Pulmonary infections

Question 1

Gram positive vs gram negative staining

Answer 1

Gram positive: purple.
Gram negative: pink.

Question 2

A patient coughs up sputum that grows acid-fast bacilli that stain red with Zeihl-Neelsen staining. What’s the likely diagnosis?

Answer 2

TB

Question 3

A patient has recently had a cheap hotel holiday and presents with hyponatraemia. What’s the likely diagnosis?

Answer 3

Legionella pneumophila (Legionnaires’ disease).

Question 4

A farmer presents with a flu like illness. What’s the most likely diagnosis?

Answer 4

Coxiella burnetii (Q fever).

Question 5

COVID-19 management

Answer 5

Supportive care: oxygen, IV fluids, VTE prevention, analgesia.
Antiviral - Remdesivir.
Anti inflammatory - Dexamethasone.

Question 6

What is the gold standard investigation for TB?

Answer 6

Sputum culture

Question 7

Pneumonia, peripheral blood smear showing rbc agglutination

Answer 7

Mycoplasma pneumoniae

Question 8

Pneumonia with lymphopenia, hyponatraemia and deranged LFTs

Answer 8

Legionella

Question 9

Pneumonia in an alcoholic

Answer 9

Klebsiella

Question 10

Antibiotics for MRSA

Answer 10

• Vancomycin (first line)
• Teicoplanin
• Linezolid