Pulmonary (Uworld)

Question 1

Lung abscess path?

Answer 1

Aspiration of oropharyngeal/gingival anaerobes, pneumonitis leads to pneumonia leads to abscess/empyema.

Question 2

lung abscess risk factors?

Answer 2

dysphagia,substance abuse, seizures.

Question 3

lung abscess manifestations?

Answer 3

subacute fever, night sweats, weight loss, cough with putrid sputum.

Question 4

lung abscess diagnosis?

Answer 4

cavitary infiltrates with air-fluid levels, cultures rarely useful.

Question 5

lung abscess treatment?

Answer 5

ampicillin-sulbactam,imipenem,meropenem, alternate:clindamycin.

Question 6

lung abscess bacteria?

Answer 6

peptostreptococcus, prevotella, fusobacterium.

Question 7

lung abscess caused by?

Answer 7

swallowing dysfunction or periods of unconsciousness (substance abuse, general anesthesia, head trauma)

Question 8

affected area develops?

Answer 8

pneumonitis, typically evolves 7-14 days into necrotic infection, characterized radiologically by lung cavity with air-fluid level.

Question 9

empiric antibiotic therapy

Answer 9

amicillin-sulbactam(or carbapenam) has excellent pulmonary penetration and activity against obligative and facultative anaerobes.

Question 10

clindamycin

Answer 10

reserved for pt that have beta lactam allergy due to risk of clostridioides difficile infection.

Question 11

Pulmonary Tb suspect

Answer 11

hemoptysis, endemic area, symptoms, and upper lobe involvement

Question 12

Pulmonary tb radiographic abnormalities?

Answer 12

patchy or nodular opacity, multiple nodules, cavity involving the apical posterior segments of the upper lobes of the lungs.

Question 13

pulmonary TB management

Answer 13

complete respiratory isolation to avoid exposure until confirmed or ruled out by further testing ex: acid fast bacilli smear and culture.