Pneumonia

Question 1

What’s pneumonia?

Answer 1

Consolidation and inflammation of lung tissue(alveoli and parenchyma) due to an infectious agent.

Question 2

Etiology of Pneumonia

Answer 2

Bacteria: streptococcus pneumonia(commonest), chlamydia pneumonia,neisseria meningitides, klebsiella pneumonia

Viruses: influenza virus, adenovirus, rhinovirus coronavirus

Fungi: pneumocystic pneumonia,
Mycoplasma pneumonia

Question 3

Etiology of Pneumonia in neonates

Answer 3

Streptococcus pneumonia,E.Coli, chlamydia trachomatis, respiratory syncytial virus

Question 4

Etiology of Pneumonia in infants (1-5yrs)

Answer 4

Streptococcus pneumonia, staph aureus, H. influenza, Listeria Monocytogens

Question 5

Etiology of Pneumonia in young children

Answer 5

Streptococcus pneumonia,mycoplasma

Question 6

Pathogensis of Pneumonia and it’s phases

Answer 6

So after it gets into the body, there’s CONGESTION then the Parenchyma cells go through what we call RED HEPATIZATION. Then the white blood cells start to fight the infection giving the colour of GREY HEPATIZATION and lastly RESOLUTION (where we hear crackles)

Question 7

Symptoms of pneumonia

Answer 7

Cough with PURULENT sputum 
Dyspnea
Malaise 
Pleuritic chest pain
Hemoptysis 
Fever with chills 
Headache , nausea and vomiting

Question 8

Classification of Pneumonia

Answer 8

Based on means of acquisition:

• Community acquired
• Hospital acquired( ventilator acquired and health care acquired)
• Aspiration pneumonia
• Recurrent pneumonia

Based on infectious agent:

• Bacterial
• Fungal
• Viral
• Parasitic

Based on area affected:

• Lobar pneumonia
• Bronchopneumonia
• interstitial

Based on period

• acute
• chronic

Question 9

Risk factors for Pneumonia, adults

Answer 9

For adults:
HIV 
Tobacco smoking 
Alchoholism 
Chronic disease - chronic kidney disease , DM 
Structural lung disease 
Injection drug use 
Malignancies 
Immunosuppressive drugs
Loss of consciousness and aspiration 
Seizures

Question 10

Risk factors for Pneumonia, children

Answer 10

It’s common in males  
Immunosuppression
Severe malnutrition 
Lack of immunization
Sickle cell disease HIV and AIDS
Low birth weight
Social economic factors
Environmental factors
Co morbidities like congenital heart disease

Question 11

Investigations for pneumonia

Answer 11

Physical exam 
Chest X-ray 
Sputum culture
FBC
Serum EUCr
Arterial blood gas 
PCR

Question 12

On physical exam in pneumonia, we see?

Answer 12

Fever , cyanosis, tachypnea, reduced chest expansion, dull percussion note , increased tactile and vocal fremitus , egophony, crackles

Question 13

Mgt of pneumonia

Answer 13

IV fluids
Oxygen therapy 
Antibiotics with culture specific 
Analgesics 
Chest physiotherapy

Question 14

Complications of pneumonia

Answer 14

Pulmonary: lung abscess, empyema, pleural effusion

Extra pulmonary: septic abscess, septicemia, endocarditis, pericarditis

Question 15

What is CURB-65?

Answer 15

C – confusion, 
U – urea >7mmol/L, 
R – respiratory rate >30, 
B – blood pressure of less than 90 systolic or less than 60 diastolic and 
65 – age of 65 or above

criteria is a clinical prediction rule validated and recommended by the British Thoracic Society for assessing the severity of community-acquired pneumonia.

The score ranges from 0 to 5 and a score of 1 or 0 can be given if each of the above risk factors are present or not, respectively.

A score between 0 and 1 indicates that the patient may be treated as an outpatient. Patients with a score of 2 may be considered for a short stay in hospital with outpatient follow up. Scores between 3 and 5 indicate severe pneumonia and hospitalization with the possibility of escalation to intensive care being required. The a CURB-65 score of 4 indicates a severe pneumonia and a mortality risk of 15–50 per cent