shock,

ARDS,

acute renal failure.