PNEUMONIA Flashcards
What role do inflammatory mediators like interleukin 6 and tumor necrosis factor play in the body’s response to infection or injury?
a) They increase local neutrophil numbers
b) They result in fever
c) They inhibit the release of chemokines
d) They repair damaged tissues
B
A 45-year-old patient with acute bronchitis shows increased levels of interleukin 8 (IL-8) and granulocyte colony-stimulating factor (G-CSF) in their blood. What is the most likely consequence of these elevated chemokines in the local tissue?
a) Decreased neutrophil infiltration
b) Increased neutrophil accumulation at the site of inflammation
c) Suppressed immune response at the infection site
d) Enhanced resolution of inflammation
B
A 55-year-old patient with pneumonia is found to have impaired oxygenation and low blood oxygen levels (hypoxemia). Radiographs show bilateral infiltrates. What pathophysiological mechanism is most likely responsible for these findings?
a) Alveolar capillary leak due to mediators released by macrophages and neutrophils
b) Airway obstruction due to excessive mucus production
c) Increased surfactant production and alveolar stabilization
d) Reduced blood flow to the lungs due to pulmonary embolism
A
In the initial stage of classic pneumonia, what is the predominant characteristic of the alveolar exudate?
a) High levels of neutrophils and fibrin
b) Proteinaceous exudate with bacteria and edema
c) Predominance of macrophages and resolution of inflammation
d) Erythrocytes and fibrin deposition
B
What is the defining feature of the red hepatization phase of pneumonia?
a) Presence of abundant neutrophils and fibrin
b) Lysis of erythrocytes in the alveolar exudate
c) Erythrocytes in the intraalveolar exudate
d) Clearance of bacteria from the alveolar space
C
In the gray hepatization phase of pneumonia, which of the following is the predominant cell type found in the alveoli?
a) Erythrocytes
b) Macrophages
c) Neutrophils
d) Lymphocytes
C
What does the gray hepatization phase in pneumonia correspond with?
a) Resolution of infection and clearance of debris
b) Continued bacterial replication and worsening inflammation
c) Successful containment of infection and improvement in gas exchange
d) Dominance of erythrocytes and hemolysis
C
In the final phase of resolution in pneumonia, which cell type becomes predominant in the alveolar space?
a) Neutrophils
b) Macrophages
c) Lymphocytes
d) Erythrocytes
B
A patient who stayed in a hotel or cruise ship in the previous 2 weeks is at risk of infection with:
A. Histoplasma capsulatum
B. Legionella spp.
C. Avian influenza virus
D. Francisella tularensis
B. Legionella spp.
Travel to the Ohio or St. Lawrence River Valley is associated with which pathogen?
A. Hantavirus
B. Histoplasma capsulatum
C. Burkholderia pseudomallei
D. Chlamydia psittaci
B. Histoplasma capsulatum
Which of the following pathogens is linked to exposure to rabbits?
A. Mycobacterium tuberculosis
B. Francisella tularensis
C. Legionella spp.
D. Chlamydia pneumoniae
B
Which high-risk condition warrants blood cultures in patients with pneumonia?
A. Hypertension
B. Asplenia
C. Diabetes mellitus
D. Hyperlipidemia
B. Asplenia
**Certain high-risk patients should
have blood cultured, including those with neutropenia secondary to pneumonia, asplenia, complement deficiencies, chronic liver disease, or severe CAP, and those at risk of MRSA or P. aeruginosa infection.
What type of infection specifically increases the need for blood cultures in patients with severe community-acquired pneumonia (CAP)?
A. Haemophilus influenzae infection
B. MRSA infection
C. Legionella spp. infection
D. Coxiella burnetii infection
B. MRSA infection
Which of the following is a non-MDR (multidrug-resistant) pathogen associated with ventilator-associated pneumonia?
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
C. Acinetobacter spp.
D. Burkholderia cepacia
B. Streptococcus pneumoniae
Which pathogen is categorized as an MDR pathogen in ventilator-associated pneumonia?
A. Haemophilus influenzae
B. Methicillin-resistant Staphylococcus aureus (MRSA)
C. Proteus spp.
D. Serratia marcescens
B. Methicillin-resistant Staphylococcus aureus (MRSA)
Fungal pathogens like Aspergillus spp. are categorized under which group in ventilator-associated pneumonia?
A. Non-MDR pathogens
B. MDR pathogens
C. Viral pathogens
D. Nonpathogenic organisms
B. MDR pathogens
What is a recommended prevention strategy to address oropharyngeal colonization with pathogenic bacteria in ventilator-associated pneumonia?
A. Hand washing with alcohol-based hand rub
B. Avoidance of prolonged antibiotic courses
C. Noninvasive ventilation
D. Tight glycemic control
B. Avoidance of prolonged antibiotic courses
Which prevention strategy is suggested to reduce cross-infection from other colonized patients?
A. Endotracheal intubation
B. Early percutaneous tracheostomy
C. Hand washing with alcohol-based hand rub
D. Elevation of the head of the bed
C. Hand washing with alcohol-based hand rub
What prevention strategy is used to maintain lower respiratory host defenses?
A. Avoidance of high gastric residuals
B. Tight glycemic control
C. Proper cleaning of reusable equipment
D. Rapid-sequence intubation
B. Tight glycemic control
To prevent microaspiration around the endotracheal tube, which of the following is recommended?
A. Avoidance of sedation
B. Head of bed elevated
C. Intensive infection control education
D. Change ventilator circuits only when soiled
B. Head of bed elevated
What is a primary difference between hospital-acquired pneumonia (HAP) in non-intubated patients and ventilator-associated pneumonia (VAP)?
A. HAP has a higher mortality rate.
B. Non-MDR pathogens are more frequent in HAP.
C. MDR pathogens are more common in HAP.
D. Diagnosis is easier for HAP.
B. Non-MDR pathogens are more frequent in HAP.
Why might anaerobes be more common in non-VAP HAP patients?
A. Increased risk of macroaspiration
B. Greater exposure to MDR pathogens
C. Higher oxygen tensions in the lower respiratory tract
D. Resistance to antibiotics
A. Increased risk of macroaspiration
