Chapter 122 - Lung abscess

Question 1

Lang Abscess can be single or multiple but usually are marked by a single dominant cavity ____ in diameter

Answer 1

> 2cm

Question 2

Definition of a primary abscess

Usually arises from ____
Principally caused by _____
Occur in ____

Answer 2

• usually arise from aspiration
• principally caused by anaerobic bacteria
  Occur in the absence of an underlying pulmonary or systemic condition

Question 3

Primary lung abscess is comprised of how many percent of cases?

Answer 3

80%

Question 4

Two settings wherein secondary abscesses arise

Answer 4

Postobstructive process (foreign body or tumor )

Systemic process (HIV, immunocompromising condition)

Question 5

Duration of an acute lung abscess

Answer 5

<4-6 weeks

Question 6

How many percent of cases comprise chronic abscess

Answer 6

40%

Question 7

Major risk factor for primary lung abscess

Answer 7

Aspiration

Question 8

Age group and and gender commonly affected by primary lung abscess

Answer 8

Middle aged men

Question 9

Important risk factors associated with the development of lung abscess

Answer 9

1. Colonization of the gingival crevices by anaerobic bacteria or microaerophilic streptococci
2. risk of aspiration

Question 10

Causative agent causing septic emboli from tricuspid valve endocarditis

Answer 10

Staphylococcus aureus

Question 11

Septic theombophlebitis resulting from an infection beginning in the pharynx spreading to the neck and the carotid sheath.

Syndrome & causative agent

Answer 11

Lemierre’s syndrome

Fusobacterium necrophorum

Question 12

Most common locations of primary lung abscesses

Answer 12

Posterior upper lobes
Superior lower lobes

Right most commonly bec right mainstem bronchus is less angulated

Question 13

True or False

Knowing the identity of the causative anaerobic isolate alters the response to treatment

Answer 13

False

Question 14

In how many percent of primary lung abscesses will cultures turn out negative ?

Answer 14

40%

Question 15

Term used when no pathogens are isolated from a primary lung abscess

Answer 15

Nonspecific lung Abscess

Question 16

Refers ro cases with foul smelling breath, sputum, empyema

Answer 16

Putrid lung abscess

Question 17

Location of secondary abscess

Answer 17

Varies with underlying cause

Question 18

Moat common organism causing secondary lung abscess

Answer 18

Pseudomonas aeruginosa and other gram (-) rods

Question 19

Obtaining culture material is of special i importance in which type of abscess?

Answer 19

Secondary

Question 20

Microorganism causing lung abscess associated with high fevers and a fulminant course

Answer 20

Non-anaeroic such as Staphylococcus aureus

Question 21

In which imaging will a thick walled cavity with an air fluid level be detected

Answer 21

Chest radiograph

Question 22

Imaging that permits better delineation andnprovide earlier evidence of cavitation

Answer 22

CT scan

Question 23

Recommended regimen for primary lung abscess

Answer 23

1. Clinda 600mg IV TID

2. BL/BLIC IV

Question 24

Treatment duration for lung abscess

Answer 24

3-4 weeks to 14 weeks

Question 25

Why is metronidazole not effective as a single agent?

Answer 25

Does not cover microaerophilic streptococci

Question 26

Size of abscess that is less likely to respond to antibiotic therapy

Answer 26

> 6-8cm

Question 27

Mortality rate of primary lung abscess

Answer 27

2%

Question 28

Mortality rate of secondary lung abscess

Answer 28

75%

Question 29

Poor prognostic factors for lung abscess

Answer 29

Age >60
Aerobic bacteria
Sepsis
Sx >8weeks
Size >6cm