ID

Question 1

CAP age <65, otherwise healthy, no antimicrobials in last 3 months

Answer 1

S. Pneumo, Mycoplasma, C pneumonia, H. flu, viral

Macrolide or doxycycline

Question 2

CAP age >65 w/ COPD, CHF, RF, DM, liver dz, EtOH abuse, or antimirobial in last 3 months

Answer 2

S. Pneumo, H. Flu, aerobic GNR (E. Coli, Enterobacter, Klebsiella), S. Aueus, Legionella, viral
fluroquinolone, or Beta lactam + macrolide

Question 3

CAP that requires hosp

Answer 3

S. Pneumo, H. Flu, anaerobes, Aerobic GNR, Legionella, C. pneumonia.
Fluroquinolone OR antipenomococcal beta lactam + macrolide

Question 4

CAP req ICU

Answer 4

S. Pneumo, Legionella, H. Flu, anaerobes, aerobic GNRs, Mycoplasma, pseudomonas
Antipneumococcal beta lactam + Azithromycin or fluroquinolone

Question 5

Inst or Hosp acquired pneumonia if in hops >48 hours, long term care >14 days, vent associated pneumonia

Answer 5

GNR (pseudomodas and acinetobacter), S. Aureus, Legionella, mixed
Extended spectrum cephalosporin or Carbepenem with antipseudomonal coverage
add amino glycoside or fluroquinolone to cover resistant pseudomonas until sensitivies come back

Question 6

Pneumonia in critically ill or worsening over 24-48 hours on initial abc

Answer 6

MRSA

add Vanc or linezolid, boa den gram neg coverage

Question 7

Bac meningitis in age <1 month

Answer 7

GBS, E.Coli/GNR, Listeria

Amp + Gent or Cefotaxime

Question 8

Bac Meningitis 1-3 months

Answer 8

S. Penumo, N. Men, H. Flu

vanc + Ceftriaxone or Cefotaxime

Question 9

Bac meningitis 3 months- adulthood

Answer 9

S. Pneumo, Meningococci

Vanc + Ceftriaxone of Cefotaxime

Question 10

Bac Meningitis >60 alc, chronic illness

Answer 10

S. Pneumo, G neg bacilli, listeria

AMp + Vanc + Cefotaxime, or Ceftriaxone