S9.2 LRTI And Pneumonia

Question 1

What are the defences of the URT?

Answer 1

Mucociliary clearance
Cough and sneeze reflex
Mucosal immune system

Question 2

What is pneumonia?

Answer 2

Inflammation of the alveoli causing fluid and inflammatory infiltrate.
Presents with fever, cough, pleuritic chest pain, SOB, often abnormal CXR due to the damaged parenchyma.

Question 3

What microorganisms are responsible for Community acquired pneumonia?

Answer 3

Mainly - Streptococcus pneumoniae and haemophilus influenzae

Rarely - Staph aureus, Klebsiella pneumonia

Question 4

How is community acquired pneumonia diagnosed?

Answer 4

Symptoms: SoB, cough +/- sputum (yellow), fever, pleuritic chest pain
Signs: pyrexia, tachycardia, cyanosis, dullness on percussion, bronchial breathing, crackles

Question 5

What is the management of community acquired pneumonia?

Answer 5

Mild-moderate: amoxicillin or doxycycline

Moderate-severe (i.e. needing hospital): co-amoxiclav and doxycycline

Question 6

What is the management for atypical pneumonia?

Answer 6

Caused by organisms without a cell wall, so penicillin won’t work
So need agents that act on protein synthesis - macrolides (clarithromycin) and tetracyclines (doxycycline)

Question 7

Describe viral pneumonia

Answer 7

Caused by influenza, parainfluenza, RSV, adenovirus

Damages cells lining airway and alveoli by virus and immune cells

Question 8

Describe hospital acquired pneumonia

Answer 8

Common types: S. aureus, Pseudomonas spp, Haemophilus influenza
Treatment: 1st line - coamoxiclav, 2nd line meroperum

Question 9

What is aspiration pneumonia?

Answer 9

Aspiration of exogenous material or endogenous secretions into the RT, caused by neurological dysphagia, epilepsy, drowning.
Treat with co-amoxiclav.

Question 10

How can pneumonia be prevented?

Answer 10

Immunisation - flu vaccine

Smoking cessation