Pmeumonia

Question 1

4 symptoms of pneumonia:

Answer 1

• Fever
• Reproductive cough (yellowish greenish)
• SOB
• Pleuritic chest pain

Question 2

CXR of Typical pneumonia: […]
CXR of Atypical pneumonia : […]

Answer 2

Typical: consolidation
Atypical: bilateral infiltration

Question 3

You must obtain […] for diagnosis of pneumonia

Answer 3

Sputum culture & gram stain

Question 4

It takes […] weeks for patches on CXR of lobar pneumonia to disappear

Answer 4

6 weeks

Question 5

Most common causative organism of CAP:

Answer 5

Strep pneumonia

Question 6

Most common causative organism of HAP:

Answer 6

Pseudomonas
E.coli
Klebsiella
MRSA

Question 7

Most common causative organism of Ventilation associated pneumonia:

Answer 7

Pseudomonas

Question 8

Expect […] as causative organism of pneumonia in HIV patients with CD4<200

Answer 8

PCP
Pneumocystic Carinii or Jirovici

Question 9

[…] test to detect Mycoplasma pneumonia

Answer 9

IgM cold agglutinin

Question 10

[…] test to detect Legionella

Answer 10

Urinary antigen

Question 11

[…] test to detect PCP

Answer 11

Silver stain

Question 12

[…] is common pneumonia organism in alcoholic

Answer 12

Klebsiella

Question 13

CURB-65 stands for

Answer 13

Confusion
Urea >7
RR >30
BP <90/60
Age 65+

Question 14

Air-fluid level on CXR

Answer 14

Lung abscess

Question 15

Lung abscess mostly caused by […] organism

Answer 15

Aneorobics

Question 16

Tx of lung abscess:

Answer 16

Clindamycin

Question 17

Antibiotic of choice for Atypical pneumonia:

Answer 17

Macrolides (Azithromycin)
or Doxycyclin

Question 18

Inpatient treatment of pneumonia (CURB:2)
Antibiotics choice: […]

Answer 18

Ceftriaxone
or FQ

Question 19

Inpatient treatment of pneumonia (CURB>2)
Pseudomonas -ve
Antibiotics choice: […]

Answer 19

Ceftriaxone + Macrolide (Azithro)

Question 20

Inpatient treatment of pneumonia (CURB>2)
Pseudomonas +ve
Antibiotics choice: […]

Answer 20

Imepenem
+ FQ

Question 21

62 yo male diabetic present with pneumonia CXR small pleural effusion. What is considered poor prognostic factor?
A. Age
B. DM
C. Crackles
D. Pleural effusion

Answer 21

DM
Debatable

Question 22

69 YO DM, present with pneumonia, RR:23 BP: 120/80 Temp: 38.5 WBC: 12 BUN: 5
CXR: Rt lower lobe infiltration.
Best management:

A. Admit to ward, IV abx
B. Admit to ICU, IV abx
C. Oral abx & observe in ER for 24hr
D. Oral abx & follow outpatient in 7 d

Answer 22

D. Oral abx & follow outpatient in 7 d

CURB-65 : 1
✅Age 65+
✖️ Confusion
✖️ Urea >7
✖️ RR >30
✖️ BP <90/60

Question 23

Which patient with lobar pneumonia treated as outpatient?
A. 88 YO, BP: 90/59, T: 40, RR:20, HR: 116
B. 88 YO, BP: 88/60, T: 37, RR:25, HR: 120
C. 50 YO, BP: 80/60, T: 34, RR:31, HR: 120
D. 55 YO, BP: 100/90, T: 39, RR:30, HR: 100

Answer 23

D. 55 YO, BP: 100/90, T: 39, RR:30, HR: 100

CURB-65 : 1
A. 2 (age, BP)
B. 2 (age, BP)
C. 2 (BP, RR)

Question 24

Young male healthy
presented with pneumonia CXR: bilateral lower lobe infiltration. Vitally stable. Choice of ABX:
A. Moxifloxacin 400 mg IV OD
B. Ceftazidime 1 g IV q8h
C. Meropenem 1 g IV q8h
D. Piptazo

Answer 24

Moxifloxacin
Is FQ (CURB-65: 0-1) should be outpatient !

Question 25

Pneumonia in the ICU
Best empiric treatment is Azithromycin + […]

Answer 25

Vancomycin
To cover MRSA