HAC- EBM

Question 1

Pneumonia

Answer 1

inflammation of lung due to microorganisms (bacteria, viruses, fungi, parasite)

Question 2

pneumonitis

Answer 2

inflammation of lung due to factors other than microbial. (chemicals, bird feces, gastric contents, asbestos, silica)

Question 3

Bronchitis

Answer 3

inflammation of bronchi or bronchial tubes
cough
green, clear, yellow sputum

Question 4

community acquired pneumonia

Answer 4

CAP

- presumed to be infectious from contact within the community

Question 5

healthcare associated pneumonia

Answer 5

HCAP

Question 6

healthcare acquired pneumonia

Answer 6

pneumonia occurs 48 or more hours after admission which was not incubating at time of admission

Question 7

ventilator associated pneumonia

Answer 7

arises more than 48-72 hrs after

Question 8

Most common pathogen detected with pneumonia

Answer 8

1. Thinovirus
2. Influenza A/B
3. S. pneumoniae

Question 9

Symptoms of pneumonia

Answer 9

cough, fever, SOB, fatigue, malaise

Question 10

signs of pneumonia

Answer 10

• consolidation on CXR
• air bronchogram
• elevated WBC
• hypoxemia
• dullness to percussion
• tactile
• tachypnea
  fever
  rales
  egophony and dullness to perfussion
  hemoptysis

CXR- pleural effusion, abscess, broniial pbreath sounds

Question 11

CURB-65

Answer 11

tool to decide of pt needs to be admitted

Confusion
BUN > 20
RR > 3- BP (SBP 65

0-1 = low risk (Outpt)
2==hospital admission
>2 assess for admission to ICU

in outpt BUN could be dropped and a score of 1 could suggest hospitalization

Question 12

Which CURB criteria is lowest reason to admit

Answer 12

age

Question 13

Decision making tools for pneumonia

Answer 13

CURB-65
SMART COP
PSI - stratifies adults into 5 categories for risk of death in 30 days from all causes

Question 14

First lines of treatment for CAP in healthy

Answer 14

azithromycin
doxycycline (first line if macrolide resistance > 20%)

Question 15

Treat CAP with pt with other comorbidities (heart dz, lung dz, liver, etc) WHAAAT

Answer 15

azithro PLUS beta
fluoroquinolone
beta lactam PLUS macrolide

Question 16

Treatment for INPT ICU treatment

Answer 16

beta lactam plus either arithromycin or fluoroquinolone

Question 17

If worried about pseudomonas

Answer 17

antipneumococcal, antipseudomonal beta lactam

pip-tazo plus cipro or levo

Question 18

Lights criteria

Answer 18

• tells whether effusion fluid is transudate or exudate; if at least one of following three criteria filled, fluid = exudate

Protein Fluid/Protein Body > 0.5
LDH Fluid/ LDH Body > 0.6
LDA Fluid > 2/3 upper limit of normal

Question 19

Parapneumonic effusion

Answer 19

effusion assd with pneumonia

• occur in 40% cases
• usually resolves w/antibiotics alone
• can do VATS or chest tube

Question 20

most common cause of post-influenza pneumonia

Answer 20

complication of influenza

Strep pneumo most common but we worry about staph as well

Question 21

Vaccines for pneumonia

Answer 21

Over 65, now everyone gets Prevnar then get pneumovax a year later

Question 22

MONA criteria

Answer 22

Morphine
oxygen
nitroglycerin
aspirin
beta blocker