pneumonia

Question 1

what is pneumonia

Answer 1

an infection that can inflame the air sacs, causing them to fill with pus and fluid (not always) - not contagious

Question 2

what are the 3 classes of pneumonia

Answer 2

clinical eg community, organisms, morphology eg lobar

Question 3

what is the pathology of pneumonia

Answer 3

acute immune system (macrophages, neutrophils etc), immune system can become involved

Question 4

who is at risk of pneumonia

Answer 4

elderly, immunocompromised, COPD, aspiration of gastric contents, cardiac failure

Question 5

what is lobar pneumonia

Answer 5

consolidation affecting a complete lung lobe

Question 6

what is bronchopneumonia

Answer 6

starts in bronchi and bronchioles and spreads to adjacent alveoli

Question 7

what are symptoms of pneumonia

Answer 7

cough +/- green sputum, difficulty breathing, tachycardia, fever, chest pain, malaise, haemoptysis, crackles, abdo pain

Question 8

what are complications of pneumonia

Answer 8

empyema, bronchiectasis (fixed opening of airway), lung abscess

Question 9

what are the investigations for pneumonia

Answer 9

CXR for consolidation bloods, serology, CURB65

Question 10

what is the criteria for CURB65

Answer 10

confusion, urea >7, Resp >30, BP < 90/60, over 65 (3 or more)

Question 11

what is the most common cause of pneumonia and how do you treat it

Answer 11

strep pneumonia - penicillin

Question 12

what can cause pneumonia in COPD commonly

Answer 12

haem infleunza

Question 13

what can infect post influenza

Answer 13

staph aureus

Question 14

name some atypical causes of pneumonia

Answer 14

Chlamydophila Psitacci, - Coxiella Burnetti, - Legionella pneumophilia, Pneumocystis (Jiroveci

Question 15

what can cause chlaymidia psitacci

Answer 15

birds

Question 16

what can cause coxiella burnetti

Answer 16

sheep/ goats (farmers)

Question 17

what can cause legionella and what symptoms may present

Answer 17

air con (eg holiday to hot country), lots of GI symptoms

Question 18

what type of patient is likely to get Pneumocystis (Jiroveci

Answer 18

immunocomprised

Question 19

when is pneumonia hospital acquired

Answer 19

more than 3 days

Question 20

if curb65 is less than 2 for CAP what is given + what If pen allergy

Answer 20

amoxicillin (doxy)

Question 21

if curb65 is 3-5 what treatment is given + what If pen allergy

Answer 21

Co-amoxiclav (levofloxacin) + PO doxycyline

Question 22

in non severe HAP, what treatment is given + what If pen allergy

Answer 22

amoxicillin (doxy)

Question 23

In severe HAP what treatment is given + what If pen allergy

Answer 23

IV amox (co-tramoxazole) + metro

Question 24

in HAP non-severe aspiration what is given + what If pen allergy

Answer 24

metro + amox (doxy)

Question 25

in HAP severe aspiration what is given

Answer 25

metro + gent + amox