Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HPIM 19th ID > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Outpatient pneumonia involving MDR pathogens

A

HCAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pathogen with exclusive risk from home infusion therapy and home wound care

A

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Possible pathogens for antibiotic use the preceding 3 months

A

Pseudomonas

MDR Enterobacteriaceae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MC mode of entry of microbial pathogen

A

Aspiration from oropharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Triggers the clinical syndrome of pneumonia

A

Host inflammatory response

NOT the proliferation if microorganisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Caused by inflammatory mediators released by macrophages and newly recruited neutrophils

A

Capillary leak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 stages of pneumonia

A

Edema/Congestion
Red Hepatization
Gray Hepatization
Resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stage with presence of proteinaceous exudates and bacteria in alveoli

A

Edema/Congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presence of erythrocytes in the cellular intraalveolar exudate with occasional bacteria recognized on collected pathologic specimens

A

Red hepatization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

No new erythrocytes are extravasating; predominant cells are neutrophils; abundant fibrin deposits with disappearance of bacteria; corresponds to the successful containmentof infection and improvement in gas exchange

A

Gray hepatization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Macrophages predominate

A

Resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pattern MC in nosocomial pneumonia

A

Bronchopneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pattern MC in CAP

A

Lobar pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pattern MC in VAP

A

Respiratory bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

May present as alveolar process in radiography

A

Viral

Pneumocystis pneumonias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of anaerobic pneumonia

A

Abscess formation
Empyemas
Parapneumonic effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Complicates Influenza infection

A

S.aureus pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Serious consequence of MRSA

A

Necrotizing pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adequate sputum specimen fo CS

A

> 25 neutrophils/hpf

<10 squamous epthelial cells/lpf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most frequently isolated pathogen in blood culture

A

S.pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Urine antigen test is highly specific and sensitive

A

Legionella pneumophila

Pneumococcal

22
Q

Standard of diagnosis of respiratory viral infection

A

PCR of nasopharyngeal swabs

23
Q

PCR determination of the pathogen is associated with inc risk of septic shock, need for mech vent and death

A

Pneumococcal pneumonia

24
Q

Useful biomarker to identify worsening disease or treatment failure

A

CRP

25
Q

Useful biomarker to determine the need for antimicrobial therapy

A

Procalcitonin

26
Q

Variables in CURB-65

A 
Confusion
Urea >7 mmol/L
RR >/= 30
BP = 90 systolic; = 60 diastolic
Age >/= 65
27
Q

Obvious indication for ICU care

A

Septic shock

Respiratory Failure at ER

28
Q

Primary organisms with resistance issues

A

S.pneumoniae

CA-MRSA

29
Q

Most important risk factor for antibiotic-resistant pneumococcal infection

A

Use of a specific antibiotic within the previous 3 months

30
Q

Mechanism of resistance to penicillins

A

Presence of low-affinity penicillin-binding proteins

31
Q

MIC penicillin susceptible

A

= 2 mcg/ml

32
Q

MDR strains

A

Isolates resistant to >/= 3 drugs of antimicrobial classes with different mechanisms of action

33
Q

Resistant to cephalosporins

A

Enterobacter spp.

Tx: Fluoroquinolones or Carbapenems

(used in ESBL-producing bacteria)

34
Q

Main risk factors for P.Aeruginosa

A

Structural lung disease (bronchiectasis)

Recent treatment with antibiotics or glucocorticoids

35
Q

Longer duration of treatment of pneumonia

A 
Bacteremia
Metastatic infection
Pseudomonas
MRSA
Ineffective initial treatment
Severe CAP
36
Q

Causes polymicrobial lung abscess from pneumonia

A

Typical with aspiration pneumonia, mixed aerobes/anaerobes

37
Q

Increased risk of MDR in HCAP

A

Recent hospitalization in 90 days

38
Q

Highest hazard ratio in developing VAP

A

First 5 days

39
Q

Three factors critical in the pathogenesis of VAP

A

Colonization if oropharynx with pathogenic microorganisms

Aspiration of organisms from the oropharynx into the lower respiratory tract

Compromise of normal host defense mechanisms

40
Q

Most obvious risk factor which bypass the normal mechanical factors that prevent aspiration

A

Endotracheal tube

41
Q

Major risk factor for infection with MRSA and ESBL-positive strains

A

use of B-lactam drugs (cephalosporins)

42
Q

Meds added for patients with active influenza or with history of influenza within 2 weeks of CAP

A

Vanco or Linezolid

43
Q

Increases the bioavailability of oral ampicillin

A

Sulbactam

44
Q

Indication for repeat CXR in CAP

A

Failure to improve after 72 hours of treatment

45
Q

De-escalation of antibiotics

A 
(-) fever >24 hours
Normal RR and less cough
No bacteremia
Etiologic agent not high risk
No unstable comorbids
No organ dysfunction
Competent GIT
46
Q

Duration of treatment for MRSA-CAP

A

non-bacteremic: 7-21 days
(Pseudomonas: 14-21 days)

bacteremic: up to 28 days

47
Q

Duration of treatment of MSSA-CAP

A

non bacteremic: 7-14 days

bacteremic: up to 21 days

48
Q

Duration of treatment for Mycoplasma and Chlamydophila

A

10-14 days

49
Q

Duration of treatment for Legionella pneumonia

A

14-21 days

50
Q

During 24 hours prior to discharge

A 
Temp 36-37.5
Pulse <100/min
RR 16-24/min
SBP >90 mmHg
O2 sat >90 %
Functioning GIT

HPIM 19th ID (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions