Pneumonia

Question 1

What is pneumonia?

Answer 1

Symptoms and signs consistent with an acute LRTI + ABNORMALITIES ON X-RAY

Question 2

Symptoms of pneumonia?

Answer 2

Pleuritic pain
SOB
Cough
Fever

Question 3

Signs of pneumonia?

Answer 3

Focal chest signs

Decreased chest expansion
Dull percussion
Increased vocal fremitus 
Reduced breath sounds 
Bronchial breathing

Question 4

Types of pneumonia?

Answer 4

Community acquired pneumonia
Hospital acquired pneumonia (>48hrs from admission)
Aspiration pneumonia

Question 5

How to assess severity of pneumonia?

Answer 5

CURB-65

Question 6

What does CURB-65 stand for?

Answer 6

If a patient has any of the following they score 1 point for each:

C = confusion
U = urea >7mmol/L
R = respiratory rate >30
B = blood pressure <90/60
Age > 65

Question 7

How is CURB-65 used to guide management?

Answer 7

0-1 (mild) = oral antibiotics as outpatient
2 (moderate) = admit to hospital + antibiotics
3+ (severe) = admit to hospital and consider ITU if shock/hypercapnia

Question 8

How to diagnose pneumonia?

Answer 8

CXR - will see

• consolidation
• air bronchograms
• pleural effusion

Question 9

Most common cause of CAP?

Answer 9

S pneumoniae

Question 10

Atypical pathogens which cause pneumonia?

Answer 10

Mycoplasma pneumoniae
Legionella
Chlamydia pneumoniae/psittaci
Coxiella burnetii

Question 11

How to treat atypical pathogens?

Answer 11

Macrolides e.g. erythromycin

Question 12

How to treat pneumonia?

Answer 12

Antibiotics - usually beta-lactam e.g. amoxicillin, varies depending on trust