121 Pneumonia

Question 1

Most likely pathogen if with history of antibiotic therapy in preceeding 3 months?

Answer 1

Pseudomonas areguniosa

Question 2

Most likely pathogen if on chronic dialysis

Answer 2

MRSA

Question 3

Most common likely pathogen of pneumonia in those hospitalized for more than 48 hours, hospitalized for more than 2 days in prior 3 months and those in nursing home or extended care facility residence

Answer 3

MRSA, pseudomonas aeruginisa, Acinetobacter, MDR enterobacteriacae

Question 4

Most likely pathogen for pneumonia if with MDR infection

Answer 4

MRSA, MDR Enterobactericae

Question 5

Cytokines that induce fever

Answer 5

IL-1 and TNF

Question 6

Cytokines responsible for the release of neutrophils and their attraction to the lungs leading to peripheral leukocytosis and increased purulent secretions

Answer 6

IL 8 and GCSF

Question 7

Phases of pneumonia

Answer 7

1. Edema
2. Red hepatization
3. Gray hepatization
4. Resolution

Question 8

A 75/M present with 4-day productive cough with associated fever, Generalized weakness, and loss of appetite. He has HTN and COPD with good compliance to medication. PE: BP 90/60. HR 103/min, RR 32 cpm T 38.2 degrees Celsius. No neck vein distention, + crackles on both bases and occasional wheezes; no pedal edema. Which Antibiotic combination is appropriate for the patient?
A. IV Ceftriaxone + oral Azithromycin
B. IV Cefuroxime + oral Levofloxacin
C. IV Ampicillin Sulbactam + oral Levofloxacin
D. Oral co amoxiclav + Oral Azithromycin

Answer 8

A. IV Ceftriaxone + oral Azithromycin

Question 9

30F with recent influenza, presents with fever, productive cough, hemoptysis and cavitary infiltrate on chest x-ray. What empiric antibiotic will you give?
A. Amikacin
B. Clindamycin
C. Levofloxacin
D. Vancomycin

Answer 9

Cavity pneumonia is consist with Staph Aureus. D. Vancomycin

Question 10

58M DM, chronic smoker presents with 5 days history of cough and fever. BP 80/50 mmHg. T 39. What must be administered in first 3 hours?
A. Norepinephrine drip
B. IV crystalloid fluid
C. Pulmonary artery catheter insertion
D. Broad spectrum antibiotics

Answer 10

B. IV crystalloid Norepinephrine: only when fluid resuscitation done. Broad spectrum must be administered within 30 minutes but hypotension must be addressed first

Question 11

most common pathophysiology leading to pneumonia

Answer 11

aspiration from the oropharynx

Question 12

epidemiologic factors suggesting possible cause of CAP. travel to southeast asia

Answer 12

burkholderia pseudomallei, avian influenza virus

Question 13

epidemiologic factors suggesting possible cause of CAP. travel to southwestern United States

Answer 13

hantavirus, coccidiodes

Question 14

epidemiologic factors suggesting possible cause of CAP. lung abscess

Answer 14

CA MRSA, oral anaerobes, endemic fungi, M tuberculosis, atypical mycobacteria