5. Pneumonia

Question 1

What are the 4 main classifications for pneumonia?

Answer 1

1.  community acquired  (developed at home)
     hospital acquired  (developed in hospital)

2. viral
   bacterial
3. lobular pneumonia (upper lobe/ middle lobe/ lower lobe)
   lobar pneumonia (left lung/ right lung)
   multilobar (both lungs)
4. alveolar (infection of airsacks itself)
   interstitial (infection between airsacks)

Question 2

What is the difference between viral & bacterial pneumonia?

Answer 2

very similar but:

viral bacterial
- higher temperature - not so high temperature
- coughing mostly without sputum - coughing with sputum
- if sputum, from upper part - sputum can change Color
(bronchi not affected),
doesn‘t change color
- mostly interstitial - mostly lobar and lobular

Question 3

How will I examine a patient with pneumonia?

Answer 3

1. Anamnesis
2. Examination
   
   • chest classification according to shape
   • vocal fremitus (viral: symmetrical; bacterial: changes in particular places; both increased)
   • percussion (check symmetry; healthy: normal, resonant sound; ill: dull sound)
3. Auscultation
   
   • viral: no findings
   • bacterial: crackles during inspiration; wheezes during expiration)

Question 4

How will I diagnose pneumonia?

Answer 4

1. blood tests
   
   • viral infection: leukocytes not increased (viral infection: intracellular: hard to reach for immune system)
   • bacterial: increased leukocytes
2. X-Ray
3. CT-Scan (if X-Ray is not enough)

Question 5

How will I differentiate between Tuberculosis & pneumonia?

Answer 5

1. X-Ray

2. microbiological test of sputum (shows exact bacterial cause and important for prescribtion of antibiotics)

Question 6

What is the treatment for pneumonia?

Answer 6

-symptomatic treatment
-antiviral drugs
(Remdesivir: has to be given from 3rd-6th day on otherwise no actual effect, only side effects)