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TCD Cases > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What is the most common causative organism of community acquired pneumonia?

A

Streptococcus Pneumonia

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2
Q

What are the 4 common clinical features associated with pneumonia?

A
  1. Cough
  2. Breathlessness
  3. Fever
  4. Chest pain
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3
Q

Pneumonia due to which 2 infective organisms are particularly associated with myalgia and arthralgia?

A
  1. Legionella

2. Mycoplasma

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4
Q

Outline the white cell derangements associated with a bacterial or viral infection respectively

A

Bacterial - neutrophilia

Virus - Neutropenia

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5
Q

Name a fungi that can cause pneumonia

A

Pneumocystis Jiroveci

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6
Q

What infective organism most commonly causes pneumonia in patients with COPD?

A

Haemophilus Influenza

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7
Q

Name the organism most likely to cause pneumonia in alcoholics

A

Klebsiella Pneumonia

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8
Q

What are the 3 main signs heard on auscultation that are associated with pneumonia?

A
  1. Reduced breath sounds
  2. Bronchial breathing
  3. Coarse crackles
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9
Q

Recall the components of the CURB-65 scoring system

A

C - Confusion (AMT < 8/10)
U - Urea > 7mmol/L
R - Respiratory Rate > 30 breaths per minute
B - Blood pressure: systolic < 90, diastolic < 60

65 - Aged > 65

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10
Q

What are the 4 classical features of pneumococcal pneumonia?

A
  1. Rapid onset
  2. High Fever
  3. Pleuritic chest pain
  4. Herpes Labialis
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11
Q

Give 4 clinical characteristics associated with Legionella pneumonia

A
  1. Atypical Chest signs
  2. Dry cough
  3. Hyponatraemia
  4. Lymphopenia
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12
Q

What type of microbe is clostridium difficile?

A

Gram positive rod

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13
Q

What is the name of the syndrome that can be caused by C.diff exotoxin?

A

Pseudomembranous colitis

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14
Q

Which antibiotics are now thought to be the leading cause of C.diff infections in hospitals?

A

Second and third generation cephalosporins

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15
Q

Aside from antibiotics, give another drug type that can increase an individuals risk of a C.diff infection

A

Proton pump inhibitors

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16
Q

What is the first line therapy for C.diff infection

A

10-14 days of metronidazole

17
Q

Strep. Pneumonia menignitis commonly affects which age group?

A

3 months - 6 years

18
Q

What is the first line antibiotic used in the treatment of atypical pneumonias?

A

Clarithromycin

19
Q

What is the first line treatment for pneumocystis jiroveci Pneumonia?

A

Co- trimoxazole

20
Q

Name a common complication of pneumocystis jiroveci pneumonia

A

Pneuomothorax

21
Q

List 3 possible extra pulmonary manifestations of pneumocystis jiroveci pneumonia

A
  1. Hepatosplenomegaly
  2. Lymphadenopathy
  3. Choroid lesions
22
Q

How does the CURB-65 score correspond to the risk of mortality at 30 days?

A

0-1 - < 5% mortality rate
2-3 - <10%
4-5 - 15-30%

23
Q

Give 3 inflammatory markers to look at when deciding whether an infective exacerbation of COPD requires antibiotics

A
  1. Wheeze
  2. Breathlessness
  3. Increased eosinophil count
24
Q

Compare the aetiology of community and hospital acquired pneumonias

A

Community - Gram positive bacteria, Mycoplasma, influenza

Hospital - Gram negative bacteria, Staph Aureus

25
Q

Outline the main clinical findings seen in CAP (6)

A
  1. Pyrexia
  2. Tachypnoea
  3. Dull to percussion
  4. Bronchial breathing
  5. Focal crackles
  6. Mental confusion
26
Q

Patients with CAP that can be treated at home are given which antibiotic?

A

Amoxicillin

27
Q

Define empyema

A

Pus in the pleural space

28
Q

In suspected bacteraemia, how many blood culture samples should be taken?

A

Two sets of two bottles should be taken at different times and different sites.
NB/ 3 cultures should be taken in cases of infective endocarditis and PUO (pyrexia of unknown origin)

29
Q

Recall 3 organisms that are considered to have multi drug resistance

A
  1. Extended spectrum beta lactamases
  2. Carbapenemases (CPE, KPC)
  3. Colistin resistant E.Coli
30
Q

Name 2 organisms that can be investigated via urine antigen analysis

A
  1. Pneumococcus

2. Legionella

31
Q

What is beta-D-glucan and how is useful?

A

Used for the investigation of potential fungal infections. It is a pan fungal cell wall component released into the blood during invasive fungal infections (v.high sensitivity but not specific

32
Q

Name the 4 serological markers used to identify the different phases of a HBV infection

A
  1. Hepatitis B surface antigen
  2. Hepatitis B surface antibody
  3. Total hepatitis B core antibody
  4. IgM antibody to hepatitis B core antigen
33
Q

Name 2 drugs that can lead to re-activation of TB

A
  1. Infliximab

2. Corticosteroids

34
Q

Rifampicin is commonly associated with which adverse effect?

A

Hepatotoxicity

TCD Cases (25 decks)

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