Pneumonia

Q: Acute bronchiolitis and viral pneumonia are manifestations of:

Lower respiratory tract infection. Both processes occur below the larynx.

Q: A male infant is born at term with no congenital anomalies noted. A year later he has failure to thrive and has had one bacterial pneumonia after another, with both *Haemophilus influenzae* and *Streptococcus pneumoniae* cultured from sputum. Which disease is he most likely to have?

X-linked agammaglobulinemia. * Recurrent bacterial infections suggest impaired B-cell function with lack of immunoglobulin production. Once protective maternal antibodies wane, the disease manifests more severely. ---

Q: A 77-year-old woman was started on antibiotics for pneumonia treatment. After 3 days of antibiotic therapy, the serum creatinine doubled. Which of the following antibiotics is most likely responsible for this increase in serum creatinine?

Tobramycin. Aminoglycosides such as tobramycin accumulate in the proximal tubular cells of the kidney and disrupt calcium-mediated transport processes. This results in kidney damage ranging from mild, reversible renal impairment to severe, potentially irreversible acute tubular necrosis. Nephrotoxicity is not commonly associated with tetracyclines, macrolides, or oxazolidinones. ---

Also written as PCP.

Pneumonia is infection of the lung parenchyma (alveoli and interstitium) with consolidation: the air spaces fill with inflammatory exudate.

Pneumonia

Presentation: Typically community-acquired pneumonia (CAP). Sudden onset of fever, chills, productive cough (often with rust-colored sputum due to blood), pleuritic chest pain, and dyspnea. Physical examination may reveal lobar consolidatio
Complications: Empyema (pus in pleural space), lung abscess, necrotizing pneumonia.

Read this in Streptococcus pneumoniae: Characteristics, Pathogenesis, and Management

What our notes say

Pneumonia is infection of the lung parenchyma (alveoli and interstitium) with consolidation: the air spaces fill with inflammatory exudate. (Pneumonia)
Chest X-ray is not routine unless pneumonia is suspected (older patient, high fever, tachycardia, tachypnoea, focal signs). (Bronchitis (Acute and Chronic))
Antibiotics if sputum is purulent or pneumonia (amoxicillin, doxycycline or co-amoxiclav). (Chronic Obstructive Pulmonary Disease (COPD))
Several small cavities (below 2 cm) in a pneumonic area are necrotising pneumonia. (Lung Abscess)
Pneumonia — Year 4 Internal Medicine (Respiratory) Notes (Pneumonia)
| Heart failure (commonest, bilateral) | Pneumonia (parapneumonic effusion, empyema) | (Pleural Effusion)

Study material on Pneumonia

Images

Peak expiratory flow and lung function testing

Practice questions on Pneumonia

Acute bronchiolitis and viral pneumonia are manifestations of:

Upper respiratory tract infection
Lower respiratory tract infection
Tuberculous invasion
AIDS
Both a and b

Answer: B. Both processes occur below the larynx.

A male infant is born at term with no congenital anomalies noted. A year later he has failure to thrive and has had one bacterial pneumonia after another, with both Haemophilus influenzae and Streptococcus pneumoniae cultured from sputum. Which disease is he most likely to have?

DiGeorge syndrome
Selective IgA deficiency
Epstein-Barr virus (EBV) infection
Acute leukemia
X-linked agammaglobulinemia

Answer: E. * Recurrent bacterial infections suggest impaired B-cell function with lack of immunoglobulin production. Once protective maternal antibodies wane, the disease manifests more severely. ---

A 77-year-old woman was started on antibiotics for pneumonia treatment. After 3 days of antibiotic therapy, the serum creatinine doubled. Which of the following antibiotics is most likely responsible for this increase in serum creatinine?

Doxycycline
Tobramycin
Linezolid
Clarithromycin
Usually mediated by non-specific mechanisms

Answer: B. Aminoglycosides such as tobramycin accumulate in the proximal tubular cells of the kidney and disrupt calcium-mediated transport processes. This results in kidney damage ranging from mild, reversible renal impairment to severe, potentially irreversible acute tubular necrosis. Nephrotoxicity is not commonly associated with tetracyclines, macrolides, or oxazolidinones. ---

A 55-year-old man has had absolute neutrophil count of 900 for the past 6 months. He has had three episodes of bacterial pneumonia. He is otherwise healthy with no medications, no autoimmune disease, and no family history. Bone marrow is normocellular. Most likely explanation?

Cyclic neutropenia
Drug-induced agranulocytosis
Severe congenital neutropenia
Chronic idiopathic neutropenia

Answer: D. Persistent mild to moderate neutropenia in an otherwise healthy adult + normal bone marrow + no identifiable cause = chronic idiopathic neutropenia. Unlike cyclic neutropenia (periodic drops) or drug-induced agranulocytosis (acute, severe), this is a stable benign condition. ---

This bacterial species is the most common cause of "typical" pneumonia.

H. influenzae
S. pneumoniae
M. pneumoniae
L. pneumophila E.

Answer: A. *Streptococcus pneumoniae* is the leading cause of classic (lobar/typical) community-acquired pneumonia, distinguished clinically from "atypical" pneumonias caused by *Mycoplasma* or *Legionella*. --- ---

An 8-year-old boy had meconium ileus at birth, elevated sweat chloride, and recurrent Pseudomonas pneumonias. He is at greatest risk for which pulmonary abnormality?

Adenocarcinoma
Bronchiectasis
Pleural fibrous plaques
Pneumothorax

Answer: B. CF causes chronic airway inflammation and obstruction leading to bronchiectasis. Progressive loss of pulmonary vasculature leads to pulmonary hypertension and cor pulmonale. ---

Pneumonia

Pneumonia

What our notes say

Study material on Pneumonia

Images

Practice questions on Pneumonia

Acute bronchiolitis and viral pneumonia are manifestations of:

A male infant is born at term with no congenital anomalies noted. A year later he has failure to thrive and has had one bacterial pneumonia after another, with both *Haemophilus influenzae* and *Streptococcus pneumoniae* cultured from sputum. Which disease is he most likely to have?

A 77-year-old woman was started on antibiotics for pneumonia treatment. After 3 days of antibiotic therapy, the serum creatinine doubled. Which of the following antibiotics is most likely responsible for this increase in serum creatinine?

A 55-year-old man has had absolute neutrophil count of 900 for the past 6 months. He has had three episodes of bacterial pneumonia. He is otherwise healthy with no medications, no autoimmune disease, and no family history. Bone marrow is normocellular. Most likely explanation?

This bacterial species is the most common cause of "typical" pneumonia.

An 8-year-old boy had meconium ileus at birth, elevated sweat chloride, and recurrent Pseudomonas pneumonias. He is at greatest risk for which pulmonary abnormality?

Related topics

A male infant is born at term with no congenital anomalies noted. A year later he has failure to thrive and has had one bacterial pneumonia after another, with both Haemophilus influenzae and Streptococcus pneumoniae cultured from sputum. Which disease is he most likely to have?