Recurrent pneumonia in children — structured oral (viva)

Branch 1 — Definition and first move

Examiner: "This girl has had four pneumonias. What is your definition of recurrent pneumonia, and what is the first thing you want to establish?" Candidate: Recurrent pneumonia is two or more episodes in a year, or three or more ever, each radiographically confirmed and with the film clearing between episodes. My first move is to review all the previous films and decide whether the pneumonias struck the same site each time or different sites, because that single question splits the differential into structural, same-site causes and systemic, different-site causes. Here the episodes involved both lower lobes, so this is a different-site, systemic pattern. ^[1]