Pneumonia

Question 1

Typical Pneumonia: common bugs

Answer 1

Strep pneumo
H. Flu
GAS
Kleb
M. Catarrhalis

Question 2

Typical Pneumonia: onset?

Answer 2

Acute

Question 3

Typical Pneumonia: SX

Answer 3

Fever, CHILLS, sweats, prod/nonproductive cough

Question 4

Typical Pneumonia: Xray findings

Answer 4

lobar consolidations

Question 5

Atypical Pneumonia: bugs

Answer 5

Mycoplasma
Chlamydia
Legionella

Question 6

Atypical Pneumonia: onset?

Answer 6

Gradual, typically this is less serious

Question 7

Atypical Pneumonia: Xray findings

Answer 7

diffuse interstitial infiltrates or patchy ground glass appearance

Question 8

Atypical Pneumonia: Sx

Answer 8

fever, NO CHILLS, non-productive cough

Question 9

What is the most deadly infectious disease in US?

Answer 9

CAP

Question 10

What is the timing requirement that constitutes community acquired pneumonia from hospital acquired?

Answer 10

CAP- needs to be caused from outside of the hospital or withIN 48hrs of hospitalization

Hospital acquired- occurs more than 48 hours after admission to the hospital or other health care facility and excludes any infection present at the time of admissiont

Question 11

What is the first line treatment for someone who has to be treated in the ICU for CAP?

Answer 11

Respiratory Flouroquinolone (Moxi-, Gemi- Levo- FLOXACIN)

Question 12

What is the typical followup period after being treated for CAP?

Answer 12

about 6 weeks AFTER treatment

Question 13

Hospital acquired PNA: SX

Answer 13

at least one: fever, leukocytosis and purulent sputum

Question 14

Hospital acquired PNA: Xray findings

Answer 14

new or progressive opacity

Question 15

Most common organisms in HAP

Answer 15

– Staphylococcus aureus (MSSA and MRSA)
– Pseudomonas aeruginosa
– Gram-negative rods including non-extended spectrum β-lactamase (ESBL) producing and ESBL-producing (Enterobacter species, Klebsiella pneumoniae, and Escherichia coli)

Question 16

T/F: HAP is the leading cause of death due to infection with mortality rates ranging from 20% to 50%

Answer 16

TRUE

Question 17

The most common cause of community-acquired pyogenic bacterial pneumonia is?

Answer 17

Strep Pneumo

Question 18

Empiric tx for strep PNA as an OP? IP?

Answer 18

Outpatient: Amoxicillin
Inpatient: IV Pen G

Question 19

complications of strep PNA?

Answer 19

empyema, endocarditis, pericarditis, meningitis

Question 20

Who should get the pneumococcal vaccine?

Answer 20

– Patients at increased risk for developing severe pneumococcal disease (eg, asplenic patients, those with sickle cell disease)

– Chronic illnesses (eg, cardiopulmonary disease, alcoholism, renal disease, cancer)

– Persons OVER 65 years of age

– Elderly individuals with unknown immunization status should be immunized once

Question 21

most common atypical PNA bug?

Answer 21

Mycoplasma

Question 22

You see “ Red sputum currant jelly” you think?

Answer 22

Klebsiella

Question 23

Pts PNA symptoms after being at a conference and staying in a hotel, you think?

Answer 23

Legionella!

Question 24

Some who developed anaerobic PNA may have a predisposition to?

Answer 24

Aspiration

Question 25

What are some findings of Anaerobic PNA?

Answer 25

poor dentition
foul smelling sputum
fever
weight loss
malaise

Question 26

Do you treat viral PNA with ABX?

Answer 26

Heck no! You do some bed rest, pain management and antitussives

Question 27

If you wanted to prescribe Zanamivir, when is the ideal timing for it?

Answer 27

You want to give antivirals within 48hrs of symptoms or else they are less effective after that window of time

Question 28

Diagnostic evaluation for suspected nosocomial pneumonia includes:

Answer 28

blood cultures from at least 2 different sites!

Question 29

T/F. You should wait until culture results are back before prescribing antibiotics for a nosocomial/hospital-acquired pneumonia.

Answer 29

FALSE - start empiric ASAP

Question 30

Death from H1N1 is 4x greater in which race?

Answer 30

American Indians