The worsening cough

List two conditions other than pneumonia that could cause this radiographic picture (½ mark for each)

In view of the history you conclude that the most likely diagnosis is community acquired pneumonia (CAP).

Initial bloods were taken earlier and the results are now available (assume normal if not listed):

WCC 18.3

Neutrophils 16.4

CRP 187

Na 146

K 4.2

Urea 8

Creatinine 101

eGFR >60

lactate 2.5

1. List the components of the CURB-65 score (with cut off measurements) (½ mark)
2. Based on this patient’s CURB score, what specific microbiological investigation should now be done? (½ mark)

The next day you see another patient who presents with a pyrexial illness and productive cough. You again suspect pneumonia but the chest x-ray looks slightly unusual. The consultant suggests the patient may have an atypical pneumonia .

1. List 2 risk factors for atypical pneumonia (¼ mark for each)
2. List 2 clinical features that are typically found in atypical pneumonia (¼ mark for each)