Theory · 5. Pneumonia

Covers pneumonia as alveolar inflammation, then sets out four types (lobar, multilobar, bronchopneumonia and interstitial) by area affected and causes, with the four histological stages of lobar disease. It goes on to symptoms, examination findings across the lobar stages, laboratory and imaging tests including chest X-ray patterns and spirometry, and local and systemic complications.

Inside: 8 sections · 2 labelled pictures · 5 tables · 14 flashcards · 4 min

Topic 5 of 88 in the MU Sofia syllabus for Internal Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 8 sections, about 215 words (4 min of reading), with 14 flashcards.

Definition:

Inflammation of the lung parenchyma (specifically the alveoli), usually caused by an infection. The alveoli fill with fluid, making gas exchange difficult and leading to respiratory symptoms.

Symptoms

Shared general features:

Cough (productive in alveolar types, dry in interstitial)
Fever (high in bacterial types, variable in viral)
Dyspnea (shortness of breath)
Chest pain (pleuritic, worsens on inspiration), sharp/stabbing chest pain.

Physical Examination

General signs: Fever, tachypnea, tachycardia. May see hypotension in severe cases, or herpes labialis (cold sores) due to immune stress.
Facies febrilis: Flushed face due to high fever.

On Lung Exam:

Bronchopneumonia: ↓ Vesicular breathing, scattered crackles or rhonchi. Patchy consolidation.
Interstitial pneumonia: Often only ↓ breath sounds or ↓ mobility of chest on affected side.

Instrumental Tests

Lobar → solid white opacity in one lobe
Bronchial → patchy infiltrates, base-heavy
Interstitial → diffuse streaky or patchy lines, especially near hilum

Spirometry - Restrictive pattern (↓ FVC, ↓ FEV1, normal or ↑ FEV1/FVC).

Used especially in interstitial pneumonia

Blood gases - ↓ PaO₂ (hypoxemia); sometimes ↑ PaCO₂ in severe cases