Pneumonia

Question 1

What are the general risk factors for pneumonia?

Answer 1

Smoking, COPD, CF, increasing age, neurological disease, intubation, immunocompromise

Question 2

What are the typical pathogens in community pneumonia?

Answer 2

1. Streptococcus pneumo
2. Moraxella catarrhalis
3. Haemoplis influenzae
4. Klebsiella pneumoniae
5. Influenza virus A &B

Question 3

What are the atypical pathogens in pneumonia?

Answer 3

1. Chlamydophila pneumonia
2. Mycoplasma pneumonia
3. Legionella pneumophilia
4. All of these are intracellular pathogens, generally have interstitial disease pattern and less acute onset

Question 4

What are the risk factors for klebsiella infection?

Answer 4

Alcoholism

Question 5

How do typical vs viral vs atypical CAP present?

Answer 5

1. Typical: sick, productive cough, signs of consolidation
2. Atypical: insidious onset, dry cough
3. Viral: hx of URTI infection

Question 6

What are the most common hospital acquired pneumonia bugs?

Answer 6

1. S. Aureus (MRSA)
2. Pseudomonas
3. GNB
4. Acinetobacter
5. Stenotrophonas

Question 7

What bugs are most common in aspiration pneumonia?

Answer 7

1. Mouth flora

2. Anaerobes

Question 8

Pseudomonas

Answer 8

1. Gram negative bacilli, aerobic
2. Causes lobar pneumonia
3. Seen in neutropenic patients (bone marrow transplant, burns)
4. More commonly seen in hospital

Question 9

Haemophilis influenza

Answer 9

1. Encapsulated gram negative coccobacilli
2. Causes community acquired typical pneumonia
3. Most common bacterial cause of COPD exacerbation
4. Particularly bad for those without spleen

Question 10

Staph Aureus

Answer 10

1. Gram positive cocci in clusters
2. Causes typical CAP, hospital acquired
3. High incidence of complications ( abcess and empyema)
4. Associated with IV drug use (endocarditis!)

Question 11

Streptococcus pneumonia

Answer 11

1. Gram positive cocci in pairs and chains

2. Most common cause of CAP

Question 12

What is the cardinal inflammatory cell in CAP?

Answer 12

Neutrophils

Question 13

Ddx lung abcess

Answer 13

Aspiration of infective material
Aspiration of gastric contents
Complication of bacterial pneumonia
Bronchial obstruction ( cancer) 
Septic embolism