Typical Pneumonia

Question 1

Pneumonia predispositions

Answer 1

Defect in anat structures, alchohol, smokeing, elederly, chronic conditions (CF, diabetes, COPD), Immunocomp

Question 2

Pneumonia Diagnostic PE

Answer 2

Auscultation (rales and rhonchi), percussion (dull), CXR, blood and sputum cultures

Question 3

Pneumonia Lab Diag

Answer 3

Geckler criteria = epi cells less than 10, leuk greater than 25
To get sputum = BAL (less invasive), biopsy, needle aspirate

Question 4

Pneumonia Typical

Answer 4

Purulent productive cough with EC microbes = lobar

Question 5

Pneumonia Atypical

Answer 5

Non productive cough (watery) with IC microbes = bilat

Question 6

Pneumonia Typical Symptoms

Answer 6

Fever, shaking, chest pain, dyspnea, productive cough, tachypnea, tachycardia. ER = blood in sputum, cyanotic, decreased mental function, weight loss. Elderly have fewer symptoms and slow progression

Question 7

Pneumonia Aspiration

Answer 7

Forgein material = S Aureus and Klebsiella

Question 8

Pneumonia Lobar

Answer 8

Entire lobe inflammed and consolidated = S Aureus and Klebs

Question 9

Pneumonia Bronchopneumonia

Answer 9

centered on bronchioles = Pseudomonas

Question 10

Strep Pneumonia Clinical

Answer 10

Number one after flu, Typical and CAP; lobar

Question 11

Strep Pneumonia Char

Answer 11

Gram pos lancet shaped paired cocci, capsule

Question 12

Strep Pneumonia VF

Answer 12

Capsule, IgA protease, Pneumolysin (decreases cilia movement and decreased PMN, cytotoxic to phags and epi cells, activates complement and TNF alpha and IL-1), Neurominidase

Question 13

Strep Pneumonia Diag

Answer 13

Neufeld Quelling rxn, bile soluble, optochin sensative, alpha hemolytic

Question 14

Strep Pneumonia RF

Answer 14

pathogenesis associated with post-flu, alchs, elderly, COPD

Question 15

Strep Pneumonia VCCN

Answer 15

PVCV (23) = for high risk over 2 yrs and adults over 65

PCV13 for younger than 2 months - conjugated vccn

Question 16

Pseudomonas Aeruginosa Clin

Answer 16

Typical Pneumonia (HAP/CAP), bilateral bronchopneumonia, chronic in CF pts, cyanosis, confusion.

Aspiration pneumonia can lead to necrotizing bronchopneu

Question 17

Pseudomonas Aeruginosa Char

Answer 17

Gram neg rod

Question 18

Pseudomonas Aeruginosa Tx

Answer 18

combo anti-biotics

Question 19

Pseudomonas Aeruginosa VFs

Answer 19

Biofilm (adhesins); pigment is invasive, Exotoxin A (ADP ribosylation of RBC EF-2 inhib protein synth)

Question 20

Pseudomonas Aeruginosa Diag

Answer 20

Culture, nonfermentor and oxidase positive.

CXR: bilat with nodule infiltrates, cavitation w/ or w/o pleural effusion

Question 21

Klebsiella Pneumoniae Clin

Answer 21

Typical (HAP); Aspiration lobar pneu, necrotic destruction of alveolar spaces, cavity formation, Currant Jelly sputum (blood tinged), increased fatality

Question 22

Klebsiella Pneumoniae Char

Answer 22

Gram neg bacilli; large polysacc capsule

Question 23

Klebsiella Pneumoniae RF

Answer 23

Greater than 40 yrs old, alch, diabetic, immonocomp

Question 24

Klebsiella Pneumoniae Diag

Answer 24

lactose pos, oxidase neg, indole neg

Question 25

E Coli Char

Answer 25

Indole pos, lactose pos, citrate neg