10. Pneumonia

Question 1

What patient symptoms can usually give an indication of Pneumonia?

Answer 1

1. Cough +
   A. Pleural Pain
   B. Dyspnoea
   C. Tachypnoea
2. Systemic:
   A. Sweats/Fever/Shivers
   B. Aches/Pains
3. Signs
   A. Focal Chest signs

Question 2

What investigations can be done to Aid/Confirm Diagnosis of Pneumonia?

Answer 2

1. Chest Radiograph within 4 hours

2. FBC (WCC above 15x10^9)

Question 3

What investigations can be done to Stratify the Severity/Risk?

Answer 3

1. Urea/Electrolytes
2. FBC/CRP levels
3. ABG

Question 4

What is the CURB65 score?

Answer 4

A scoring system used to differentiate Mild/Moderate/Severe Pneumonia

C onfusion
U rea > 7 mmol/L
R rate > 30/min
B Pressure (<90/60)
65 : Age

Question 5

What management options are available for those with Pneumonia?

Answer 5

1. Oxygen: Aim for target saturations
2. Fluids/Analgesia/DVT Prophylaxis
3. Chest/Physio/Nutritional support
4. Smoking cessation

Question 6

What antibiotic treatment options are available for those with Pneumonia?

Answer 6

1. Beta-Lactams + Macrolides (Severe)

Question 7

What bacteria can Beta-lactams kill?

Answer 7

S.pneumoniae

Question 8

What bacteria can Macrolides kill?

Answer 8

S.pneumonia
Legionella
Mycoplasma