Pneumonia

Question 1

Mcc of Community acquired Pneumonia (typical)

Answer 1

Strp pneumoniae
<5yrs - viral

Question 2

Xray presentation in Pneumonia

Answer 2

Ground glass appearance
Consolidation
Increased broncho-vascular markings
Lobular/whole lung involvement

Question 3

Which type of Pneumonia has dry cough?

Answer 3

Viral/atypical Pneumonia

Question 4

Colour of sputum in bacterial Pneumonia

Answer 4

Yellowish green

Question 5

C/F of Pneumonia

Answer 5

Fever+cough+chest pain+breathing difficulty

Cough with sputum (most cases)
High temp, fever, rigors
Chest pain
Rapid shallow breathing

Question 6

Auscultatory findings in Pneumonia

Answer 6

Crepitus
Bronchial breath sounds
Increased vocal resonance
Dullness on percussion in large consolidation

Question 7

Treatment for bacterial Pneumonia

Answer 7

Amoxiclav for 5-10 days

Question 8

Hospital acquired/Ventilator acquired Pneumonia is caused due to which organism

Answer 8

When occurred between 2-90 days of hospitalisation
Gram negative bacteria
i.e., E coli, Pseudomonas, MRSA

Question 9

Atypical Pneumonia caused by

Answer 9

Mycoplasma
Chlamydia
Legionella

Question 10

C/F of atypical pneumonia

Answer 10

MILD symptoms compared to typical
GIT involved
No sputum
No consolidation
Diffuse infiltration on Xray

Question 11

Lobular infiltration of lung seen in typical or atypical pneumonia?

Answer 11

Typical pneumonia

Question 12

Xray findings in atypical pneumonia

Answer 12

Diffuse increased broncho-vascular markings
Ground glass appearance

Question 13

Mx of Mycoplasma pneumoniae

Answer 13

Mc type of atypical pneumonia
Young adults

Doxy 100 mg 2wks
Roxithromycin 300mg

Question 14

Legionnaires disease

Answer 14

Legionella pneumonia
Air condition in large buildings, water contamination

High fever, diarrhoea, dry cough

Question 15

Mx for Legionnaires disease

Answer 15

Azithromycin/Erythromycin IV
Add
Ciprofloxacin/Rifampicin if severe

Question 16

Rusty sputum seen in pneumonia caused by

Answer 16

Strep pneumoniae

Question 17

Currant jelly sputum seen in

Answer 17

Klebsiella (alcoholics)

Question 18

Initial investigation for typical or atypical pneumonia

Answer 18

CXR

Question 19

Most specific test for pneumonia

Answer 19

Sputum culture esp in bacterial pneumonia
Atypical organisms difficult to identify via sputum culture

Question 20

CURB 65

Answer 20

For severity/Rx plan of pneumonia

Confusion
Uraemia (BUN>20mg/dl)
Resp rate >30/min
BP systolic<90 or diastolic<60
Age > 65

each factor - 1 point

0 : OP
1-2 : Admit in medical ward
>2 : ICU

Question 21

Rx of CURB score 0/mild pneumonia

Answer 21

Amoxiclav 875/125mg 5-7 days
add
Roxi/Doxy if atypical suspected

Question 22

Rx of CURB score 1-2 or moderate pneumonia

Answer 22

Admit pt
Benzyl Penicillin 1.2g IV
Procaine Penicillin 1.5g IV (DOC for s.pneumoniae)
Ceftriaxone 1g

Question 23

Rx of CURB score >2 or severe pneumonia

Answer 23

Azithromycin 500mg IV (covers atypical bact)
add
Cefotaxime 1g IV

(or)

Ceftriaxone 1gm
add
Flucloxacillin if S. aureus suspected

Question 24

Can you give Azithro in hospital acquired penumonia?

Answer 24

No (Caused by E.coli, Pseudomonas)

Piptaz
Cefepime/Ceftazidime
Ticarciline clavulanic acid