Pneumonia

Question 1

Hospital-acquired pneumonia develops after more than __ hours in hospital

Answer 1

48

Question 2

What term refers to infection and inflammation in teh bronchial tubes?

Answer 2

Acute bronchitis

Question 3

Is pneumonia an upper or lower respiratory tract infection?

Answer 3

Lower

Question 4

Is acute bronchitis an upper or lower respiratory tract infection?

Answer 4

Lower

Question 5

What term refers to infection and inflammation in the bronchioles

Answer 5

Bronchiolitis

Question 6

What age is bronchiolitis most common in?

Answer 6

Under 2 y/o, particularly under 6 months

Question 7

What is the most common cause of bronchiolitis?

Answer 7

Respiratory syncytial virus (RSV)

Question 8

What is the common cause for upper respiratory tract infections (blocked nose, sore throat, dry cough)?

Answer 8

Viruses

Question 9

Generally the lower down the respiratory tract, the ____ the probability of bacterial infection

Answer 9

higher

Question 10

What is the most common bacteria causing pneumonia?

Answer 10

Streptococcus pneumoniae

Question 11

Name other bacterial causes of pneumonia (other than strep pneumoniae)

Answer 11

Haemophilus influenzae
Group A strep (eg streptococcus pyogenes)
Staphylococcus aureus
Mycoplasma pneumoniae

Question 12

What is the most common viral cause of pneumonia?

Answer 12

Respiratory syncytial virus (RSV)

Question 13

Name other viral cuases of pneumonia, other than RSV

Answer 13

Parainfluenza virus
Influenza virus

Question 14

In a neonate what organisms from the birth canal may cause pneumonia?

Answer 14

Group B streptococcus (GBS)
Escherichia coli
Listeria
Klebsiella

Question 15

What are the 2 key causes of pneumonia in children with cystic fibrosis?

Answer 15

Staph aureus
Pseudomonas aeruginosa

Question 16

In immunocompromised patients (eg HIV) what microorganisms could cause the pneumonia?

Answer 16

Pneumocystis jirovecii
Cytomegalovirus

Question 17

What are presenting symptoms of pneumonia?

Answer 17

Productive cough
High fever
SOB
Lethargy
Drowsiness
Confusion

Question 18

What are signs of pneumonia on examination?

Answer 18

Fever (over 38.5)
Tachypnoea
Tachycardia
Signs of respiratory distress (recessions, nasal flaring, tracheal tug)
Low oxygen sats
Hypotension
Cyanosis

Question 19

What causes the bronchial breath sounds to be harsh and equally loud on inspiration and expiration in pneumonia?

Answer 19

Consolidation of lung tissue around the airway, amplifying the airway sounds heard at the chest surface

Question 20

What sound is heard in pneumonia when air passes through fluid?

Answer 20

Focal coarse crackles

Question 21

Dullness to percussion over the affected area occurs due to…

Answer 21

Lung tissue collapse or consolidation

Question 22

What investigations are taken for uncomplicated pneumonia?

Answer 22

Typically none. Diagnosis made clinically with empirical treatment.

Possible CXR

Question 23

What shows on CXR in pneumonia?

Answer 23

Consolidation

Question 24

True or false: WBCs and CRP are both raised roughly in proportion to the severity of the infection

Answer 24

True

Question 25

What should be taken in patients with suspected sepsis?

Answer 25

Blood cultures

Question 26

C____ b___ g____ analysis measures the lactate and pH and is used to identify acidosis in acutely unwell patients.

Answer 26

Capillary blood gas

Question 27

What are typical oral antibiotics used for pneumonia?

Answer 27

Amoxicillin Co-amoxiclav (covers staph aureus so useful in FC) Clarithromycin

Question 28

What are indications to use IV antibiotics for pnuemonia?

Answer 28

Sepsis Complicated pneumonia Reduced absorption of oral antibiotics (eg vomiting)

Question 29

What conditions should be considered for children with recurrent hospital admission for chest infections?

Answer 29

Cystic fibrosis Primary ciliary dyskinesia Bronchiectasis Immunodeficiency eg HIV Neurological disease eg cerebral palsy Congenital heart disease

Question 30

What happens in immunoglobulin class-switch recombination deficiencies?

Answer 30

Unable to convert IgM to IgG so don't form long-term immunity to pathogens. may be picked up if testing IgG for previous vaccines.