Pneumonia is an infection that causes inflammation within the alveoli of the lungs. It affects millions of people around the world each and every year. That is why, as a Respiratory Therapist or medical professional, it’s a condition that you must be aware of.
We created this study guide (with practice questions) to help you learn the basics of pneumonia and develop a better understanding of this topic.
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What is Pneumonia?
Pneumonia is an infection that causes inflammation in the lungs and results in fluid build-up, fever, cough, and difficulty breathing. It’s caused by a various organisms, such as viruses, bacteria, and fungi.
There are several causes of pneumonia, including viruses, bacteria, fungi, and parasites. Common viruses that can cause pneumonia include influenza (flu), respiratory syncytial virus (RSV), and rhinoviruses (common cold).
The most common types of bacteria that can cause pneumonia include Streptococcus, Mycoplasma, Haemophilus influenzae, and Legionella pneumophila.
Some common fungi that can cause pneumonia are Pneumocystis jirovecii, Cryptococcus, and Histoplasmosis.
Signs and Symptoms
The signs and symptoms of pneumonia can vary in severity from person to person. Here are some of the most common examples:
- Productive cough
- Fever and chills
- Shortness of breath
- Chest pain
Keep in mind that other signs and symptoms for pneumonia may be present. These are just a few of the most common examples.
Types of Pneumonia
Pneumonia is often classified according to how the patient acquired the disease. Here are the different types:
- Community-Acquired Pneumonia (CAP)
- Hospital-Acquired Pneumonia (HAP)
- Ventilator-Associated Pneumonia (VAP)
- Aspiration Pneumonia
CAP is when a patient acquires Pneumonia outside of the hospital. HAP is when it’s acquired during a hospital stay. VAP is acquired while the patient is on a mechanical ventilator.
Lastly, Aspiration Pneumonia is acquired when a patient aspirates bacteria into the lungs.
Pneumonia is most commonly diagnosed by looking at the patient’s chest x-ray, which will show signs of consolidation. Other useful tests and findings include:
- Vital signs
- Arterial Blood Gas (ABG)
- Pulmonary Function Tests (PFT)
- Sputum culture
- Complete Blood Count (CBC)
Pulse oximetry would likely reveal hypoxemia, and a faster breathing rate is also common. The patient’s breath sounds will likely reveal crackles (rales) or rhonchi, and a dull note may be heard during chest percussion.
The patient’s PFT results would likely reveal decreased lung volumes and capacities. A sputum culture would reveal which type of bacteria is causing the infection.
And a complete blood count (CBC) would show the number of white blood cells to help determine if the infection is viral or bacterial.
Pneumonia should be treated on a case-by-case basis depending on the patient’s signs and symptoms. However, here are some of the most common treatment methods:
- Antibiotic medications
- Oxygen therapy
- Airway clearance therapy
- Hyperinflation therapy
- Fluid management
Again, each patient will be treated differently depending on the cause of infection and severity of symptoms. In severe cases, intubation and mechanical ventilation would be indicated.
Pneumonia Practice Questions:
1. What is pneumonia?
Pneumonia is an inflammatory condition of the lungs primarily affecting the alveoli, which may fill with fluid and pus. It is an acute infection of the lung parenchyma.
2. What are the symptoms of pneumonia?
High fever and chills, headache, loss of appetite, mood swings, cough with sputum, shortness of breath, joint pain, fatigue, and aches.
3. What are some ways to diagnose pneumonia?
Chest x-ray, sputum culture, CBC, and ABG.
4. What is the assessment of viral pneumonia?
Low-grade fever, non-productive cough, WBC normal (or slightly increased); it is typically less severe than bacterial pneumonia.
5. What is the assessment of bacterial pneumonia?
High fever, productive cough, WBC elevated, chest x-ray shows severe infiltrates.
6. What methods can be used for the therapeutic management of pneumonia?
Antibiotic medications, oxygen therapy, bed rest, airway clearance therapy, hyperinflation therapy, and fluid management.
7. What medications can be used for the treatment of pneumonia?
Antibiotics, bronchodilators, and corticosteroids.
8. What type of pneumonia is frequently undiagnosed?
9. What are the three key signs of bacterial pneumonia?
Expectoration of yellow sputum, increased white blood cell count, and the presence of fever.
10. What type of anatomic alteration leads to aspiration pneumonia?
Alveolar consolidation, atelectasis, and inflammation of the alveoli.
11. What term applies to the filling of alveolar spaces due to pneumonia?
12. The expression “walking pneumonia” is generally applied to patients with what type of pneumonia?
13. What is the most commonly found bacterial cause of pneumonia?
14. What are the clinical manifestations of patients with severe pneumonia?
Chest pain, tachycardia, hemoptysis, cyanosis, hypoxia symptoms, tachypnea, and dyspnea.
15. What is breathing like for a patient with pneumonia?
Pulse oximetry would likely reveal hypoxemia, and they will likely show signs of tachypnea.
16. What causes “walking pneumonia,” and who typically gets it?
It is caused by atypical organisms like mycoplasma pneumonia and chlamydophila. It affects young, healthy adults and presents with a
17. What viruses can cause pneumonia?
Influenza A or B, respiratory syncytial virus, rhinovirus, and coronavirus (SARS,
18. What fungi can cause pneumonia?
19. What are the non-infectious etiologies of pneumonia?
Carcinomas, lymphomas, vasculitis, sarcoidosis, heart failure, and pulmonary embolism.
20. What are the causes of pneumonia?
Bacteria, viruses, mycoplasma, fungus, parasites, and fluid stasis of the lungs caused by accumulation from secondary conditions such as asthma and COPD.
21. What is the problem with pneumonia?
Even with antibiotics, patients with pneumonia still have high morbidity and mortality rates.
22. What are the types of pneumonia?
Community-acquired pneumonia, hospital-acquired pneumonia, and aspiration pneumonia.
23. What is community-acquired pneumonia?
This type happens prior to hospitalization.
24. What kind of therapy is required to treat pneumonia?
Antibiotic therapy needs to be started as soon as possible.
25. What is hospital-acquired pneumonia?
This type of pneumonia happens at least 48 hours after admission to the hospital.
26. What is the pathophysiology of pneumonia?
Microorganism enters the alveoli of the lungs, which leads to an infection and inflammatory response.
27. What is the inflammatory response?
Neutrophils are activated, which results in edema of the airways and fluid leaks from the capillaries to the alveoli. This affects normal oxygen transport.
28. What are the mechanical barriers of a bacterial infection?
Mechanical barriers include air filtration, epiglottis, cough reflex, mucociliary response, reflex bronchoconstriction, and the secretion of immunoglobulins and alveolar macrophages.
29. What are the risk factors of pneumonia?
Pneumonia is caused by a weakening of processes such as loss of consciousness (intubation), air pollution, and tobacco use. Also, people older than 65 are at a higher risk. Other risk factors include abdominal/thoracic surgery, bedrest/immobility, chronic disease/illness, immunosuppressed, and alcohol use.
30. What is aspiration pneumonia?
A type of pneumonia that occurs when bacteria is aspirated into the lungs.
31. What is opportunistic pneumonia?
It is a type of pneumonia commonly seen in immunocompromised individuals (such as HIV), those receiving radiation therapy, chemotherapy, and long-term corticosteroid therapy.
32. What are the sudden symptoms of pneumonia?
Sudden symptoms include fever, shaking, chills, shortness of breath, tachypnea, cough, purulent sputum, and pleural cerebral palsy.
33. What is consolidation?
It is a common sign of bacterial pneumonia. When the normally air-filled alveoli
34. Why is antibiotic therapy beneficial for pneumonia?
Macrophages break down bacteria and process debris. Lung tissue is then allowed to recover, and gas exchange returns to normal. They help maintain homeostasis, and healing occurs if there are no other complications.
35. What are the diagnostic tests for pneumonia?
Chest x-ray, sputum culture, sputum gram stain, blood cultures, WBCs, and ABGs.
36. What are the standard treatment options for pneumonia?
Antibiotics, IVF and PO hydration, supplemental O2, analgesics, antipyretics, nutrition-frequent small meals, and balance rest with activity.
37. What are standard practices that patients with pneumonia should learn?
They need to learn hand hygiene, cough etiquette, a
38. What are the various complications of pneumonia?
Atelectasis, pleurisy, bacteremia, meningitis, acute respiratory failure, sepsis, septic shock, and empyema.
39. What event triggers the clinical syndrome of pneumonia?
The host’s immune response leads to the inflammatory mediators that create an
40. What type of pneumonia is most common in children?
41. What type of pneumonia is most common in adults?
42. What type of pneumonia is commonly found in people with HIV?
43. What are the most common types of pneumonia in neonates?
Group B Strep and HSV
44. What is the most common cause of pneumonia in infants?
Bordetella pertussis and
45. What is the most common cause of pneumonia in children?
RSV and influenza
46. What is the most common pathogen found in young, healthy adults who have contracted pneumonia?
47. What is the most common cause of pneumonia in older adults?
Strep pneumonia and H. flu
48. What are some common physical examination findings with pneumonia?
Crackles, rhonchi, or wheezes on auscultation; tachypnea; dullness to percussion.
49. What is the one-year mortality rate of someone with pneumonia older than 65?
50. What chest x-ray finding indicates that
51. What is the most common chest x-ray finding with pneumonia?
52. What chest x-ray finding is usually associated with empyema?
53. What is a bronchogram on a chest x-ray?
Air-filled bronchi made visible by opacification of surrounding alveoli and peribronchial thickening.
54. What will you usually see on a CBC with pneumonia?
Leukocytosis and L shift
55. What will the ABG typically show for a patient with pneumonia?
Respiratory alkalosis (hyperventilation) with hypoxemia
56. What biomarkers are potentially used to help diagnose pneumonia?
CRP and Procalcitonin (PCT)
57. What is a typical workup of a patient with suspected pneumonia?
Medical history, physical examination, laboratory tests, PA and lateral chest x-ray, microbial studies, culture and gram stain, and blood cultures in a hospitalized patient with sepsis.
58. What should true sputum show when trying to find the cause of pneumonia?
An abundance of inflammatory cells, no squamous epithelial cells, and large numbers of a single organism.
59. What pattern of pneumonia will have entire lobe consolidation?
60. What pattern of pneumonia is typically multifocal and patchy?
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61. What pattern of pneumonia is caused by viruses?
Interstitial, which is characterized by a ground-glass appearance
62. What are the four most common symptoms of pneumonia?
63. What are the different categories of pneumonia?
Acute vs. chronic (time), typical vs. atypical (clinical characteristics), alveolar vs. interstitial (x-ray pattern), and community-acquired vs. nosocomial (location of illness onset).
64. What are the types of hospital-acquired pneumonia?
Hospital-acquired (HAP), ventilator-associated (VAP), and healthcare-associated (HCAP).
65. What type of pneumonia is considered community-acquired (CAP)?
Pneumonia that develops outside of the hospital setting.
66. What causes CAP?
It is most commonly caused by bacteria that traditionally has been divided into two groups (typical and atypical).
67. Can COVID-19 cause pneumonia?
Yes, some infected with coronavirus can develop pneumonia in one or both lungs.
68. What factors impair the pulmonary clearance of pneumonia?
Viral upper respiratory tract infection, smoking, alcohol, uremia, and bronchial obstruction.
69. What is an early symptom of pneumonia?
70. Can pneumonia lead to acute respiratory distress syndrome (ARDS)?
Yes, pneumonia can lead to ARDS in severe cases.
Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you read in this article. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.
The following are the sources that were used while doing research for this article:
- Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020. [Link]
- Rrt, Des Terry Jardins MEd, and Burton George Md Facp Fccp Faarc. Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019. [Link]
- Jain, Vardhmaan. “Pneumonia Pathology – StatPearls – NCBI Bookshelf.” National Center for Biotechnology Information, 29 May 2020, www.ncbi.nlm.nih.gov/books/NBK526116.
- “Pneumonia | American Lung Association.” American Lung Association, www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia.
- “Causes of Pneumonia | CDC.” Center for Disease Control and Prevention, 9 Mar. 2020, www.cdc.gov/pneumonia/causes.html.
- World Health Organization: WHO. “Pneumonia.” World Health Organization, 2 Aug. 2019, www.who.int/en/news-room/fact-sheets/detail/pneumonia.
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