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Respiratory > Pneumonia and tuberculosis > Flashcards

Pneumonia and tuberculosis Flashcards

1
Q

What are the most common causes of lobar pneumonia?

A

Streptococcus pneumoniae

Klebsiella pneumoniae

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2
Q

What are the most common causes of bronchopneumonia?

A

Staphylococcus aureus

Haemophilus influenzae

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3
Q

Give 3 causative organisms of atypical pneumonia

A

Mycoplasma
Legionella
Chlamydia

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4
Q

Give 4 causative organisms of aspiration pneumonia

A

Streptococcus pneumoniae
Staphylococcus aureus
Pseudomonas aeruginosa
Klebsiella pneumoniae

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5
Q

What is the most common cause of community-acquired pneumonia?

A

Streptococcus pneumoniae

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6
Q

Give 3 presenting features of pneumonia caused by Strep. pneumoniae

A

Rapid onset fever
Pleuritic chest pain
Herpes labialis

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7
Q

Which groups are particularly at risk of pneumonia caused by Klebsiella pneumoniae?

A

Diabetics

Alcoholics

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8
Q

What type of sputum suggests pneumonia caused by Klebsiella pneumoniae?

A

Redcurrant jelly sputum

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9
Q

Klebsiella pneumoniae affects which lobes most often?

A

Upper lobes

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10
Q

Which pneumonia-causing organisms are particularly capable of causing abscess and empyema formation?

A

Staphylococcus aureus

Klebsiella pneumoniae

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11
Q

Give 2 presenting features of Mycoplasma pneumonia?

A

Erythema multiforme

Haemolytic anaemia

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12
Q

Give 3 complications of Mycoplasma pneumonia

A

Pericarditis
Renal failure
Neurological problems

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13
Q

What organism commonly causes exacerbations of COPD and bronchiectasis?

A

Haemophilus influenzae

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14
Q

How is Chlamydia psttaci transmitted?

A

Bird urine and faeces

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15
Q

Give 3 presenting features of Chlamydia pneumonia?

A

Conjunctivitis
Headache
Organomegaly

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16
Q

Does Chlamydia pneumonia respond to penicillins?

A

No

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17
Q

What test can be useful in diagnosing Legionella or pneumococcal pneumonia?

A

Urine antigen testing

18
Q

What test can be useful in diagnosing Mycoplasma pneumonia?

A

Serology

19
Q

Give 3 features of empyema fluid

A

pH<7.2
Low glucose
Raised LDH

20
Q

Which antibiotic can cause cholestatic jaundice?

A

Co-amoxiclav

21
Q

How is an empyema treated?

A

Chest drain

22
Q

What are the 5 components of CURB65?

A 
Confusion
Urea>7
RR 30+
SBP 90 or less OR DBP 60 or less
Age>65
23
Q

What is the appropriate management for community-acquired pneumonia, CURB65 0-1?

A

5 days outpatient oral amoxicillin +/- clarithromycin (doxycycline if allergic to penicillin)

24
Q

What is the appropriate management for community-acquired pneumonia, CURB65 2?

A

Admit to hospital
Oral amoxicillin and clarithromycin
Add IV vancomycin if MRSA

25
Q

What is the appropriate management for community-acquired pneumonia, CURB65 3+?

A

IV co-amoxiclav AND clarithromycin
Consider ITU assessment
Add vancomycin if MRSA

26
Q

What is the appropriate management for low severity hospital-acquired pneumonia?

A

Oral co-amoxiclav (clarithromycin if allergic to penicillin, doxycycline if MRSA risk)

27
Q

What is the most appropriate management for high severity hospital-acquired pneumonia not requiring critical care?

A

IV co-amoxiclav +/- gentamicin (add vancomycin if MRSA)

28
Q

What is the most appropriate management for high severity hospital-acquired pneumonia requiring critical care?

A

IV piperacillin-taxobactam (add vancomycin if MRSA)

29
Q

What type of immune response is triggered by Mycobacterium tuberculosis?

A

TH1 response

30
Q

What is a Ghon focus?

A

A tuberculous caseating granuloma with macrophages

31
Q

What is a Ghon complex?

A

Ghon focus plus hilar lymph node

32
Q

Which part of the lung is most affected by secondary TB?

A

Apex of lung (due to high oxygen and poor lymphatic drainage)

33
Q

Give 4 examples of extrapulmonary manifestations of TB

A

Tuberculous meningitis
Pott’s disease (TB in vertebral bodies)
Urogenital TB
Miliary TB

34
Q

What does the size of the hypersensitivity reaction due to a Mantoux skin test indicate?

A

Current infection OR past infection/BCG vaccination

35
Q

Give 2 groups of people where an IFN-gamma test is more accurate than a Mantoux test for TB screening

A

Babies

HIV positive patients

36
Q

Which investigation is first-line in suspected TB?

A

Sputum smear stain for acid-fast bacilli (e.g. Ziehl-Neelsen stain)

37
Q

Give 4 drugs used to manage TB

A

Rifampicin
Isoniazid
Ethambutamol
Pyrazinamide

38
Q

For how long are ethambutamol and pyrazinamide given for TB?

A

2 months

39
Q

For how long are rifampicin and isoniazid given for TB?

A

6 months

40
Q

What is the definition of MDR-TB?

A

TB resistant to at least rifampicin and isoniazid

41
Q

Give 1 drug used to treat MDR-TB

A

Bedaquiline

42
Q

Name 3 fungi that can cause pneumonia in immunocompromised people

A

Candida
Cryptococcus
Pneumocystis jirovecii

Respiratory (6 decks)

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