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PEBC > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Pneumonia is an acute infection of the ____________

A

Pulmonary parenchyma

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2
Q

The three different kinds of pneumonia are
1.
2.
3.

A
  1. CAP
  2. HAP
  3. VAP
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3
Q

Community acquired pneumonia is pneumonia in a patient not hospitalized or hospitalized for less than ___ hours

A

48

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4
Q

List two complications of pneumonia

A
  1. bacteremia
  2. sepsis / septic shock
  3. empyema
  4. lung abscess
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5
Q

List 3 common symptoms of pneumonia

A
  1. Fever
  2. Chills
  3. Cough
  4. SOB
  5. Chest pain
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6
Q

What are the common community acquired pneumonia (CAP) pathogens as an OUTPATIENT

A

Respiratory Viruses
S. pneumoniae
M. catarrhalis
C. / M. pneumoniae (Atypical)
S. aureus
H. influenzae

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7
Q

What are the common community acquired pneumonia (CAP) pathogens as an INPATIENT (NON-ICU)

A

Outpatient pathogens +/- gram negative bacilli

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8
Q

What are the common community acquired pneumonia (CAP) pathogens as an INPATIENT (ICU)

A

S. pneumoniae
S. aureus (including MRSA)
H. influenzae
Legionella spp.

“PAIL”

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9
Q

What are the common hospital acquired (HAP) and ventilator acquired (VAP) pathogens

A

S. aureus (including MRSA)
P. aeruginosa
S. pneumoniae (less common)
enteric gram negative bacilli

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10
Q

The pneumonia severity index (PSI) and CURB-65 scores are used to determine the probability of _____ and _____ in patients with pneumonia

A

morbidity and mortality

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11
Q

A curb65 score of 2 or more means the patient should be:

A

admitted to the hospital

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12
Q

List some common risk factors for CAP

A

Very young or very old
immunocompromised
underlying diseases (DM, CHF, COPD)

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13
Q

When starting empirical therapy for pneumonia, patients who have received an antibiotic in the past 3 months should be given an agent from a ___________ class of antibiotics in order to minimize the risk of treatment failure due to antimicrobial resistance

A

different

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14
Q

Empiric therapy of CAP

Outpatient (no modifying risk factors)

A

“ADAM”

Amoxcillin (children and adults)
Doxycycline
Macrolide (azithro or clarithro) *if rate of resistance is <25%

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15
Q

Empiric therapy of CAP

Outpatient (WITH modifying risk factors)

A

Beta-lactam (amox/clav or 2nd gen cephalosporin) + macrolide/doxy

Respiratory FQ

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16
Q

Inpatient therapy of CAP

NON-ICU

A

Respiratory FQ

Beta-lactam (ceftriaxone, cefotaxime, or amox/clav) + macrolide

17
Q

Inpatient therapy of CAP

ICU

A

Beta-lactam IV + (FQ IV or azith IV)

18
Q

Inpatient therapy of CAP/ ICU

Pseudomonas suspected

A

Antipseudomonal beta-lactam + Ciprofloxacin or Levofloxacin
= pip-taz, cefepime, meropenem, ceftazadime

Antipseudomonal beta-lactam + AG + IV azithromycin

19
Q

Empiric therapy for HAP or VAP

Stable (low risk) patient / No MRSA

A

Pip-taz
Cefepime
Levofloxacin

Meropenem
Imipenem

20
Q

Empiric therapy for HAP or VAP

Stable (low risk) / possible MRSA

A

Pip-taz
Cefepime
Levofloxacin
Ciprofloxacin*
Aztreonam*

Meropenem
Imipenem

MRSA coverage
Vanco
Linezolid

21
Q

Empiric therapy for HAP or VAP

Unstable / High risk (ventilated or septic shock) / IV Abx Exposure
Severe HAP/ALL VAP

A

Pip-taz
Cefepime
Meropenem
Imipenem
Aztreonam
—————-
Levo
Cipro
AG
————–
MRSA coverage
Vanco
Linezolid

Severe always have double coverage pseudomonas + MRSA coverage

22
Q

Targeted Therapy for CAP

S. pneumoniae= _______, _________, cefotaxime, ceftriaxone

H. influenzae = _________, 2nd/3rd gen cephalosporins, amox/clav

M. catarrhalis (Always produce beta lactamase) = __________, ___________

M. pneumoniae/C. Pneumoniae=
Legionella spp =

MSSA = ________, cefazolin, cephalexin

MRSA = Vancomycin, Linezolid, and NOT _______

A

S. pneumoniae= Pencillin, Amoxicllin, cefotaxime, ceftriaxone

H. influenzae = Amoxcillin, 2nd/3rd gen cephalosporins, amox/clav

M. catarrhalis (Always produce beta lactamase) = 2nd/3rd gen cephalosporin, amox/clav

M. pneumoniae/C. Pneumoniae= FQ, Macrolides, Tetracyclines
Legionella spp = FQ, Macrolides, Tetracyclines
*these two are atypical, lacking cell wall, so only these classes will provide coverage

MSSA = cloxacillin (IV), cefazolin, cephalexin

MRSA = Vancomycin, Linezolid, and NOT DAPTOMYCIN because it is inactivated by pulmonary surfactant, rendering it ineffective

23
Q

Total duration of therapy for CAP is between __ and ___ days

A

5 and 7

24
Q

Total duration of therapy for HAP/VAP is __ days and longer (__ to __) days in certain cases

A

7 days 10-14

25
Q

For pneumonia treatment, it is OK to use/change to PO therapy when the patient is _____

A

STABLE
- tolerate oral
-afebrile for 48-72h
-hemodynamically stable
- improving oxygenation

26
Q
A

PEBC (35 decks)

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