Week 2 Pneumonia ✅

Question 1

What factors about sputum do we need to know about?

Answer 1

Volume, colour, texture, smell

Question 2

What is significant about bronchiactasis?

Answer 2

Affects older people
Lots of sputum

Question 3

How can phlegm be measured?

Answer 3

Teaspoon, egg cup, cup

Question 4

What causes a barking cough?

Answer 4

Increased pressure against vocal cords

Question 5

What does whooping cough sound like?

Answer 5

Cough cough…… bark

Question 6

What is stridor?

Answer 6

Harsh inspiratory sound
upper airway - trachea upwards e.g. mass against trachea

Question 7

What is wheeze?

Answer 7

Episodic lower respiratory sound on expiration

Question 8

Why do we get pleuritic pain?

Answer 8

Lungs have no pain fibres

Question 9

Why do anaerobic bugs when pleuritic chest pain?

Answer 9

Not moving lungs to breathe so worse infection

Question 10

What scale is breathlessness measured on?

Answer 10

MRC scale 1-5

Question 11

What must you ask for in a respiratory drug history?

Answer 11

Inhalers

Question 12

What is whispering pectoriloquy?

Answer 12

Whispered words are heard clearly in the presence of consolidation on auscultation

Question 13

What is the GCS for AVPU?

Answer 13

A - 15
V - 12/13
P - 8-9
U - 3

Question 14

What is pneumonia?

Answer 14

Consolidation from infection on x-ray
Pus/blood/fluid etc

Question 15

Problems with diagnosing pneumonia in primary care? PoC testing?

Answer 15

No CXR!
PoC - COVID test, spirometry

Question 16

What are the symptoms of pneumonia?

Answer 16

Cough + 1 other respiratory system + 1 systemic symptom

Question 17

What types of pneumonia are there?

Answer 17

Community acquired
Hospital acquired
Nursing home acquired
Aspiration
Immunocompromised
Ventilated associated (as bypassed nose and throat)
Bacterial
Viral
Fungal

Question 18

How do you get aspiration pneumonia?

Answer 18

Problems with larynx - food going into lungs when swallowing

Question 19

What does viral pneumonia look like on CXR?

Answer 19

Lots of little bilateral changes

Question 20

What must you do if fungal pneumonia is suspected?

Answer 20

Screen for HIV as it is longer growing pathogen

Question 21

What is atypical pneumonia?

Answer 21

Pathogen hard to grow in lab - more uncommon pathogen

Question 22

Which tool should be used if pneumonia is suspected?

Answer 22

CURB65 secondary care
CRB5 in GP

Question 23

Where do aerobic and anaerobic pathogens grow in the lungs?

Answer 23

Aerobic - lung apex/top of lungs
Anaerobic - base of lungs

Question 24

If CRP is not high, what type of pneumonia might the patient have?

Answer 24

Viral

Question 25

If CRP is high, what type of pneumonia might the patient have?

Answer 25

Bacterial, fungal or even abscess

Question 26

What is the first and second line treatment for pneumonia?

Answer 26

Amoxicillin
Doxycycline

Question 27

How do you assess confusion?

Answer 27

AMTS (abbreviated mental test score)

Question 28

If a patient complains of cough, how long should you advise it will take to resolve?

Answer 28

3-4 weeks

Question 29

Why is pneumonia more likely in lung cancer?

Answer 29

Mass in lung blocks mucocillary staircase

Question 30

If a cough has not resolved in 6 weeks what are the next steps?

Answer 30

CXR

Question 31

What should you do if a smoker has a cough for >6 weeks?

Answer 31

CZE

Question 32

Why does pulmonary embolism kill?

Answer 32

Causes the right side of the heart to beat faster but if it cant then die

Question 33

What type of pain is pancoast tumour?

Answer 33

Persistent pain

Question 34

What are symptoms of pancoast tumour?

Answer 34

Pain, wasting of hands/arm etc

Question 35

How many mls of fluid is there normally in the pleural space?

Answer 35

5ml