Revision: Pneumonia/ TB

Question 1

which type of hypersensitivity is TB?

Answer 1

delayed type 4, caseating

Question 2

what is the main cause of TB?

Answer 2

mycobacterium tuberculosis

Question 3

what is seen on CXR in (active) TB?

Answer 3

• Shadows, lesions, consolidation
• Ghon focus in periphery of mid zone of lung - primary site of infection
• Bilateral hilar lymphadenopathy
• ‘Miliary shadowing’ = miliary TB

Question 4

active TB management?

Answer 4

• Rifampicin, Isoniazid, Pyrazinamide and Ethambutol for 2 months- RIPE
• Rifampicin and Isoniazid for a further 4 months- RI

Question 5

latent TB management?

Answer 5

• Rifampicin and Isoniazid for 3 months- RI
• OR Isoniazid for 6 months

Question 6

rifampicin side effects?

Answer 6

red/ orange body fluid discolouration

Question 7

isoniazid side effects?

Answer 7

peripheral neuropathy

Question 8

pyrazinamide side effects?

Answer 8

hepatoxicity

Question 9

ethambutol side effects?

Answer 9

blurred/ poor/ loss of vision

Question 10

what is pneumonia?

Answer 10

Common LRT infection characterized by inflammation of the lung tissue

Question 11

what is the most common cause of pneumonia?

Answer 11

strep pneumoniae

Question 12

possible cause of pneumonia in elderly/ COPD patients?

Answer 12

Haemophilus influenza

Question 13

pneumonia in PWID/ after influenza?

Answer 13

staph aureus

Question 14

legionella associated with?

Answer 14

inhalation of contaminated water droplets

Question 15

pneumonia in children and young adults, peaks/ comes in waves every 4 years?

Answer 15

mycoplasma pneumonia

Question 16

pneumonia in farmer/ Q fever?

Answer 16

coxiella burnetti

Question 17

pneumonia in bird owners?

Answer 17

chlamydia psitacci

Question 18

aspiration pneumonia?

Answer 18

klebsiella
(red currant jelly sputum)

Question 19

pneumonia in immunocompromised e.g. AIDS patients?

Answer 19

pneumocytis jirovecci

Question 20

signs of pneumonia?

Answer 20

• Rigors
• pyrexia
• Crackles and rub
• herpes labialis
• Tachypnoea
• cyanosis
• hypOtension

Question 21

what makes up curb 65?

Answer 21

for PNEUMONIA
- Confusion
- Urea ≳ 7 mmol
- Resp. rate > 30
- BP - systolic < 90, diastolic ≲ 60

• ≳65 years

Question 22

rust coloured sputum?

Answer 22

strep pneumonia

Question 23

green sputum in pneumonia?

Answer 23

pseudomonas, haemophilus

Question 24

describe anaerobes sputum ?

Answer 24

foul smelling and bad-tasting sputum

Question 25

CAP curb 0-2 management?

Answer 25

PO/IV amoxicillin (doxycycline if allergic)

Question 26

CAP curb 3-5 management?

Answer 26

Co-amoxiclav PLUS oral Doxycycline (Levofloxacin if
pen allergic)

Question 27

CAP ICU?

Answer 27

co-amoxiclav + clarithromycin

Question 28

HAP non severe/0-2 management?

Answer 28

PO amoxicillin (if penicillin allergic: PO doxycycline)

Question 29

HAP severe/ 3-5 management?

Answer 29

IV amoxicillin + gentamicin

Question 30

non severe aspiration pneumonia management?

Answer 30

oral amoxicillin and metronidazole

Question 31

severe aspiration pneumonia management?

Answer 31

IV amoxicillin, metronidazole and gentamicin

Question 32

atypicals management?

Answer 32

doxycycline
legionella- levofloxacin