Infections

Question 1

Risk factors for CAP

Answer 1

low BMI
Smoking
Chronic Disease
Resp. Disease - COPD/Asthma
Aspiration (epilepsy, smoke, neurological disease, alcohol abuse)

Question 2

Which treatments increase risk of CAP?

Answer 2

Steroids (ICS, Oral)

Proton pump inhibitors

Question 3

Which treatments decrease risk of CAP?

Answer 3

Flu vaccine
Pneumococcal vaccine
Statins
ACE Inhibitors

Question 4

Most common causative organism in CAP

Answer 4

strep. pneumonia

Question 5

Common causative organism of CAP in younger patients

Answer 5

Mycoplasma

Question 6

Legionella is a common cause of CAP in…

Answer 6

patients who have been on holiday to a dodgy hotel/area (air conditioning systems)

Question 7

24% of CAP is caused by?

Answer 7

viruses

Question 8

Symptoms of CAP

Answer 8

breathless, cough, wheeze, chest pain, fever, pleuritic pain, sometimes haemoptysis

Question 9

Non-specific symptoms of CAP

Answer 9

malaise, myalgia, rigors, sweats, arythalgia, anorexia, headache

Question 10

Where is confusion common in CAP?

Answer 10

Sepsis or older patients

Question 11

In CAP, percussion would be resonant - TRUE OR FALSE

Answer 11

FALSE - percussion would be dull

Question 12

Investigations that may be carried out in CAP?

Answer 12

CXR
Blood culture
FBC --> increased neutrophils and WCC
U&E
Throat swab
LFTs
Sputum 
Atypical serology

Question 13

The CURB 65 score is an indicator of…

Answer 13

mortality on admission

Question 14

C of CURB 65

Answer 14

Confusion (new onset)

Question 15

U of CURB65

Answer 15

Urea > 7mmol/l

Question 16

R of CURB 65

Answer 16

resp rate >30

Question 17

B of CURB65

Answer 17

BP systolic <90mmHg or diastolic <60mmHg

Question 18

65 of CURB65

Answer 18

> =65 years of age

Question 19

Antibiotic which puts patient at risk of C.difficile

Answer 19

Ciprofloxin

Question 20

In common and atypical pneumonia the first treatments are…

Answer 20

amoxicillin 250mg daily 5 days

doxcycline 200mg day 1, 100mg TD2-5

Question 21

In severe CAP treatment is…

Answer 21

IV co-amoxiclav and clarithromycin

Question 22

In penicillin allergic patients with severe CAP, you treat with…

Answer 22

IV levofloxin

Question 23

What may clarithromycin be replaced with in severe CAP?

Answer 23

oral doxycycline

Question 24

What might be suspect if patient does not start to get better with CAP treatment?

Answer 24

resistance, pleural effusion (empyema), Abscess or cavitation, metastatic infection, ARDS, death

Question 25

Common causative organisms in empyema?

Answer 25

strep. milleri, strep in general, klebsiella

Question 26

Common causative organisms of lung abscesses?

Answer 26

staph, klebsiella, anaerobes

Question 27

treatment for lung abscesses?

Answer 27

flucloxacillin, augmentin, metronidazole

Question 28

Common patient presentation of atypical chlamydia pneumonia

Answer 28

40 yr old pigeon fancier

Question 29

common patient presentation of atypical klebsiella pneumonia

Answer 29

alcoholic or TB

Question 30

common patient presentation of atypical staph aureus pneumonia

Answer 30

IV drug user

Question 31

common patient presentation of atypical H.influenzae pneumonia

Answer 31

COPD

Question 32

If you suspect someone might have TB, do you treat straight away?

Answer 32

Yes, detain and treat until you have an answer, if its not TB no harm done