Resp Pneumonia

Question 1

Most common typical pneumonia causes of CAP

Answer 1

Typical: strep pneumoniae
Haemophilus influenzae

Klebsiella pneumoniae

Question 2

Most common community acquired atypical pneumonia pathogens

Answer 2

Mycoplasma pneumoniae (most common)
Chlamydiphilia pneumoniae

Virus: rsv, influenza virus, cmv, adenovirus, coronaviridae

Question 3

Most common hospital acquired pneumonia

Answer 3

Gram negative bacteria such as pseudomonas aeruginosa
Enterobacteriaceae

Staph esp mrsa
Strep

Question 4

Most common cause of pneumonia in newborns

Answer 4

E. coli
Group b strep
Strep pneumoniae
H influenzae

Question 5

Most common cause of pneumonia in children 4 weeks-18 years

Answer 5

Chlamydia trachomatis 
Chlamydophilia pneumoniae 
Strep
Rsv
Mycoplasma

Question 6

What are the 4 stages of pneumonia

Answer 6

Congestion day
Red hepatization -alveolar lumen fills with exudate rich in fibrin bacteria rbc and inflammatory cells.. liver like consistency

Gray hepatization -erythrocytes and most bacteria degraded

Resolution- macrophages remove suppurative exudate

Question 7

What are routine diagnostic tests done on a patient sus or pneumonia

Answer 7

CBC, inflam markers- esr crp and leukocytosis

Serum procalcitonin(pct) - acute phase reactant - >.25 increased probability of bacterial infection 
Low level after 3 days of antibiotics suggest antibiotics are working

Blood culture, sputum culture, mrsa nares swab,
Test for certain pathogens like covid 19, influenza swab etc

Chest X-ray pa and lateral

Broncho-patchy infiltrates
Lobar- one or more lobes

Question 8

Describe curb- 65 score

Answer 8

Criteria for hospitalization

C onfusion (+disoriented)
U rea >7
R espiratory rate >20
B lood pressure <90 systolic , <60 diastolic

65 age >65

0-1 outpatient
>= 2 hospitalization indicated
>= 3 consider icu level

Question 9

Emperic antibiotic of choice for a patient without comprbidities or risk factor for resistant pathogens

Answer 9

One of:
Macrolide
Amoxicillin
Doxycycline

Question 10

Emperic antibiotic of choice for a patient with comorbidities or risk factor for resistant pathogen

Answer 10

Combo of:
Amoxicillin-Clavulnate/cefuroxime
Plus 
Macrolide
Or Doxycycline 

Mono:
Levofloxacin

Question 11

Antibiotic tx for mrsa cap

Answer 11

Vancomycin

Linezoid