26: PNA and ARDS

Question 1

HAP

Answer 1

hospital-acquired PNA - after at least 2 days of hospitalization

Question 2

VAP

Answer 2

ventilator-associated PNA

Question 3

aspiration PNA

Answer 3

PNA due to inhalation of contents from stomach or mouth

Question 4

RFs for HAP

Answer 4

male, malnutrtition, burns, trauma, post surgery, severe illness, ARDS

Question 5

pathogenesis of PNA

Answer 5

infecting agent enters nasopharynx -> translocates to lower airways

Question 6

two most frequent pathogens for HAP and VAP

Answer 6

P. aeruginosa, S. aureus

Question 7

main concern about HAP and VAP

Answer 7

Abx resistance

Question 8

types of bacteria that typically cause aspiration PNA

Answer 8

anaerobes and gram-negative bacilli

Question 9

what % of CAP is the etiology not detected?

Answer 9

50%

Question 10

when to add MRSA coverage with CAP

Answer 10

severe CAP if recently hospitalized, on parenteral Abx, and at risk for MRSA

Question 11

when to add pseudomonas coverage in CAP

Answer 11

severe CAP if recently hospitalized, on parenteral Abx, and at risk for pseudomonas

Question 12

treatment for aspiration PNA

Answer 12

same agents as CAP

Question 13

treatment for aspiration PNA due to poor dentition

Answer 13

broad coverage B-lactam like ampicillin-sublactam, or a quinolone

Question 14

two major conditions that cause ARDS

Answer 14

PNA, sepsis

Question 15

microthrombi in ARDS

Answer 15

microthrombi can accumulate in the alveoli -> impaired absorption of O2 + impaired excretion of CO2