Pneumonia

Question 1

pneumonia vitals?

Answer 1

fever, tachypnea, tachycardia, hypoxemia

Question 2

Lung exam with consolidation…auscultation? percussion? fremitus? egophony?

Answer 2

Rales, Dull, Increased, Yes

Question 3

Lung exam with pleural effusion auscultation? percussion? fremitus? egophony?

Answer 3

decreased, dull, decreased, No

Question 4

What bugs do we have airborne precautions with?

Answer 4

VZV, TB, measles

Question 5

TF- gram stain is more accurate than culture for sputum?

Answer 5

yes- due to fastidious organisms

Question 6

When do we order a urine legionella + LFT?

Answer 6

high fever, hyponatremia, elevated AST/ALT

Question 7

When do we order an RSV panel?

Answer 7

newborn or child

Question 8

Besides BMP, CBC w/ diff, ABG, and sputum stains, what is the gold standard for pneumonia evaluation and diagnosis? what are the indications?

Answer 8

CXR
cough + 1 of fever or tachy
cough + 2 of rales, decreased sounds, no history of asthma, not improving, worsening, worrisome

Question 9

what type of pneumonia is common for staph a and H influenzae?

Answer 9

bronchopneumonia

Question 10

What are the thoracentesis indications?

Answer 10

new pleural effusion >1cm decubitus

parapneumonic effusion

Question 11

What are chest tube indications?

Answer 11

loculated pus
pleural fluid w/ positive gram stain
pH3x ULN

Question 12

Light’s criteria

Answer 12

Exudate
pleural fluid protein/serum protein >.5
pleural fluid LDH/serum LDH >.6
Pleural fluid LDH >2/3 ULN

Question 13

What is CURB 65?

Answer 13

confusion, uremia (bun >20, tachypnea >30, hypotension 65

> 2 hospitalize
4 ICU

Question 14

1 pathogen overall?

Answer 14

strep p

Question 15

COPD no vaccine common pathogens?

Answer 15

H influenzae and moraxella

Question 16

young children>

Answer 16

mycoplasma, chlamydia, viral

Question 17

Elderly, smokers, TNF inhibitors?

Answer 17

legionella

Question 18

Alcoholics and aspirators?

Answer 18

klebsiella

Question 19

Post viral?

Answer 19

staph a

Question 20

outpatient CAP treatments

Answer 20

1 of
macrolide
doxy
FQ not cipro

Question 21

Inpatient CAP treatment

Answer 21

1 of
macrolide + srd gen ceph (ceftriaxone or cefotaxime)
or
FQ

Question 22

ICU CAP treatment

Answer 22

1 of 3rd gen ceph or amp/sulbactam
+
1 of macrolide or FQ

Question 23

Common HAP and HCAP pathogens?

Answer 23

staph a/MRSA

GNR- pseudomonas, kleb, e coli, enterobacter, serratia

Question 24

treatment for HAP and HCAP

Answer 24

vanco
+ piptazo or cefepime or carbapenems
+FQ or gentamycin

Question 25

aspiration treatments?

Answer 25

3rd generation ceph. Or florquinolone + clindamycin or metronidazole

Question 26

pneumonia is the immunocompromised host treatment?

Answer 26

as above, but add TMP/SMX + steroids to cover for PCP