SHOULD BE IN CLINICAL- Hospital Acquired Pneumonia

Question 1

What flu vaccine do children receive?

Answer 1

Fluenz Tetra
*intranasal spray
*live attenuated virus

Question 2

What vaccine do children receive for pneumonia?

Answer 2

Pneumococcal polysaccharide conjugate vaccine (PCV)
*get at 12 weeks and 1 yo

Question 3

What vaccine do adults at high risk receive for pneumonia?

Answer 3

Pneumococcal polysaccharide vaccine (PPV)
*65+
*long term condition- either one off or every 5 years depending

Question 4

What is HAP?

Answer 4

Pneumonia contracted by a patient 48-72 hours after hospital admission (mostly E. coli)

Question 5

What are predisposing factors for HAP?

Answer 5

*stroke
*chronic lung disease
*mechanical ventilation
*previous antibiotics

Question 6

Which patients are at higher risk?

Answer 6

*comorbidity- lung disease or immunosuppressed
*recent use of broad spectrum antibiotics
*colonisation of multi drug resistant bacteria

Question 7

What is first line treatment of HAP if non severe ?

Answer 7

Co-amoxiclav 500/125mg orally three times daily x5 days
Alternative- doxycycline 200mg first day then 100mg daily for further 4 days

Question 8

What is the first line treatment for HAP in severe cases?

Answer 8

Levofloxacin 500mg once daily (twice daily if more severe) IV

Question 9

What antibiotics should be added to treatment if suspected MRSA?

Answer 9

Vancomycin- 15mg/ kg to 20mg/kg two or three times daily IV (adjust depending on serum vancomycin levels)

Question 10

What is bronchitis?

Answer 10

Inflammation of bronchi

Question 11

What are characteristics of acute bronchitis?

Answer 11

*last up to 3 weeks
*INFECTIVE
*complication of a viral URTI
*secondary bacterial infection- usually caused by already weakened respiratory system

Question 12

What are characteristics of chronic bronchitis?

Answer 12

*daily predictive cough that lasts for 3 months of the year and for at least two years in a row
*long term inflammation of airways
*not primarily infective
*patients more susceptible to acute infections

Question 13

What viruses can cause acute bronchitis?

Answer 13

Rhinovirus
Coronavirus
Influenza virus

Question 14

What bacteria can cause acute bronchitis?

Answer 14

Streptococcus pneumoniae
Haemophilus influenzae

Question 15

What are symptoms of bronchitis?

Answer 15

*productive cough- Green/yellow sputum (purulent)
*wheezing
*breathlessness
*rhonchi- loud abnormal sounds of chest

Question 16

Are antibiotics prescribed in acute bronchitis?

Answer 16

No- self limiting illness. Unnecessary- increases chance of resistance

Question 17

What is the potential antibiotic treatment for acute bronchitis?

Answer 17

First line adult- doxycycline 200mg stat then 100mg daily for 4 days
2nd line adult- amoxicillin capsules 500mg three times daily for 5 days
(Allergy- clarithromycin 500mg twice daily for 5 days
First line child- Amoxicillin oral suspension 125/250/500mg three times daily for 5 days
(Allergy- clarithromycin oral suspension based on weight for 5 days

Question 18

What is bronchiolitis?

Answer 18

Inflammation and infection of bronchioles
(1 in 3 babies get during first year)

Question 19

What are symptoms of bronchiolitis?

Answer 19

*wheeze
*cough
*rhinorrhoea-thin clear nasal discharge