pneumonia

Question 1

what the main pathogens causing CAP?

Answer 1

streptococcus pneumoniae

haemophilus influenzae

Question 2

what are the main pathogens that cause HAP>

Answer 2

S. Aureus
Klebsiella pneumoniae
P. aeruginosa

Question 3

what are atypical pneumonia pathogens and what is the difference in atypical pneumonia presentation?

Answer 3

mycolasma pneumoniae
chlamydophilia pneumoniae
legionella pneumoniae

a persistent cough that may come in fits throughout the day.
flu-like symptoms, such as fever, chill, or cold sweat.
a sore, dry, or itchy throat.
a persistent headache.
weakness or fatigue.
chest pain when breathing deeply.
aches and pains in the muscles and joints.

Question 4

what are the S&S of pneumonia?

Answer 4

fever 
SOB 
productive cough 
malaise 
pleuritic chest pain 

cyanosis
confusion
tachycardia, hypotension and tachypnoea

Question 5

on respiratory exam, which indicates consolidation?

Answer 5

decreased expansion
dull percussion
increased vocal resonance

Question 6

what are the InV for pneumonia?

Answer 6

CXR

• consolidation
• cavitation
• pleural effusion

O2 sats and ABG

FBC, U&Es, LFTs, CRP

• Increased WCC and CRP
• Increased urea

blood and sputum cultures

Question 7

how is severity of pneumonia assessed?

Answer 7

CURB65

Confusion 
Urea >7mmol/l 
RR > 30 
Blood pressure <90/60 
65 years or older 

0-1 = home treatment 
2 = hospital 
>3 = consider ICU

Question 8

how is pneumonia treated?

Answer 8

treat hypoxia and shock i.e 02 and fluids

analgesia

CURB 65 <2 = oral amox OR doxy

CURB 65 >3 = IV clarithromycin + IV amox
OR
IV Co-amoxiclav

IV/oral levofloxacin if suspected atypical