Community Acquired Pneumonia

Question 1

Most common extracellular/typical bacterial pathogens

Answer 1

-Strep pneumoniae (pts w/no spleen are more vulnerable)
-Hemophilus influenzae (occursin post COPD pts)
-Moraxella catarrhalis
these are outside of the cell, and can be killed with PCN

Question 2

How do you get CAP

Answer 2

typically inhaling a pathogen, most commonly a bacteria

Question 3

Most common intracellular/atypical bacterial pathogens

Answer 3

-Mycoplasma pneumoniae (common in younger pts, walking pneumonia, can cause erythema multiforme)
-Chlamydia pneumonia
-Legionella pneumophilia (infects older pts 70-90
look for serum urine antigen to dx)
no sputum production

Question 4

Do we perform a gram stain on pneumonia pts?

Answer 4

no bc atypical cannot be gram stained

Question 5

typical vs

atypical presentation

Answer 5

high mortality, high fever, productive cough

more systemic disorders, dry cough, low mortality

Question 6

imaging for CAP?

Answer 6

PA and lateral CXR, air bronchogram, blood culture

Question 7

staph aureus causes….

Answer 7

cavitational CXR

Question 8

pt needs to be admitted under these circumstances?

Answer 8

• RR >30/min
• multilobar
• respiratory failure

Question 9

CURB 65

Answer 9

Confusion
Urea>20 mg
Respiratory rate>30/min
Blood pressure<90
age>65
0-1 pt goes home w/anbx
2 use clinical judgement
3+ admissions

Question 10

Anbx for typical and atypical

Answer 10

fluoroquinolones and macrolides

-use for outpatient

Question 11

anbx for typical

Answer 11

PCN based

inpatient use combo of PCNs and macrolides bc macrolides also have antiinflammatory properties

Question 12

how long to recheck xray

Answer 12

12 weeks unless it is getting worse

Question 13

comlications

Answer 13

increase risk of MI from inflammation

CVD