Pneumonia

Frage	Antworten
1. TRUE/FALSE? A. Pneumonia kills almost 1 million children <5 years of age, worldwide, each year.	True
1. TRUE/FALSE? B. Death rates from childhood pneumonia are rising worldwide.	False. Rates are dropping worldwide (50% in the past 15 years).
1. TRUE/FALSE? C. The pneumococcal vaccine is the only vaccine which can help reduce rates of pneumonia.	False. Pneumococcal, measles, pertussis and HiB vaccines all help prevent pneumonia.
1. TRUE/FALSE? D. Pneumococcal vaccine was introduced for all Australian children in 2000.	False. It was introduced for ALL children in 2005. It was available for high risk children before this.
1. TRUE/FALSE? E. Aboriginal/Torres strait Islander people are at higher risk of severe pneumonia than non-Aboriginal people.	True. Aboriginal/Torres Strait Island people have a 3 times higher risk of developing severe pneumococcal disease.
2. TRUE/FALSE? A. Pneumonia can present as fever and tachypnoea, without cough.	True, cough may be a later sign.
2. TRUE/FALSE? B. A child with pneumonia will always have crackles on auscultation.	False. Focal reduced breath sounds or bronchial breathing may be the only finding on auscultation.
2. TRUE/FALSE? C. A child with suspected pneumonia should always have a CXR.	False. Mild pneumonia is diagnosed clinically and can be treated with oral antibiotics and follow up review. CXR should be used if uncertain diagnosis or to assess for complications.
2. TRUE/FALSE? D. CRP should always be checked in pneumonia.	False. CRP does not help distinguish between viral and bacterial pneumonia. It can be used to monitor response to treatment and complications eg. empyema.
2. TRUE/FALSE? E. A child with pneumonia and oxygen saturations 90% in room air has mild disease.	False. Hypoxia is a sign of severe disease and child should be admitted for treatment and oxygen.
3. TRUE/FALSE? A. Oral amoxicillin is first line treatment for a child with mild pneumonia.	True. Although this may vary based no local guidelines and child’s age.
3. TRUE/FALSE? B. Suspected atypical pneumonia should be treated with roxithromycin/azithromycin.	True. Mycoplamsa is not susceptible to penicillin based antibiotics.
3. TRUE/FALSE? C. Group B strep causes low grade infection in neonates.	False. Group B Strep can cause rapid sepsis and neonatal death and if suspected, should be treated with IV antibiotics pending results.
3. TRUE/FALSE? D. Viruses generally cause lobar pneumonia.	False. Viruses generally cause diffuse or bilateral pneumonia.
3. TRUE/FALSE? E. Clindamycin should be added in severe pnuemonia.	True. Clindamycin has anti-toxin properties and should be added in any septic child with pneumonia or severe pneumonia not responding to first line treatments.
4. TRUE/FALSE? A. SIADH should be managed with fluid restriction and monitoring electrolytes.	True. Serum sodium should not rise too quickly therefore levels must be monitored and generally, fluids should be restricted to 2/3 of normal intake.
TRUE/FALSE? B. Pleural effusion always requires drainage.	False. Pleural effusions do not require drainage if they are not causing respiratory distress or hypoxia.
TRUE/FALSE? C. Necrotising pneumonia is associated with a very poor outcome.	False. Despite causing severe lung damage, necrotising pneumonia generally fully resolves with excellent long term outcomes.
TRUE/FALSE? D. Loss of a clear right heart border on CXR suggests right middle lobe involvement.	True. The right middle lobe abuts the right heart border on CXR.

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