Pneumonia

Question 1

Components of CURB65 score

Answer 1

Confusion

Urea

Respiratory rate

BP

Age

Question 2

Urea cut off for CURB65

Answer 2

> 20 mg/dl

Question 3

RR cut off for CURB65 score

Answer 3

30 or more

Question 4

BP cut off for CURB65 score

Answer 4

< 90 systolic

< 60 diastolic

Question 5

CURB65 score for admission to medical floor

Answer 5

2

Question 6

CURB65 score for admission to ICU

Answer 6

3-5

Question 7

Pneumonia severity index for admission to medical floor

Answer 7

70

Question 8

Pneumonia severity index for admission to ICU

Answer 8

130

Question 9

2 major criteria for severe pneumonia

Answer 9

Need for vent or shock requiring pressers

Question 10

Non severe hospitalized CAP abx regimen

Answer 10

3rd gen ceph + macrolide

OR

Fluoroquinolone

Question 11

Only 2 indications for anaerobic coverage

Answer 11

abscess or empyema

Question 12

Severe hospitalized CAP abx regimen w/o risk factors for pseudomonas or MRSA

Answer 12

beta lactam + azithromycin or fluoroquinolone

Question 13

Severe hospitalized CAP abx regimen with risk factors for pseudomonas or MRSA

Answer 13

Anti-pseudomonal beta lactam + fluoroquinolone + MRSA coverage

Question 14

5 Risk factors for resistant GNR infections requiring double coverage

Answer 14

Recent IV abx (90 days)

Respiratory failure

Hospitalized more than 5 days

High local incidence of resistance

Immunosuppressed

Question 15

Length of treatment for VAP/HAP that is not pseudomonas or MRSA

Answer 15

7-8 days

Question 16

Length of treatment for VAP/HAP that is pseudomonas or MRSA

Answer 16

8-15 days due to high recurrence rate

Question 17

Definition of HAP

Answer 17

Pneumonia after 48 hours of admission to the hospital

Question 18

Definition of VAP

Answer 18

Pneumonia after 48 hours on vent

Question 19

Is tracheal aspirate as good as bronch specimen for VAP specimen

Answer 19

Yes

Question 20

Clinical criteria for VAP

Answer 20

New infiltrate AND

Clinical evidence of infection

Question 21

Patient who does not meet both criteria for VAP is diagnosed with what

Answer 21

Ventilator associated tracheobronchitis

Question 22

Does ventilator associated tracheobronchitis require antibiotics

Answer 22

No

Question 23

2 requirements for diagnosis of empyema

Answer 23

Frank pus

And/or

Positive gram stain/culture

Question 24

Requirements to label a parapneumonic effusion as complicated

Answer 24

pH < 7.20

Glucose < 60

LDH > 3x upper limit

Question 25

Do parapneumonic effusions require drainage

Answer 25

No

Question 26

Do complicated effusions and empyema require drainage

Answer 26

Yes