Lung Infections

Question 1

What is the best initial test for Community-Acquired Pneumonia

Answer 1

Chest X-Ray

Question 2

What are the indications to hospitalize a patient with Pneumonia

Answer 2

Hypotension: SBP <90
RR>30, pO2 <60, pH < 7.35
BUN >30, Na< 130, Glucose >250
HR > 125
Confusion
Temperature > 104 F
Age >= 6t5 with comorbidity
-Cancer, COPD, CHF, RF, Liver Disease

Question 3

Indicators of Empyema

Answer 3

pH <7.2 or PMN’s >1,000

Question 4

How to treat Empyema

Answer 4

Chest Tube Drainage

Question 5

Light’s Criteria for Exudative Effusion

Answer 5

Protein >50% serum
LDH >60% serum
Cancer, infection, CT disease

Question 6

Light’s Criteria for Transudative Effusion

Answer 6

Protein <50% serum
LDH < 60% serum
CHF, Nephrotic Syndrome, Atelectasis
Hypoalbuminemia

Question 7

Treatment for Hospital-Acquired Pneumonia

Answer 7

Antipseudomonal Cephalosporin
-Cefepime, Ceftazadine

Antipseudomonal Penicillin
-Piperacillin/Tazobactam

Carbapenems
-Impinem, Meropenem

Question 8

Most Accurate test for Ventilator-Acquired Pneumonia

Answer 8

Open lung biopsy

Question 9

Treatment for Ventilator-Acquired Pneumonia

Answer 9

1 antipseudomonal beta-lactam
-Cephalosporin
-Penicillin
-Carbapenem

1 more antipseduomonal agent
-Aminoglycoside
-Fluoroquinolone

1 MRSA agent
-Vancomycin
-Linezolid

Question 10

Best Initial Test for Lung Abscess

Answer 10

Chest X-ray
-cavity +/- air fluid level

Question 11

Most accurate test for lung absces

Answer 11

Chest CT

Question 12

Treatment for Lung Abscess

Answer 12

Clindamycin or Penicillin

Question 13

Best initial test for Pneumocystis Pneumonia

Answer 13

Chest X-ray or ABG
-bilateral infiltrate
-increased A-a gradient

Question 14

Most accurate test for Pneumocystis Pneumonia

Answer 14

BAL

Question 15

Treatment for Pneumocystis Pneumonia

Answer 15

TMP/SMX: Best

Alternatives
-atovaquine
-clindamycin + Primaquine or Pentamidine

Question 16

Best Initial Test for TB

Answer 16

Chest X-ray

Question 17

Most accurate test for TB

Answer 17

Pleural Biopsy

Question 18

Treatment for TB

Answer 18

Rifampin 6 months
Isoniazid 6 months
Pyrazinamide 2 months
Ethembutol 2 months

Question 19

Treat Nontuberculosis Mycobacteria

Answer 19

Azithromycin (clarithromycin)
and
Rifampin (Rifabutin)
and
Ethambutol

Question 20

Diagnostic Testing for Allergic Bronchopulmonary Aspergillosis

Answer 20

Peripheral Eosinphilia
Skin test reactivity to Aspergillus Ag
Ab to Aspergillus precipitate on blood test
Increased serum IgE
Pulmonary infiltrates
-on CXR or CT

Question 21

Treatment for Allergic Bronchopulmonary Aspergillosis

Answer 21

Oral Steroids: Prednisone

Oral Itraconazole

Omalizumab

Question 22

Most accurate Test for Covid-19

Answer 22

PCR