community acquired pneumonia

Question 1

pneumonia is more common in who?

Answer 1

older,males, Af Am

Question 2

aspiration pneumonia, lung abscess, anaerobic organisms, difficulty swallowing, alcohol

Answer 2

anaerobic organisms pneumonia

Question 3

what is the most commonly identified cause of community acquired pneumonia?

Answer 3

strep pneumoniae

Question 4

In pneumonia cases post influenza, after previous antibiotics , or with lung disease, consider? (3)

Answer 4

Staph aureus, Enterobacteriaceae, Pseudomonas

Question 5

what pathogen is often seen in older patients & those with underlying lung disease (COPD or CF)

Answer 5

H. infleunza

Question 6

name that pathogen: pneumonia cases with close person-person contact (schools, military)

Answer 6

Mycoplasma pnuemoniae or chlamyophilia

Question 7

name that pathogen: pneumonia outbreaks assc;d with cooling towers, showers, hot tubs

Answer 7

legionella

Question 8

name that pathogen: pneumonia seen in elderly or very young after previous influenza

Answer 8

staph aureus

Question 9

name that pathogen: fulminant disease w/ early empyema

Answer 9

grp A streptococcus

Question 10

how commonly are gram negative bacili causes of CAP ?

Answer 10

uncommon, really only seend with patients required ICU tx

Question 11

sx of pneumonia

Answer 11

cough, fever, pleuritic chest pain, dyspnea, sputum production

Question 12

does cough assc’d with pneumonia have sputum production?

Answer 12

not always, depends on pathogen

Question 13

____ and _____ can sometimes also present wtih pneumonia

Answer 13

chest pain and chills

Question 14

___is less common in the elderly, while _____is the most sensitive sign in elderly

Answer 14

fever, tachypnea

Question 15

what is the gold standard for dx of pneumonia?

Answer 15

CXR

Question 16

do you have to identify the pathogen before tx’ing pneumonia?

Answer 16

not required - empiric tx is very successful

Question 17

which situations is idenification of pathogen critical? (5)

Answer 17

1. legionella
2. influenza A/B
3. MERS
4. Community acquired MRSA
5. agents of bioterrorism

Question 18

is sputum gram stain & culture recommended for outpatient or inpatient?

Answer 18

ICU admission

Question 19

when is is sputum gram stain & culture recommended? (6)

Answer 19

1. ICU admission
2. failure of antibiotic tx
3. cavitary changes on imaging
4. immunocompromised host
5. alcoholism
6. suspecteddrug resistance

Question 20

in those with preexisting pulm issues, when is is sputum gram stain & culture recommended? (3)

Answer 20

1. severe COPD
2. pleural effusion
3. epidemic pneumonia

Question 21

what type of testing is more sensitive/specific than sputum for legionella and S. pneumoniae?

Answer 21

urinary testing

Question 22

can urinary testing be used if the patient has already started antibiotics?

Answer 22

yes, still valid

Question 23

can urine tell you antibioitic sensitivity?

Answer 23

NOO

Question 24

how to tx pneumonia in a previously healthy patient with no comorbidities?

Answer 24

oral macrolide

Question 25

how to tx pneumonia in In patients with comorbidities such as cardiac/pulmonary/renal/liver disease, diabetes, asplenia, immunosuppression, or antibiotic in previous 3 months

Answer 25

oral macrolide + beta lactam or just oral respiratory quinolone

Question 26

treatment for pneumonia should be given for a minimum of _____ days

Answer 26

5