Pneumonia

Question 1

Immunocompetant risk factors 5m

Answer 1

1. Viral upper respiratory tract infection
2. Ethanol abuse
3. Cigarette smoking
4. Heart failure
5. Chronic obstructive pulmonary disease

Question 2

Immunosupressed likely risk factors 3m

Answer 2

• AIDS
• Malignancy - leukemia and lymphoma

Question 3

Three methods of respiratry tract infection 3

Answer 3

1. Inhalation - small aerosole droplets
2. aspiration from the oropharynx through the lanrynx
3. blood - rare - staphylococcus

Question 4

Staphyloccus aureus -Three major settings in which this organism is seen as a cause of pneumonia are

Answer 4

1) as a secondary complication of respiratory tract infection with the influenza virus;
(2) in the hospitalized patient, who often has some impairment of host defense mechanisms and whose oropharynx has been colonized by Staphylococcus;
(3) as a complication ofwidespread dissemination of staphylococcal organisms through the bloodstream.

Question 5

Gram positive and gram negative

Answer 5

ability to retain crystal violet staining

Question 6

which gram-negative organisms are potential causes of pneumonia and state why? 6m

Answer 6

Haemophilus influenzae, a small coccobacillary gram-negative organism, is often found in the nasopharynx of normal individuals and in the lower airways of patients with COPD

pneumonia in children and adults

Klebsiella - GI alcoholism

Pseudomonas aeroginosa - hospital environments - antibiotic treatment

Question 7

give examples of gram positive pneumonia 2

Answer 7

Streptococcus pn pneumococcus

staphylococcus aureus

Question 8

List types of patients who will physically have increased risk to aspiration pn 3m

Answer 8

impaired consciousness (e.g., as a result of coma, alcohol or drug ingestion, or seizures) and those with difficulty swallowing (e.g., as a result of stroke or diseases causing muscle weakness) are prone to aspirate and are at risk for pneumonia caused by anaerobic or mixed mouth organisms. In addition, patients with poor dentition or gum disease are more likely to develop aspiration pneumonia because of the larger burden of organisms in their oral cavity.

Question 9

state a clinical and teo radiographic features of Atypical pneumonia

Answer 9

white cell count normal

cxr nonspecific findings sometimes multilobar involvement or pleural effusion

Question 10

State a state causative organism for HAP, CAP, atypical 3m

Answer 10

HAP - Staphylococcal pn

CAP - pneumococcal pn

atypical - mycoplasma or legionella

Question 11

State the typical clinical fetures of typical pn 4m

Answer 11

1. increased fever
2. rapic onset
3. sweats and chills
4. productive cough

Question 12

State the organisms likely to attribute to lobar pn 4m

Answer 12

1. Streptococcal pn
2. klebsiella
3. legionalla
4. pneumophilia

Question 13

List the charactics of Bronchopneumonia? 3m

Answer 13

1. Air bronchogram rare - N O
2. patchy consolidation - multifocal
3. Can cavitate because of necrosis
4. volume loss in affacted lobes

Question 14

Complication of bacterial pneuminias? 4m

Answer 14

1. Lung abscess
2. pneumatocele
3. Empyema
4. invasion of chest wall

Question 15

FILL IN THE BOXES 12M

Answer 15

Question 16

Typically how long does it take to develope ventilator assisted pn? 1m

What percentage range of patients tend to acquire this form on pn? 1

Answer 16

48 hours including intubation

8-24%

Question 17

Give examples of Ventilator assisted pneumonias? 3m

Answer 17

These tend to be drug resistet

MRSA - increasingly more common

Enterobacter

pseudomonas Aeruginosa

Question 18

State the clinical symtoms of Legionella 3

Answer 18

Systemic

Lower respiratory symtoms

renal defieciency

myalgia

shortness of breath

headache, malaise

cconfusion

nausea

diarrhea, or abdominal pain)

Question 19

State the organism responsible for interstitial pneumonia? 1m

Answer 19

Pneumocystic Jiroveci pnaumonia or pnrumocystis carinii PCP

• rats/ rodants

Homosexual males and iv drug users

Question 20

Sta the radiographic appearences for PCP 5m

Answer 20

1. small pneumatoceles
2. subpleural blebs
3. fine reticular interstitial changes
4. predominantly perihilar in distribution

Pleural effusions are normally not a feature, seen in less than 5% of cases

Question 21

State organisms that spread haematogenously to cause Pn? and the patient group usually seen with this feature 2m

Answer 21

Staphylecoccus aureus

IV drug users

Question 22

State the radiographic appearence of haematogenous pneumonia? 3m

Answer 22

Mid to lower zone poorly defined nodular shadowing

Frequent cavitation

Necrosis - caused by impeaded pulmonary supply

Hamptons hump wedge shape consolidation - subpleural

localise haemorrhage