RTI

Question 1

what are main organisms for CAP

Answer 1

strep pneumonia
H influenza
moraxella catarrhalis

Question 2

what is the most common typical organism for CAP

Answer 2

strep pneumonia

h influenza

Question 3

most common atypical organism for cap

Answer 3

legionella
mycoplasma
coxiella burrito

Question 4

what is associated to coxiella burneti

Answer 4

exposure to farm animal

Question 5

what is associated to chlamydia psittacosis

Answer 5

exposure to birds
splenomeg
rash
haemolytic anaemia

Question 6

explain curb 65 score

Answer 6

confusion 
urea >7
RR>30 
BP <90/60
65+ years old 

score of 2 consider admitting
score >=3 manage as severe, consider ITU

Question 7

what is bronchitis

Answer 7

inflammation of medium sized airways

Question 8

what is CXR in bronchitis

Answer 8

normal

Question 9

what are classical causes of cavitation on x ray

Answer 9

Staph aureus
Klebsiella
TB\

Question 10

what is legionella pneumophilia grown on

Answer 10

buffered charcoal yeast extract

Question 11

what is the stain for TB

Answer 11

auramine stain
Ziehl nelson

Red rods are ACID FAST BAVICILLI

Question 12

what is the most common cause of HAP

Answer 12

enterobacteriacae (e coli, klebsiella9)

Question 13

How do you diagnose pneumocystis jiroveci

Answer 13

broncheoalveolar lavage

Question 14

what is pneumocystis jiroveci x ray like

Answer 14

bat wing shadowing

Question 15

how do you treat pneumocystis jiroveci

Answer 15

co trimoxasole

Question 16

pneumocystis jiroveci prophylaxis

Answer 16

co trimoxasole

Question 17

what is treatment of invasive aspergillosis

Answer 17

amphotericin B

Question 18

where is mycoplasma pneumoniae common in

Answer 18

institutions, military barracks

due to droplet spread

Question 19

how do you treat mycoplasma pneumoniae

Answer 19

Macrolide e.g. erythromycin

Question 20

what is legionella pneumophilia associated with (in temrs of envirionment)

Answer 20

Legionnaires disease - due to air conditioning

This organism colonises water piping systems including air conditioning.

Question 21

How is legionella pneumophilia infection aquired

Answer 21

Infection is acquired by inhalation, human to human transmission does not occur.

Question 22

What electrolyte result occurs with legionella

Answer 22

HYPOnatraemia

Question 23

How do you investigate legionella

Answer 23

urinary antigen

Question 24

How is the x ray different in pneumonia vs bronchitis

Answer 24

Pneuimonia: CXR abvnormal
Bronchitis: CXR normal

Question 25

Who does bronchitis occur in

Answer 25

smokers

Question 26

what is the presentation of bronchitis (by definition)

Answer 26

cough with sputum most days for 3 months, for. 2 or more consecutive years

Question 27

What are organisms causing bronchitis

Answer 27

Viral OR Bacterial (S. pneumonia, H influenza, M catarrhalis)

Question 28

How do you manage bronchitis

Answer 28

Broncodilation | Physiotherapy + antibiotics 1

Question 29

How do you manage pneumonia

Answer 29

Supportive + antibiotics based on CURB-65

Question 30

What is the difference between atypical and typical bacteria in pneumonia

Answer 30

``` Typical = respond to penicillin Abx Atypical= do not respond to penicillin ```

Question 31

What is associations of Strep pneumonia

Answer 31

Rusty colooured sputum USually lobar Vaccinate people at risk

Question 32

What is association with H influenza / M catarrhalis

Answer 32

smokers

Question 33

What is association of S aureus pneumonia

Answer 33

recent viral infection (post-INFLUENZA) | with cavitation on CXR

Question 34

What is seen on the microscope for S aureus

Answer 34

grape bunch clusters

Question 35

What is associations of Klebsiella pneumonia

Answer 35

Alcoholism, elderly, haemoptysis

Question 36

Why do atypical organisms not respond to penicillin antibiotics

Answer 36

because they have no cell wall so they dont respond to penicillin Abx Use macrolide + tetracycline instead

Question 37

What are 4 atypical pneumoniae

Answer 37

Legionella pneumophilia Mycoplasma pneumonia Chlamydia pneumonia Chlyamydia psittaci

Question 38

Explain associations of legionella pneumophilia

Answer 38

Travel, conferences Air conditioning Water towers HEPATITIS, HYPONATRAEMIA

Question 39

Explain associations of mycoplasma penumonia

Answer 39

``` Uni students / boarding schools Systemic symptoms Dry cough Arthralgia Cold agglultinin test Erythema multiforme Risk SJS, AIHA ```

Question 40

What are associations of Bordatella pertussis

Answer 40

Whooping cough in unvaccinated esp TRAVELLERS

Question 41

What are resp tract infections associated with HIV

Answer 41

PCP, TB, cryptococcus neoformans

Question 42

What are resp tract infections associated with neutropoenia

Answer 42

Fungi - ASPERGILLLUS

Question 43

What are resp tract infection with BM treatment

Answer 43

Aspergillus | CMV

Question 44

What are resp tract infection with splenectomy

Answer 44

Encapsulated organisms (NHS)

Question 45

What does PCP look like on silver stain?

Answer 45

BOAT SHAPED

Question 46

What investigation can you get for Strep pneumonia ad legionella

Answer 46

Urine atigen test

Question 47

What investigations can you get for Chlaamydia and legionella

Answer 47

Antibody test (paired serum samples)

Question 48

How do you manage a mild-moderate pneumonia? (CURB 0,1)

Answer 48

Outpatient PO Amoxicillin --- or macrolide if allergic

Question 49

How do you manage severe pneumonia (3-5)

Answer 49

co-amoxiclav + clarythromycin IV (penicillin + macrolide)

Question 50

How do you manage atypical pneumonia

Answer 50

Macrolide / tetracycline

Question 51

What is management for HAP

Answer 51

ciprifloxacin + vancomycin

Question 52

How do you manage legionella

Answer 52

Macrolide + rifampicin

Question 53

How do you manage S aureus

Answer 53

Fluclox

Question 54

How do you manage MRSA pneumonia

Answer 54

Vancomycin

Question 55

What is the most common cause of viral pneumonia

Answer 55

Influenza. A