Pneumonia

Question 1

Precautions

Answer 1

Droplet precautions - N. meningitidis, H. influenza, B. pertussis
Airborne - TB

Question 2

Fungal pneumonia

Answer 2

Coccidio - endemic areas
Histoplasmosis - disruption of soil, spelunking
Hantavirus - mice

Question 3

Tuberculosis - radiological evidence and tx

Answer 3

Upper lobe consolidation
Reactivation TB (total 6 months):
1. Isoniazide, Rifampin, Ethanbutol, Pyrazinamide OD x2 wks
2. above twice weekly x6 wks
3. Isoniazide, Rifampin twice weekly x16 wks

Question 4

Tx of CAP in ICU

Answer 4

Cephalosporin/Macrolide
Cephalosporin/Fluoroquinolone - cephtriaxone + azithromycin
- common G+, atypical pneumo

Question 5

Causes of Bronchiectasis

Answer 5

P. aeruginosa
S. aureus
ABPA - + skin test, increase IgE tx: corticosteroids/antifungal

Question 6

Chronic bronchitis

Answer 6

H. influenza
Moxarella catarrhalis
S. pneumo
Tx - B lactam/B-lactamase OR Macrolide OR Fluoroquinolone

Question 7

Risk Factors for P. aeruginosa

Answer 7

Bronchiectasis
Daily corticosteroid tx
Recent antibiotics
Malnutrition
Tx - Fluoroquinolone + Aminoglycoside

Question 8

Risk factors for Drug-resistant S. pneumo

Answer 8

Age > 65 
Use of B-lactam antibiotics in the last 3 months
Immunosuppresssion
Multiple medical co-morbidities
Regular exposure to child in day care

Question 9

Risk factors for enteric gram-negative

Answer 9

Same as S. pneumo +

• regular alcohol
• residence in nursing home

Question 10

Risk factors for anaerobic infection

Answer 10

Significant witnessed or suspected aspiration

Question 11

Risk factors Aspergillus pneumo

Answer 11

Prolonged neutropenia
Immunosuppression
HIV

Question 12

Treatment of S. pneumo resistant to penicillin

Answer 12

Also resistant to: 
- Macrolides (TMP/SMX)
- Clindamycin
- Doxycyclin
NO resistance to: 
- Vancomycin
- Fluoroquinolones
- Linezolid

Question 13

Treatment of Varicella pneumo

Answer 13

Acyclovir

• HSV 5 mg/kg q8h
• VZV 10 mg/kg q8h

Question 14

Treatment of influenza

Answer 14

Oseltamivir