Approach to Pneumonia

Question 1

four common ways to damage lung defense?

Answer 1

viral infection
smoking
COPD
medications ( steroids)

Question 2

four severe ways to damage lung defense?

Answer 2

AIDS
immunosppressants
malignancies
tracheal tubes

Question 3

what is aspiration pneumonia?

Answer 3

is when there is a large scale aspiration event like a bolus that can go down and lead to pneumonia

Question 4

what is egophony?

Answer 4

when you ask patient to say “eee” and you hear it echoed into stethoscope…this is sign of pneumonia

Question 5

which of typical/atypical pneumonia is rapid onset and which is indolent?

Answer 5

typical is rapid and atypical is indolent

Question 6

with typical or atypical pneumonia are you more ill appearing?

Answer 6

typical

Question 7

what are the symptoms of typical pneumonia?

Answer 7

fever, rigors, chest pain, purulent sputum

Question 8

what are the symptoms of atypical pneumonia?

Answer 8

low fever, headache, dry cough

Question 9

which of atypical/typical pneumo has crackles?

Answer 9

both can

Question 10

which of atypical/typical leads to consolidation of lung?

Answer 10

typical…not atypical

Question 11

which of typical/atypical leads to leukocytosis?

Answer 11

typical

Question 12

which organisms are found in typical pneumonia? 3

Answer 12

strep pneumo
staph a
gram neg organism

Question 13

which organisms are found in atypical pneumonia? 3

Answer 13

chlamydia
mycoplasma
viruses

Question 14

is lobar pneumonia typical or atypical presentation?

Answer 14

typical

Question 15

is interstitial pneumonia typical or atypical presentation?

Answer 15

atypical

Question 16

what are the five bugs for ambulatory or CAP pneumo that are common?

Answer 16

mycoplasma
chlamydia
strep pneumo
haemophilus
virus

Question 17

aside from the five from CAP…what are the two new considerations for hospital non ICU bugs for pneumonia?

Answer 17

legionella and aspiration pneumonia

Question 18

what are two bugs characteristically found in severe ICU pneumonia situations?

Answer 18

staph A

gram negative like pseudomonas

Question 19

what type of bugs are common in aspiration pneumonia?

Answer 19

anaerobic bugs

Question 20

what are two risk factors for haemophilus pneumonia?

Answer 20

COPD and smoking

Question 21

when must you obtain culture to be able to do a gram stain?

Answer 21

prior to giving antibiotics…if obtained after it is useless

Question 22

name the five main signs that mean a patient should be admitted to the hospital with pneumonia?

Answer 22

leukocytosis
poor vital signs (high RR, low BP, fever, HR elevated)
multilobar involvement
older than 65
comorbidities

Question 23

what is the most common pneumonia that HIV patients suffer from?

Answer 23

strep pneumo…still get it a lot

just are more susceptible to PJP

Question 24

with low CD4 counts….what is different about how TB can present in HIV/AIDS patient?

Answer 24

it can present as a lower lobe infiltrate