Pneumonia

Question 1

What are the common causative organisms of pneumonia in a person who is normally healthy?

Answer 1

• streptococci pneumoniae
• haemophilus influenzae
• mycoplasma pneumoniae
• legionella
• chlamydia psittaci
• staphylococcus aureus

Question 2

What are the symptoms of pneumonia?

Answer 2

• pleuritic chest pain
• cough
• fever
• malaise
• dyspnoea
• purulent sputum
• rusty sputum

Question 3

What are the signs of pneumonia?

Answer 3

• pyrexia
• tachypnoea
• central cyanosis
• dullness to percussion of affected lobe(s)
• bronchial breathing
• inspiratory crepitations
• increased vocal resonance

Question 4

What investigations would you do for pneumonia?

Answer 4

• serum biochemistry
• FBC (would expect elevated WBC due to neutrophilia)
• CXR
• blood cultures
• sputum microscopy and culture
• urinary legionella antigen
• throat swab

Question 5

What complications might occur with pneumonia?

Answer 5

• septicaemia
• acute kidney injury
• empyema
• lung abscess
• haemolytic anaemia
• ARDS

Question 6

What is the name of the pneumonia grading scale?

Answer 6

CURB 65

Question 7

What is the treatment for pneumonia with CURB 0-1?

Answer 7

amoxycillin or clarithromycin/doxycycline

Question 8

What is the treatment for pneumonia with CURB 2?

Answer 8

amoxycillin and clarithromycin/levofloxacin

Question 9

What is the treatment for pneumonia with CURB 3-5?

Answer 9

co-amoxoclav and clarithromycin/levofloxacin

Question 10

When should levofloxacin be used instead of clarithromycin?

Answer 10

If penicillin allergic

Question 11

What additional treatment would you give a patient with pneumonia?

Answer 11

• oxygen
• IV fluids
• CPAP
• intubation and ventilation
• analgesia