Other Pneumonias

Question 1

what criteria must be met to diagnose a patient with HAP?

Answer 1

> 48 hrs in hospital in past 90 days

Question 2

what criteria must be met to diagnose a patient with VAP?

Answer 2

endotracheal intubation > 48 hours

Question 3

what is the most common HAP organism?

Answer 3

staph aureus

Question 4

what are 3 common VAP organism? (SAP)

Answer 4

Steno malto
Acine species
Pseudomonas a.

Question 5

what clinical findings are present to diagnose HAP and VAP?

Answer 5

opacities on xray
fever
leukocytosis
purulent sputum

Question 6

what would be seen in a blood gas for HAP or VAP

Answer 6

hypoxemia
hypercapnia

Question 7

what 3 diagnostics should be ordered for HAP and VAP?

Answer 7

blood culture
sputum culture
chest xray or CT

Question 8

what 2 labs should be ordered for HAP and VAP?

Answer 8

CBC
chemistry

Question 9

what is the treatment for HAP and VAP?

Answer 9

IV vancomycin + piperacillin OR cefepime

Question 10

aspiration of gastric contents or oral/dental bacteria leads to what?

Answer 10

anaerobic pneumonia
lung abscesses

Question 11

where in the lungs does aspiration lead to pneumonia?

Answer 11

gravity dependent areas

Question 12

a patient presents with fever, weight loss, malaise, poor dentition, cough with foul-smelling purulent sputum. what are they experiencing?

Answer 12

anaerobic pneumonia
lung abscess

Question 13

what would a lung abscess look like on chest Xray or CT?

Answer 13

thick-walled cavity surrounded by consolidation

Question 14

what would a necrotizing pneumonia look like on chest xray or CT?

Answer 14

multiple areas of cavitation inside consolidation

Question 15

what are 3 first line treatments for anaerobic pneumonia and lung abscesses?

Answer 15

augmentin
amoxicillin + metronidazole
clindamycin

Question 16

where is viral pneumonia located?

Answer 16

inside the alveoli

Question 17

a patient presents with fever, myalgias, fatigue, URI symptoms, increased RR, diffuse rales and wheezes, non-productive cough +/- pink frothy sputum, +/- tender trachea, and cervical lymphadenopathy. what are they experiencing?

Answer 17

viral pneumonia

Question 18

what will viral pneumonia look like on chest xray if it doesn’t look normal? (3)

Answer 18

diffuse consolidation
bronchial wall thickening
small pleural effusions

Question 19

what will viral pneumonia look like on a chest CT?

Answer 19

ground-glass opacity

Question 20

what is the general treatment for viral pneumonia? (3)

Answer 20

antivirals
NSAIDs
cough suppressants

Question 21

what are 2 NSAIDs that can be used for vial pneumonia?

Answer 21

ibuprofen
naproxen

Question 22

what are 2 cough suppressants that can be used for viral pneumonia?

Answer 22

dextromethorphan
benzonatate

Question 23

what is the most common organism in fungal pneumonia?

Answer 23

pneumocystis jirovecii

Question 24

a patient presents with abrupt onset of fever, tachypnea, SOB, dry cough, and +/- bibasilar crackles. what are they experiencing?

Answer 24

pneumocystis jirovecii

Question 25

what would pneumocystis jirovecii look like in a chest xray? (bat wings)

Answer 25

perihilar interstitial infiltrations - ground glass type

Question 26

what would blood gas of pneumocystis jirovecii look like?

Answer 26

hypoxemia hypercapnia

Question 27

what is the first line treatment for pneumocystis jirovecii?

Answer 27

trime-sulfa

Question 28

what class of medication can be used in pneumocystis jirovecii if PaO2 is less than 70, A-a gradient is more than 35, or resting room OSat is less than 92?

Answer 28

corticosteroids

Question 29

small oval bodies that reach the terminal bronchioles and alveoli?

Answer 29

mycelia

Question 30

what kind of infection occurs when mycelia transform into yeasts that are found inside macrophages?

Answer 30

histoplasmosis (fungal pneumonia)

Question 31

what are some risk factors for histoplasmosis? (4)

Answer 31

excavation going into caves remodeling old buildings cutting dead trees

Question 32

a patient presents with flu-like symptoms + cough, dyspnea, and chest pain. what are they likely experiencing?

Answer 32

histoplasmosis

Question 33

when do symptoms of histoplasmosis typically occur?

Answer 33

1-4 weeks after exposure

Question 34

what would histoplasmosis look like on a chest xray?

Answer 34

hilar/mediastinal adenopathy pulmonary infiltrates

Question 35

what 2 labs should we run for histoplasmosis?

Answer 35

antigen test of bronchial fluid or serum cytology of bronchial fluid

Question 36

what kind of patients may have chronic cavitary histoplasmosis?

Answer 36

smokers who have COPD

Question 37

what is the treatment for histoplasmosis?

Answer 37

amphotericin B + itraconazole