Pulm Pathophys

Question 1

S/S of anaerobic pneumonia

Answer 1

empyema, lung abscesses

Question 2

What are common causes of CAP

Answer 2

Atypical: mycoplasma pneumonia, legionella sp, Chlamydia pneumoniae

Typical: Strep. pneumo, Staph. aureus, H. influenzae, Klebsiella

Viral: influenza, adenovirus

Question 3

What are common causes of HAP

Answer 3

Staph aureus, pseudomonas, Serratia, Acinetobacter

from IV lines, ventilators, aspiration

Question 4

What are the immunization procedures for pneumonia and influenza?

Answer 4

pneumonia: all pts above 65 should get PPSV23 every 5 years, given to pts 19-64 who are smokers, immunocompromised, have chronic liver, lung and heart diseases (excluding HTN), and pts with malignancies.

influenza=yearly for all pts 6mo and above

Question 5

Name some thrombolytic agents, their MOAs and adverse effects

Answer 5

alteplase (tissue plasminogen activator)

Question 6

How are CAPs treated and how do these pts present?

Answer 6

fever, cough, dyspnea, myalgias, fatigue

Macrolides (with beta lactam if pt is admitted to hospital per their CURB-65 criteria), doxy, respiratory FQs

Question 7

How are HAPs treated and how do these pts present?

Answer 7

since usually MRSA, Vanco + Linezol

or two of following: pip/tazo, ceftazadime, cipro, meropenem, tobramycin

Question 8

most common mechanism for pneumonia

Answer 8

aspiration

Question 9

what distinguishes chronic COPD from asthma?

Answer 9

Asthma is reversible and occurs in younger aged population

Question 10

What distinguishes COPD from alpha-1 antitrypsin deficiency?

Answer 10

pts will have family history, it occurs earlier in life (30-40s) and radiograph will show bibasilar emphysema

Question 11

What distinguishes COPD from bronchiectasis?

Answer 11

recurrent pneumonia, smelly sputum, hemoptysis, clubbing and curved reticular/cystic pattern on radiograph