Pneumonia part 1

Question 1

5 most common pathogens causing CAP?

Answer 1

Strep pneumonia, h influenza, klebsiella, staph aureus, PA.

Question 2

What are 6 atypical pathogens causing CAP?

Answer 2

Mycoplasma pneumonia, c pneumonia, Legionella pneumonia influenza, parainfluenza, and RSV.

Question 3

What is the first line defense antibiotic for ambulatory patients with CAP? What do we give if they can’t tolerate the first line defense?

Answer 3

Macrolide.

Doxycycline

Question 4

What if the patient has increased drug resistance with CAP, what do we prescribe? Also, what 3 things would cause someone to be drug resistant?

Answer 4

Antibiotics in the past 90 days, Immunosuppression, exposed to kids.
Fluor or macrolide with beta lactam

Question 5

What do we prescribe to patients with CAP in the hospital?

Answer 5

Fluoro

Question 6

What do we prescribe a patient with CAP in the ICU?

Answer 6

Fluoro and 3rd generation cephalosporin.

Give penem for PA coverage.

Question 7

What age does atypical CAP present in and what are the symptoms?

Answer 7

Young Adults

Follow symptoms of URI

Question 8

What 3 antibiotic types do we need to give for atypical pneumonia pathogens?

Answer 8

Macrolide, Fluoro or tetracycline

Question 9

What is a unique clinical symptoms of chlamydia pneumonia?

Answer 9

Hoarse voice

Question 10

All treatments for CAP must be how many days at minimum?

Answer 10

5

Question 11

What lab can be ordered to aid in differentiating between viral and bacterial Pneumonias and why?

Answer 11

Procalcitonin because it is a precursor of calcitonin that becomes elevated in pro inflammatory stimuli, especially bacterial in origin.

Question 12

What are the 5 criteria to determine the severity of someone’s pneumonia when they show up at the ED?

Answer 12

Confusion, BUN over 20, RR over 30, BP less than 90/60, and older than 65. Each one, if positive, gets you a point.
0-1 low risk, outpatient
2 -moderate risk, closely monitor
3-5 sever pneumonia and admit to hospital.

Question 13

3 things to know about legionella?

Answer 13

Gram negative, bacillus, artificial water sources like AC or hot tub.

Question 14

What are the two things that macConkey agar selects for?

Answer 14

Gram negative and fermenters

Question 15

What 3 things to know about klebsiella itself as the pathogen as far as features of the bug?

Answer 15

Encapsulated, gram negative, fermenter

Question 16

What are your 3 fast fermenters?

Answer 16

Klebsiella, E. coli, and Enterobacter

Question 17

What are your two slow fermenters?

Answer 17

Citrobacter an serratia

Question 18

In general, what type of bacteria are lactose fermenters?

Answer 18

Gram negative rods.

Question 19

What anatomical type of pneumonia does strep pneumonia cause?

Answer 19

Lobar

Question 20

What kind of sputum does strep pneumonia cause?

Answer 20

Rust colored

Question 21

3 things to remember about strep pneumonia itself, its features?

Answer 21

Alpha hemolytic, has a urinary antigen, and encapsulated

Question 22

3 things to remember about mycoplasma pneumonia she talked about?

Answer 22

No cell wall, causes microcytic anemia, and amoxicillin will not work.

Question 23

2 features of pseudomonas?

Answer 23

Gram negative bacillus and encapsulated

Question 24

2 features of H influenza?

Answer 24

Gram negative diplocci and can be encapsulated

Question 25

What agar do we use for h influenza?

Answer 25

Chocolate agar

Question 26

What two conditions does h influenza like to colonize?

Answer 26

Smokers and immunocompromised

Question 27

What patients does m catarrhalis like to colonize?

Answer 27

Smokers, COPD, and asthmatics

Question 28

What two conditions does PA like to colonize?

Answer 28

CF and bronchiectasis

Question 29

2 features of staph aureus to know?

Answer 29

Gram positive, catalase and coagulase positive