Pneumonnia Flashcards
what should you do if you have a high clinical suspicion but CXR is negative?
get serial xrays, the disease may blossom
what do you do if the CXR shows what looks like pneumonia but the clinical picture doesn’t fit?
think of something else
what are classic presentation of legionella pneumonia?
GI sxs
hyponatremia
what is drug of choice for legionnella?
azithromycin
what are drugs that get good atypical coverage?
macrolides
doxycyline
fluorquinolones
what is proper dosing of levaquin for pneumonia?
750mg IV
what do you do with pleural fluid with a pneumonia?
tap it if there is enough (antibiotics won’t be enough)
what do you do with pts with pneumonia in flu season?
flu swab and if you still think they have it do a PCR
what are DOC in outpatient previously healthy pt with pneumonia?
macrolide
tetracycline
what are DOC in outpatient with comorbid dz with pneumonia?
levaquin, moxiflox, combo therapy (aug + azithromycin)
what are DOC in inpatient non ICU pneumonia?
levaquin, moxiflox,
ceftaroline OR
combo (rocephin PLUS azithro)
what are DOC in inpatient, ICU pneumonia?
zosyn 4.5 PLUS cipro PLUS vanc
what type of pneumonia hits hard and very abrupt?
strep pneumonia
what is the criteria for sepsis?
10% bands on WBC count
how can you evaluate for a pleural effusion?
US or CT without contrast
how long might a pneumonia take to get better radiographically?
2-4 weeks
always, always follow pneumonia until it does what?
clears up radiographically
what is the definition of an MDR pathogen?
bug with resistance to 2 or more of the abx typically used to treat it (esp important in regards to Gram negative bacilli)