Pulmonary Infection

Question 1

If basal crepitations are cleared with coughing, where does this suggest the sputum, and thus the infection, is?

Answer 1

In airways rather than parenchyma

Question 2

Why are acute exacerbations of COPD treated with antibiotics and steroids?

Answer 2

Get better faster than not giving anything at all

Fewer hospitalisations

Question 3

At what site does cough indicate pathology?

Answer 3

Any site

Question 4

At what site does sputum indicate pathology?

Answer 4

Bronchial/alveolar

Question 5

What does yellow sputum correlate with?

Answer 5

In general, bacterial infection

Exceptions

Question 6

In the absence of chronic lung disease, are antibiotics indicated in the management of acute infective bronchitis?

Answer 6

No, self-limiting

Question 7

Why is oxygen saturation low in community acquired pneumonia?

Answer 7

Decreased surface area for gas exchange > V-Q mismatch and shunting
- Blood going through that lung area doesn’t get oxygenated

Question 8

What tests can be performed when admitting a patient for community acquired pneumonia?

Answer 8

Throat swab for viruses
Blood cultures
Urinary Ags
- Looking for Legionella Ags
Pathogen often not found

Question 9

What is the management of community acquired pneumonia?

Answer 9

Empirical antibiotics cover both typical and atypical organisms
Supportive treatment of severe pneumonia
- Oxygen
- Fluids
- Pain relief
- Sputum clearance
- Careful observation
- Reassurance