Respiratore KFP 1-50 Revised MRQ

A 7-year-old boy is brought to your clinic for review after experiencing recurrent episodes of nighttime coughing and occasional wheezing over the past year. His parents are concerned about his breathing difficulties during sports and his reduced participation in physical activities at school. He has not required hospitalisation but has had multiple visits to the GP with upper respiratory complaints. There are no known food allergies, and he has not been diagnosed with eczema or hay fever. The family lives in a suburban home with no pets, and he attends primary school five days a week. The child was born at term with no complications and achieved all developmental milestones normally. There is no known family history of respiratory illness. His vaccinations are up to date, and he is otherwise well between episodes. You are considering risk factors that may predispose him to asthma.

 

 

A 6-year-old girl is brought to your practice for evaluation after her parents noticed frequent episodes of coughing, particularly at night, and occasional shortness of breath while playing. She has not required any emergency care or hospitalisation but has had several visits to the GP in the past year for upper respiratory symptoms. There is no current diagnosis of asthma, and her symptoms tend to resolve spontaneously after a few days. Her growth and development are age-appropriate, and she is not on any regular medications. There is no history of food allergies or eczema. The family has recently moved to a new apartment in the city. She attends primary school full time and participates in extracurricular activities. Her birth was full-term with no complications. You are considering possible risk factors that may increase her likelihood of developing asthma.

 

 

A 10-year-old boy is brought to your clinic for evaluation of persistent cough, occasional wheezing, and shortness of breath during playtime over the last few months. These symptoms occur more frequently during the night and early morning and are sometimes triggered by cold air or exercise. There has been no response to over-the-counter cough syrups. He has no history of eczema or allergic rhinitis. The child was born at term and has no history of recurrent infections or hospital admissions. There is no family history of asthma or other chronic lung diseases. Physical examination today is unremarkable, with no wheeze or respiratory distress noted. You suspect asthma and decide to perform further investigations to support the diagnosis and rule out differentials.

 

 

A 12-year-old girl is brought to the clinic for a review of her ongoing respiratory symptoms. She has been experiencing recurrent episodes of wheezing, cough, and shortness of breath that are often triggered by changes in weather and exercise. These symptoms have been increasing in frequency and have started affecting her school attendance and participation in sports. Her past medical history is unremarkable, and there are no other significant comorbidities. She was seen in the emergency department two weeks ago for a similar episode and was discharged with a salbutamol inhaler, which she uses several times a week. Today’s spirometry reveals mild reversible airway obstruction. Her parents are seeking clarity on how to manage her condition both acutely and in the long term, and how to avoid future exacerbations. You are planning a comprehensive asthma management approach in line with current guidelines.

 

 

A 15-year-old boy with a known history of asthma presents for routine review. He has had increasing use of his reliever inhaler over the past several months and admits to missing preventer doses. He has had two visits to the emergency department in the past year due to wheezing and breathlessness. He has not required hospital admission and reports that his symptoms tend to worsen during cold weather or after exposure to dust. He is otherwise well between episodes and continues to attend school. There is no evidence of concurrent infection or other respiratory pathology. His lung function tests show mild reversible airflow obstruction. You want to counsel him and his family about the potential complications of poorly controlled asthma.

 

 

A 17-year-old girl with a 10-year history of asthma presents for a follow-up review. Over the past year, she has reported increased frequency of symptoms despite using her reliever inhaler multiple times per week. She has missed several scheduled appointments and has not been adherent to her preventer inhaler. She was hospitalised six months ago for a severe exacerbation that required oral corticosteroids and nebulised therapy. Between attacks, she experiences occasional wheezing and fatigue. She is currently in her final year of school and says her asthma is beginning to impact her ability to participate in sports and concentrate in class. Her spirometry shows moderately reduced FEV₁ with minimal reversibility. You wish to discuss potential complications of poorly controlled asthma during the consultation.

 

 

A 13-year-old boy presents for a follow-up asthma review. He was diagnosed at the age of six and has had a fluctuating pattern of control since. He has required short courses of oral corticosteroids three times in the last year and frequently uses his salbutamol inhaler for symptom relief. He has missed school on several occasions due to respiratory symptoms, and his parents are concerned about his long-term health and ability to live a normal life. He has not seen a specialist but has been managed primarily in general practice. His spirometry shows mild airflow limitation that improves with bronchodilator therapy. He is otherwise healthy, with no comorbid conditions. His parents ask you to discuss what factors influence long-term outcomes and what aspects of his case may suggest a more guarded or more favourable prognosis.

 

 

A 10-year-old girl with a three-year history of asthma presents for her routine review. Her parents report that her symptoms are generally well-controlled on low-dose inhaled corticosteroids, and she rarely requires her reliever inhaler. She has not had any recent hospital visits or oral corticosteroid use. Her school attendance is good, and she is physically active without major limitations. She does, however, have a history of eczema in early childhood and allergic rhinitis currently managed with antihistamines. There is a family history of asthma on her mother’s side. Spirometry today shows normal lung function with no evidence of obstruction. Her parents are keen to understand whether she is likely to “grow out” of her asthma or if it might persist or worsen in the future.

 

 

A 14-year-old boy presents for evaluation of chronic respiratory symptoms. His mother reports that he has had frequent episodes of dry cough, especially at night and early in the morning. He occasionally experiences shortness of breath while playing sports and has had two prior episodes of wheezing that responded to salbutamol inhaler prescribed by the emergency department. He has no history of chest infections, foreign body aspiration, or cardiac disease. His growth and development have been normal, and he has no regular medications. There is a family history of asthma, and he has a personal history of allergic rhinitis. His physical exam today is unremarkable. You are considering a diagnosis of asthma and plan to apply appropriate diagnostic criteria.

 

 

A 16-year-old girl presents for evaluation of episodic breathing difficulty that has been occurring for over a year. She reports occasional wheezing, chest tightness, and a non-productive cough, particularly when exercising or during cold weather. The symptoms are worse at night and tend to improve without medication. She has no known cardiac or neurological conditions. Her general examination today is normal, and there are no adventitious sounds heard on auscultation. She denies fever, sputum production, or weight loss. There is a family history of allergic rhinitis and eczema. She has not yet undergone any lung function testing. You are considering a diagnosis of asthma and wish to assess her against established diagnostic criteria.

 

 

A 60-year-old man presents with a chronic cough and breathlessness that has gradually worsened over the past two years. He has no history of asthma or childhood lung disease. He works in retail and lives with his wife in a suburban area. He has seen his GP a few times over the past year for what was thought to be “chronic bronchitis” and has been prescribed multiple courses of antibiotics. He mentions that he occasionally gets wheezy in the mornings, and his physical activity has decreased due to breathlessness. He denies any occupational exposures or family history of lung disease. His past medical history includes hypertension and dyslipidaemia. You consider whether he may be at risk of chronic obstructive pulmonary disease (COPD).

 

 

A 65-year-old woman is being evaluated for progressive shortness of breath. She denies chest pain or palpitations but mentions chronic fatigue and a daily morning cough for several years. She has never smoked but reports that her husband smoked heavily indoors for over 30 years. She previously worked as a chef in a poorly ventilated kitchen using biomass fuel. There is no personal or family history of asthma or allergies. She was born and raised in a developing country and had frequent lung infections as a child. Spirometry shows a post-bronchodilator FEV₁/FVC ratio of 0.66. You consider the diagnosis of COPD and review risk factors in her history.

 

 

A 67-year-old male presents with chronic cough and exertional dyspnoea that has gradually worsened over the past few years. He has a history of heavy tobacco use but quit smoking five years ago. He reports regular sputum production in the mornings and gets breathless walking uphill or when carrying groceries. He has no known history of asthma or cardiovascular disease. On examination, he has slightly reduced air entry bilaterally but no wheeze or crackles. His oxygen saturation is 94% on room air, and his BMI is 22. You suspect chronic obstructive pulmonary disease (COPD) and begin the workup.

 

 

A 59-year-old woman presents with progressive breathlessness and chronic cough. She has been a smoker for 35 years and complains of reduced exercise capacity. She denies chest pain, haemoptysis, or weight loss. On examination, she appears comfortable at rest but gets breathless after minimal exertion. Her oxygen saturation is 91% on room air. You suspect COPD and plan to evaluate her to confirm the diagnosis, determine severity, and assess for potential complications or comorbidities.

 

 

A 68-year-old man presents for follow-up after being diagnosed with moderate COPD (GOLD stage 2) six months ago. He has a 40-pack-year smoking history and continues to smoke despite previous advice. His current symptoms include exertional dyspnoea and a chronic productive cough. He has had one exacerbation requiring oral corticosteroids in the past year but has not been hospitalised. He is currently on a short-acting beta-agonist (SABA) inhaler as needed. His oxygen saturation is 94% on room air. Spirometry shows an FEV₁ of 65% predicted with an FEV₁/FVC ratio of 0.62. He is keen to understand how his condition can be better managed and what measures can reduce his symptoms and prevent further progression.

 

 

A 72-year-old woman presents for routine COPD review. She was diagnosed five years ago and is currently classified as having severe COPD (GOLD stage 3) with an FEV₁ of 42% predicted. She reports daily breathlessness with basic activities such as walking short distances and showering. She has had two exacerbations in the past year, one of which required hospitalisation. Her current medications include a long-acting beta-agonist (LABA) and a short-acting beta-agonist (SABA) for symptom relief. She quit smoking 12 years ago. On examination, she is thin with a BMI of 18 and has oxygen saturation of 91% on room air. She asks if her current treatment should be updated and what else she can do to manage her symptoms and avoid hospital admissions.

 

 

A 74-year-old man with a 15-year history of COPD presents for follow-up after a recent hospitalisation for an acute exacerbation. He has a 50-pack-year smoking history and quit 10 years ago. He currently uses dual inhaler therapy with a long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA), as well as a short-acting bronchodilator for rescue use. He reports persistent fatigue, reduced exercise tolerance, and increasing episodes of leg swelling and breathlessness at rest. His BMI is 17, oxygen saturation is 89% on room air, and he has mild pedal oedema. You are reviewing potential complications that may be contributing to his deteriorating condition and explaining long-term risks of COPD to him and his family.

 

 

A 70-year-old woman with known COPD presents for a review. She was diagnosed seven years ago and currently uses a combination of LABA, LAMA, and SABA for symptom management. Her FEV₁ is 38% of predicted, and she reports worsening breathlessness over the past year. She had three exacerbations in the last 12 months, one of which required hospitalisation. Her BMI is 19, she reports significant fatigue and reduced mobility, and she lives alone with minimal social support. She quit smoking five years ago after a 35-pack-year history. You are counselling her and her family about long-term outcomes and want to assess what clinical features are associated with a poorer prognosis.

 

 

A 62-year-old man presents to your clinic with a history of progressive shortness of breath, daily productive cough, and reduced exercise tolerance. He is a retired construction worker and has a 45-pack-year smoking history, having quit two years ago. His symptoms have worsened over the past 18 months. He denies any history of asthma, but reports frequent chest infections over the past few years. He has no peripheral oedema or weight loss. On examination, there is reduced breath sounds bilaterally but no crackles or wheeze. Chest X-ray appears unremarkable. You are considering chronic obstructive pulmonary disease (COPD) and wish to apply the correct diagnostic work-up to confirm or exclude the diagnosis.

 

 

A 66-year-old man presents with complaints of gradually worsening breathlessness over the past year. He also reports a persistent cough with intermittent sputum production but denies chest pain or haemoptysis. His symptoms are slowly affecting his ability to perform daily tasks, including climbing stairs and doing housework. He has not previously been diagnosed with any chronic respiratory disease. He takes medications for hypertension and hyperlipidaemia. He works as a part-time handyman and lives with his wife. There is no significant weight loss, and his appetite is stable. You suspect COPD and want to take a detailed history to assess risk factors and the impact of the condition.

 

 

A 58-year-old woman presents with a long-standing history of chronic cough with daily mucopurulent sputum production. She describes frequent respiratory infections over the past few years, often requiring antibiotics. Her past medical history includes sinusitis and one episode of pneumonia requiring hospitalisation several years ago. She denies smoking and has never been diagnosed with asthma or COPD. Physical examination reveals bilateral crackles and occasional wheeze. A recent chest X-ray was inconclusive, and you are considering bronchiectasis as a differential diagnosis. You want to assess potential risk factors in her history that may support this diagnosis.

 

 

A 42-year-old man presents with a history of persistent cough and daily sputum production for the past year. He describes the sputum as thick and occasionally foul-smelling. He reports two chest infections in the past 12 months requiring antibiotics. He has no history of smoking, asthma, or occupational exposures. He was previously fit and healthy, except for frequent sinus infections as a teenager. A recent chest X-ray was non-specific, and you are considering bronchiectasis as a possible cause. You want to explore his risk factors before proceeding to high-resolution CT chest for confirmation.

 

 

A 55-year-old woman presents with a chronic productive cough, occasional haemoptysis, and worsening breathlessness over the past year. She reports multiple chest infections annually, each requiring antibiotics. Her sputum is thick and occasionally foul-smelling. She has no smoking history and denies any significant occupational exposures. Physical examination reveals bilateral coarse crackles at the lung bases. A chest X-ray shows some basal changes, but no clear diagnosis can be made. You suspect bronchiectasis and wish to proceed with appropriate investigations to confirm the diagnosis, determine the underlying cause, and guide ongoing management.

 

 

A 49-year-old man presents with a two-year history of persistent cough, daily mucopurulent sputum, and occasional haemoptysis. He reports at least three chest infections in the past year, requiring multiple courses of antibiotics. He has no smoking history and denies asthma or allergic conditions. He was born overseas and had severe pneumonia as a child. On examination, he is afebrile with stable vitals, but has coarse crackles over both lung bases. A plain chest X-ray suggests basal lung changes, and you suspect bronchiectasis. You now plan further investigations to confirm the diagnosis, assess severity, and evaluate for underlying causes.

 

 

A 62-year-old woman presents for follow-up after being diagnosed with bronchiectasis via high-resolution CT scan. She reports daily mucopurulent sputum production, fatigue, and occasional episodes of haemoptysis. Over the past year, she has had three exacerbations requiring oral antibiotics. Sputum cultures have previously grown Haemophilus influenzae. She is a non-smoker with no history of asthma. Physical examination reveals coarse crackles at the lung bases and her BMI is 18.5. Pulmonary function testing shows mild airflow obstruction. She asks what measures can help improve her condition, prevent further infections, and maintain her quality of life.

 

 

A 70-year-old man with known bronchiectasis presents for review. He reports daily cough with thick, purulent sputum and has had four exacerbations over the past year, one of which required hospital admission and intravenous antibiotics. His sputum has previously grown Pseudomonas aeruginosa. He remains breathless with moderate exertion but is able to manage basic daily activities at home. He is adherent to chest physiotherapy and currently uses a short-acting bronchodilator as needed. His spirometry shows moderate airflow limitation. He is underweight and occasionally experiences reflux symptoms. You aim to optimise his long-term management to reduce exacerbation risk and preserve lung function.

 

 

A 65-year-old man with a history of bronchiectasis presents to the clinic reporting increased fatigue and occasional streaks of blood in his sputum. He has had multiple chest infections over the years and remains on regular chest physiotherapy. Despite adherence to airway clearance and inhaler therapy, he reports progressive shortness of breath and recent unintentional weight loss. He denies fever or night sweats. His most recent sputum culture grew Pseudomonas aeruginosa. On examination, there are coarse crackles at both lung bases and mild digital clubbing. You are concerned about disease progression and want to assess for recognised complications of bronchiectasis.

 

 

A 59-year-old woman with a 20-year history of bronchiectasis presents with worsening breathlessness, fatigue, and reduced appetite. She reports frequent productive cough, and has had five antibiotic courses in the past year for chest infections. Her BMI is 17.8, and her sputum cultures have intermittently grown Pseudomonas aeruginosa. She uses daily airway clearance techniques and inhaled bronchodilators but has become increasingly frail. On examination, she has digital clubbing, bilateral coarse crackles, and mild peripheral oedema. You are concerned that her condition may be progressing and assess her for long-term complications of bronchiectasis.

 

 

A 68-year-old man with known bronchiectasis presents for review. Over the past two years, his condition has gradually deteriorated. He now experiences chronic daily sputum production, worsening breathlessness on minimal exertion, and two hospitalisations in the past 12 months due to infective exacerbations. He has lost 5 kg unintentionally and reports increased fatigue. Sputum cultures consistently grow Pseudomonas aeruginosa. Spirometry shows moderate airflow limitation, and his BMI is 18.2. He is adherent to chest physiotherapy and medications. You are assessing factors that may influence his long-term prognosis and risk of further deterioration.

 

 

A 61-year-old woman with a five-year history of bronchiectasis presents for routine follow-up. She reports daily mucopurulent sputum and three infective exacerbations in the past year. She remains independent with activities of daily living but reports that walking up stairs now causes significant breathlessness. She is colonised with Pseudomonas aeruginosa and has required multiple courses of oral and IV antibiotics in recent years. Her BMI is 19, and she has recently been diagnosed with generalised anxiety disorder. She performs chest physiotherapy regularly but admits to sometimes missing her inhaled medications. You are reviewing factors that may impact her long-term outlook.

 

 

A 68-year-old man presents with an ongoing cough, unintended weight loss, and progressive fatigue over several months. He has no history of recent infections and has never been diagnosed with asthma or COPD. He worked as a metal fabricator for over 30 years and reports long-term exposure to industrial fumes. He quit smoking 10 years ago but previously smoked a pack a day for nearly four decades. There is no known family history of lung cancer. He drinks alcohol occasionally and has no history of autoimmune disease or malignancy. A chest X-ray reveals a suspicious lesion in the right upper lobe. You are evaluating him for risk factors that increase the likelihood of bronchogenic carcinoma.

 

 

A 71-year-old woman presents with persistent hoarseness, weight loss, and fatigue. She has a past medical history of hypertension and was treated with radiotherapy for breast cancer 15 years ago. She has never smoked but spent over three decades working in a textile factory. She reports daily exposure to second-hand smoke through her husband, who is a smoker. There is no known family history of lung or other cancers. A recent chest CT revealed a suspicious left hilar mass. You are assessing her background for possible contributing risk factors for bronchogenic carcinoma.

 

 

A 64-year-old man presents with a three-month history of persistent cough, unintentional weight loss, and occasional haemoptysis. He also reports increasing fatigue and chest discomfort. He has a 40-pack-year smoking history and worked in construction for most of his life. Physical examination is unremarkable except for reduced breath sounds on the right side. A chest X-ray reveals a right upper lobe mass, raising suspicion for bronchogenic carcinoma. You plan to confirm the diagnosis, stage the disease, and assess operability.

 

 

A 69-year-old woman presents with a chronic cough, mild haemoptysis, and progressive weight loss over several months. She has a 30-pack-year smoking history and was recently noted to have a suspicious opacity in the right lower lobe on routine chest X-ray. She denies fever or recent infection. Her past history includes mild COPD and hypertension. On examination, she has dullness to percussion over the right lung base and decreased breath sounds. You suspect bronchogenic carcinoma and plan investigations to confirm the diagnosis, assess staging, and determine suitability for treatment.

 

 

A 66-year-old man is newly diagnosed with bronchogenic carcinoma after presenting with a persistent cough and weight loss. A CT chest showed a 3.5 cm right upper lobe mass with mediastinal lymphadenopathy. PET-CT confirmed no distant metastases. Biopsy revealed non-small cell lung cancer (NSCLC), and his staging is determined to be stage IIIB. He is a former smoker with mild COPD and has a performance status of 1. Pulmonary function tests show FEV₁ at 72% predicted. The oncology and thoracic surgery teams are involved in care planning. You are reviewing the management strategies appropriate for this patient based on his staging, tumour type, and functional status.

 

 

A 59-year-old woman is newly diagnosed with stage I non-small cell lung cancer (NSCLC) involving a 2.2 cm peripheral lesion in the left upper lobe. She is a lifelong non-smoker and has no significant comorbidities. Her pulmonary function tests are within normal range, and her performance status is 0. There is no evidence of nodal or distant metastasis on PET-CT. A biopsy confirms adenocarcinoma. She is referred for further evaluation to determine the most appropriate curative treatment approach. You are reviewing current best practices in the management of early-stage bronchogenic carcinoma.

 

 

A 72-year-old man with recently diagnosed stage IV non-small cell lung cancer (NSCLC) presents for discussion about his long-term outlook. He has metastases to the liver and multiple bones. He has lost 8 kg over the past 3 months, reports severe fatigue, and has a performance status of 2. He is not a candidate for curative surgery. Molecular testing is pending, and palliative chemotherapy is being considered. He asks what factors influence survival in patients with advanced lung cancer and what indicators might suggest a worse prognosis.

 

 

A 67-year-old woman is undergoing treatment for stage IIIA non-small cell lung cancer (NSCLC). She completed concurrent chemoradiotherapy six months ago and is currently being monitored with regular imaging. She has responded partially to treatment but continues to experience fatigue and mild dyspnoea on exertion. Her PET-CT scan shows no new lesions, and tumour markers remain stable. She has a history of smoking, stopped five years ago, and has no significant comorbidities. She asks about her long-term outlook and which factors might negatively affect her prognosis going forward.

 

 

A 70-year-old man with newly diagnosed bronchogenic carcinoma presents to the emergency department with shortness of breath, chest pain, and swelling of the face and upper limbs. He has a 40-pack-year smoking history and has lost 10 kg over the past few months. Imaging reveals a large right-sided hilar mass with mediastinal invasion and pleural effusion. His oxygen saturation is 91% on room air, and ECG shows sinus tachycardia. The oncology team is planning urgent intervention. You are evaluating possible complications that may arise from advanced bronchogenic carcinoma.

 

 

A 65-year-old woman with a recent diagnosis of bronchogenic carcinoma presents with worsening dyspnoea, right-sided chest pain, and hoarseness. She was initially diagnosed with stage III non-small cell lung cancer and had begun concurrent chemoradiotherapy. On examination, she appears cachectic and has dullness to percussion over the right lower lung field. Her oxygen saturation is 89% on room air. A chest X-ray shows a moderate pleural effusion, and a CT scan reveals invasion into adjacent mediastinal structures. You are reviewing the potential complications of her advanced disease.

 

 

A 76-year-old man presents with fever, productive cough, and shortness of breath. He is diagnosed with community-acquired pneumonia after a chest X-ray shows consolidation in the left lower lobe. He has a history of type 2 diabetes mellitus, chronic kidney disease stage 3, and mild cognitive impairment. He lives in a residential aged care facility and is partially dependent for activities of daily living. He is not vaccinated against pneumococcus or influenza. His respiratory rate is 26 breaths per minute, and oxygen saturation is 90% on room air. You are reviewing potential risk factors that may have predisposed him to developing pneumonia.

 

 

A 69-year-old woman presents to the emergency department with a 3-day history of fever, cough with yellow sputum, and pleuritic chest pain. She has a history of ischaemic heart disease, moderate COPD, and gastro-oesophageal reflux disease (GORD). She lives alone and has been increasingly frail over the past year, with significant unintentional weight loss. She was hospitalised three months ago for a hip fracture and had post-operative delirium. She is currently not vaccinated against influenza or pneumococcus. On auscultation, she has bronchial breath sounds in the right lower zone. You suspect pneumonia and are reviewing what factors may have predisposed her to it.

 

 

A 74-year-old man presents to the emergency department with fever, cough, purulent sputum, and pleuritic chest pain. His oxygen saturation on room air is 88%, respiratory rate is 28, and temperature is 38.6°C. He has a past history of type 2 diabetes, COPD, and chronic kidney disease. On examination, there are bronchial breath sounds and dullness to percussion in the right lower lung zone. Pneumonia is suspected. You are planning investigations to confirm the diagnosis, assess severity, and identify any complications or causative organisms.

 

 

A 62-year-old woman presents to your general practice clinic with a 5-day history of fever, chills, pleuritic chest pain, and productive cough with greenish sputum. She complains of fatigue and mild breathlessness on exertion. Her medical history includes hypertension, osteoarthritis, and past smoking history (quit 10 years ago). On examination, her temperature is 38.4°C, respiratory rate is 24, oxygen saturation is 92% on room air, and there are bronchial breath sounds with crackles over the left lower lung field. You suspect community-acquired pneumonia and plan investigations to confirm the diagnosis, determine severity, and identify causative organisms or complications.

 

 

A 71-year-old man presents to the emergency department with fever, productive cough, pleuritic chest pain, and shortness of breath. His oxygen saturation is 89% on room air, respiratory rate is 30, and temperature is 38.9°C. He has a history of chronic obstructive pulmonary disease (COPD), type 2 diabetes, and is an ex-smoker. Chest auscultation reveals crackles in the right mid and lower zones, and chest X-ray confirms right middle lobe consolidation. He is diagnosed with moderate community-acquired pneumonia based on clinical and radiological findings. His CURB-65 score is 2. You are planning evidence-based management for this patient in the hospital setting.

 

 

A 58-year-old woman presents with a 4-day history of fever, dry cough, progressive shortness of breath, and fatigue. She has no significant past medical history and is fully vaccinated. On examination, her temperature is 38.5°C, respiratory rate is 22, and oxygen saturation is 94% on room air. Auscultation reveals reduced air entry and fine crackles over the left lower lobe. Chest X-ray confirms left lower lobe consolidation. Her CURB-65 score is 1, and she appears clinically stable. She is diagnosed with mild community-acquired pneumonia and managed in the outpatient setting. You are preparing a safe and evidence-based treatment plan.

 

 

A 68-year-old man presents to the emergency department with fever, cough, and worsening breathlessness despite starting oral antibiotics three days ago for presumed community-acquired pneumonia. He has become increasingly lethargic, reports right-sided chest pain, and now has difficulty lying flat. On examination, he is febrile (38.7°C), hypotensive (BP 90/60 mmHg), and tachycardic. There is dullness to percussion and decreased breath sounds over the right lower zone. Chest X-ray shows a right-sided pleural effusion and patchy consolidation. You are concerned about potential complications from pneumonia and are evaluating for recognised clinical consequences.

 

 

A 72-year-old woman is admitted to hospital with severe community-acquired pneumonia. Despite being on IV antibiotics and oxygen therapy, she continues to deteriorate. She now complains of increasing breathlessness, confusion, and right-sided pleuritic chest pain. Her oxygen saturation is 86% on room air, respiratory rate is 32, and blood pressure is 85/55 mmHg. Laboratory results reveal elevated inflammatory markers, and her chest X-ray shows a multiloculated pleural effusion with mediastinal shift. You are concerned about progression and complications of her pneumonia.

 

 

A 79-year-old man is hospitalised with community-acquired pneumonia. He presents with confusion, hypotension (BP 85/60 mmHg), tachypnoea (RR 32), and oxygen saturation of 88% on room air. He has a history of congestive heart failure, chronic kidney disease stage 4, and type 2 diabetes mellitus. He lives in a residential aged care facility and is partially dependent for daily activities. A chest X-ray reveals bilateral lower lobe consolidation. His CURB-65 score is 4. The medical team initiates oxygen therapy, IV antibiotics, and fluid resuscitation. You are reviewing factors that are associated with poor prognosis in patients with pneumonia.

 

 

 

A 75-year-old woman is admitted with community-acquired pneumonia. She was found at home by her daughter after becoming increasingly drowsy and disoriented. On arrival, she is febrile at 38.8°C, with a respiratory rate of 30, blood pressure of 90/55 mmHg, and oxygen saturation of 86% on room air. She is unable to give a clear history. Her past medical history includes ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and mild dementia. Laboratory tests reveal a raised serum urea and elevated white cell count. Chest X-ray confirms right lower lobe consolidation. You are discussing the likely prognosis with the admitting team and reviewing factors that are associated with increased mortality in pneumonia.