Pneumonia

Question 1

Rabbit exposure puts patients at risk for what bacterial pneumonia?

Answer 1

Francisella Tularenis

Question 2

Bong marijuana use puts patients at risk for what bacterial pneumonia?

Answer 2

Pseudomonas

Question 3

CURB-65 criteria?

Answer 3

Confusion
Urea > 7 mmol/L (19.6mg/dL)
RR>=30
BP < 90/60
65 years old

0-1 = OP
2 = IP
3+ = ICU

Question 4

PORT score results for pneumonia

Answer 4

Class 1,2 = outpatient

Class 3,4 = inpatient

Question 5

What are the two genetic mechanisms for a bacteria developing resistance to macrolides?

Answer 5

• meff - efflux pump. 2/3 of resistance cases. Low level of resistance.
• erm(B) - Methylation change to macrolide binding site. High level of resistance.

Question 6

New antibiotic: Omadacycline (Nuzyra).

• Class?
• Coverage?

Answer 6

• Tetracycline class
• Covers MDRO S Pneumo, MRSA, some BNR.
• Approved for CAP & SSTI

Question 7

New antibitoic: Lefamulin (Xenleta)

• Class?
• Coverage?

Answer 7

• Pleuromutilin class

- Covers MDRO S Pneumo, MRSA, some GNR

Question 8

New antibiotic: Solithramycin (Solithra)

• Class?
• Coverage?

Answer 8

• 4th generation macrolide

- Covers MDRO S Pneumo, atypicals (including macrolide-resistant mycoplasma), moraxella, MRSA

Question 9

8 interventions shown to decrease incidence of HAP?

Answer 9

• Post-pyloric feeding.
• silver-coated ETT
• SDD (Selective digestive decontamination)
• SOD (Selective oral decontamination)
• Subglottic secretion drainage
• Aerosolized antibiotics
• Tracheal saline instillation
• PEEP

Question 10

Empiric treatment of ESBL pneumonias?

Answer 10

Carbapanems. Maybe FQs.

Question 11

Empiric treatment of Acetinobacter pneumonias?

Answer 11

Carbapanem or Augmentin.

Question 12

Empiric treatment of carbapanem resistant pneumonia?

Answer 12

IV polymyxin and inhaled colistin