4.2 E) Iii) Respiratory Pneumonia Dunn Et Al.

Front 1

List the common Bacterial Pathogens of Pneumonia (5)

Back 1

1. Streptococcus Pneumoniae ** ( most common)
2. Haemophilus influenzae ( COPD)
3. Staphylococcus aureus
4. Gram negative bacilli
5. Moraxella catarrhalis

Front 2

List the Atypical agents associated with pneumonia. (3)

Back 2

1. Mycoplasma pneumoniae
2. Chlamydiae pneumoniae
3. Legionella species.

Front 3

List the respiratory viruses associated with pneumonia (5).

Back 3

1. influenza A and B
2. Adenovirus
3. RSV
4. parainfluenza
5. Human metapneumovirus

Front 4

List the "other" organisms associated with pneumonia
( excluding common bacterial , atypical agents and viruses).

Back 4

1. Chlamydia psittaci
2. Nocardia
3. Coxiella Burnetti (Q fever)

Front 5

List the pathogens associated with immunocompromised hosts with pneumonia.

Back 5

1. Mycobacterium tuberculosis
2. Pneumocysitis jeroveci (PJP)
3. Opportunistic fungal infections.

Front 6

Which is incorrect regarding Streptococcus pneumoniae pneumonia ?
A. It is the most common cause of community acquired pneumonia illness and death.
B. It's mortality is 30% untreated.
C. It's associations include HIV , CCF and alcoholism.
D. Pleural effusions occur in 20% and empyema in 10%.

Back 6

D. pleural effusions - 10%
empyema < 20%

Front 7

Which is not an association of Streptococcus pneumoniae pneumonia ?
A. Dementia and alcoholism
B. COPD and CCF
C. Epilepsy and CVA
D. Asian background

Back 7

D. Black race

Front 8

Causative organisms associated with pleural effusion and pneumonia on CXR ?

Back 8

1. Chlamydial sp.
2. Legionella sp.
3. TB
4. Pyogenic organisms
5. Anaerobic organisms.

Front 9

Blood cultures in pneumonia-which patients?

Back 9

1. Immunocompromised

2. Severe sepsis / shock

3. Risk factors for endovascular infection:
a. prosthetic valves
b. IVDU
c. cavitary infiltrates

Front 10

High risk-group patients for Tuberculosis?

Back 10

1. Homelessness
2. IVDU
3. Alcoholism
4. HIV

Front 11

High risk History for TB?

Back 11

1. High risk group
a. Homeless
b. IVDU
c. Alcoholism
d. HIV

2. Symptoms
a. Weight loss
b. Night sweats
c. Haemoptysis
d. Persistent cough

3. Previous TB exposure

Front 12

Disease associations with Streptococcus pneumoniae ?

Back 12

1. COPD
2. Diabetes
3. Alcoholism
4. Malignancy
5. Malnutrition

Front 13

Epidemiological clues for aetiology of pneumonia ?

1. Bird handling [turkey/duck/chicken/exotic]
2. Bird exposure in Avian flu countries {Asia}
3. Handling cattle/sheep/goats/parturient cats
4. Handling infected wool
5. Insect bite -transmission from rodents/wild animals {rabbits}
6. Insect bites / scratches from infected rodents
7. Exposure to mice/mice droppings

Back 13

1. Chlamydophila psittaci
2. Influenza A H5N1 {SARS}
3. Coxiella burnetti {Q fever}
4. Bacillus anthracis {Anthrax}
5. Francisella tularensis {Tulareamia}
6. Yersina pestis {Plague}
7. Hanta virus

Front 14

Epidemiological factors for Legionella pneumoniae {3}

Back 14

1. Air conditioning cooling towers
2. Hot tubs
3. Hotel / Cruise ship stay within two weeks

Front 15

Pneumonia in the IVDU : causative organisms ? {4}

Back 15

1. S aureus
2. S pneumoniae
3. Anaerobes
4. Mycobacterium TB.

Front 16

Pneumonia in the Alcoholic- causative organisms ? { 6 }

Back 16

1. S pneumoniae
2. S aureus
3. Klebsiella pn.
4. Oral Anaerobes
5. Mycobacterium TB
6. Acinetobacter sp.

Front 17

Pneumonia in the COPD / smoker -causative organisms {6}

Back 17

1. S pneumoniae
2. H influenzae
3. Moraxella catarrhalis
4. Chlamydophila pn.
5. Legionella sp.
6. Pseudomonas aeruginosa

Front 18

Lung abscess-causative organisms ? { 5 }

Back 18

1. CA - MRSA
2. Oral Anaerobes
3. Mycobacterium TB
4. Atypical mycobacteria
5. Endemic fungi

Front 19

Pneumonia + pleural effusion -causative organisms ?
{6 }

Back 19

1. S aureus
2. S pneumoniae
3. Chlamydophila sp.
4. Legionella sp.
5. Mycobacterium TB
6. Anaerobes

Front 20

Which is incorrect regarding Urinary Antigen testing?
1. Legionella Test is specific {>95%}
2. Legionella Test is sensitive {90-100%}
3. A negative Legionella result does not exclude Legionella infection
4. L pneumophilia serogroup 2 is the most commonly reported cause of L pneumonia.
5. Pneumococcal Antigen is only 50-80% sensitive , but has high specificity {>90%}.

Back 20

4. L pneumophilia serogroup 1

Front 21

Risk factors for Pseudomonas pneumonia ? {5}

Back 21

1. COPD / Bronchiectasis
2. Recent Hospitalisation
3. Recent antimicrobial therapy
4. Neutropenia
5. Gross aspiration

Front 22

Pneumonia in AIDS-which is incorrect?
1. Bacterial pneumonia is the most common cause of acute respiratory failure.
2. Treatment of PJP is with trimethoprim + sulphamethoxazole {co-trimoxazole} + steroids
3. Legionella is rare.
4. pleural effusions are common in mycobacterial infection
5. sulphamethoxazole is well tolerated

Back 22

5. Side effects are common in HIV patients:
- nausea
- vomiting
- myelotoxicity
- rashes