Clin Med: Pneumonia

Question 1

Pathophysiology of Pneumonia

Answer 1

Inflammation of the alveoli and bronchioles due to bacteria, viruses, fungi

Question 2

1 cause of bacterial Pneumonia

Answer 2

Strep pneumoniae

Question 3

Most common viral cause of pneumonia

Answer 3

Influenza

Question 4

What is the meaning of community acquired pneumonia

Answer 4

Not inpatient - just acquired from the community

Question 5

Community Acquired Pneumonia - Classifications

Answer 5

Typical
Atypical

Question 6

Typical Community Acquired Pneumonia is caused by

Answer 6

Bacteria leading to alveolar inflammation and exudate (bacteria has entered the body and the immune system is causing the damage)

Question 7

Atypical Community Acquired Pneumonia is when

Answer 7

Organisms invade and destroy interstitial of the lungs (the bacteria is doing the harm NOT the immune system)

Question 8

Typical Community Acquired Pneumonia presents with

Answer 8

Productive cough
Lobar consolidations on CXR
High WBC count

Question 9

Typical Community Acquired Pneumonia is usually caused by

Answer 9

S. Pneumoniae

Question 10

Atypical Community Acquired Pneumonia is usually caused by

Answer 10

Mycoplasma, viral

Question 11

Atypical Community Acquired Pneumonia presents with

Answer 11

Dry cough
Lack of alveolar exudate
Normal - Mildly elevated WBC count
Patchy infiltrate on CXR

Question 12

Where is the antibody created in the body for Strep Pneumoniae

Answer 12

Spleen

Question 13

Community Acquired Pneumonia - Typical treatment adults

Answer 13

Outpatient = azithromycin or doxycycline or levofloxacin
Inpatient = ceftriaxone plus azithromycin

Question 14

Community Acquired Pneumonia - Typical treatment pediatrics

Answer 14

Outpatient = amoxicillin
Inpatient = ampicillin (fully immunized), ceftriaxone (if not fully immunized)

Question 15

What pneumonia is more common in children and college aged pts

Answer 15

Community acquired pneumonia atypical - mycoplasma

Question 16

What pneumonia is transmitted by water droplets of a poor ventilated buildings

Answer 16

Community acquired pneumonia - atypical - legionnaire’s

Question 17

Treatment for legionnaire’s pneumonia

Answer 17

Levofloxacin

Question 18

Community acquired pneumonia atypical - legionnaire’s presents with

Answer 18

Fever, chills, malaise, dry cough, diarrhea (very bad)

Question 19

Hospital acquired pneumonia is

Answer 19

Any pneumonia that presents 48 hours after admission

Question 20

Pathogens for Hospital acquired pneumonia

Answer 20

Pseudomonas, S. Aureus, Enterobacter, Klebsiella, E. Coli

Question 21

Pts at risk for hospital acquired pneumonia

Answer 21

Intubation
Tracheotomy
Immunocompromised
Chronic lung disease
(ICU pts)

Question 22

What is the most common type of pathogen in the ICU with the highest mortality rate

Answer 22

Pseudomonas

Question 23

What pt population is prone to S. Pneumoniae due to poor spleen function from infarcts

Answer 23

Sickle cell disease

Question 24

All children with sickle cell should receive prophylaxis when? and with what medication?

Answer 24

3 months - 5 years
Penicillin V daily

Question 25

This pt population is prone to pneumonia due to damaged ciliary bodies and thickened mucosa

Answer 25

Cystic Fibrosis

Question 26

What pt population is more prone to fungal pneumonia infections

Answer 26

HIV infection and suppressed immunity makes people more prone

Question 27

Unlike bacteria there are no fungal toxins, instead fungi

Answer 27

Cause a hypersensitivity reaction and create granulomas similar to TB

Question 28

Fungal Pneumonia Phases

Answer 28

1. Acute
2. Chronic pulmonary disease
3. Disseminated infection

Question 29

Fungal Pneumonia - Histoplasma Capsulatum is fungus found in

Answer 29

Bird and bat droppings

Question 30

Disseminated histoplasmosis can be fatal within

Answer 30

6 weeks

Question 31

Fungal Pneumonia - Histoplasma Capsulatum treatment

Answer 31

Intraconazole

Question 32

Fungal Pneumonia - Coccidiomycosis is also known as

Answer 32

Valley Fever - Southwest U.S.

Question 33

Fungal Pneumonia - Coccidiomycosis treatment

Answer 33

Usually self-limiting but can treat with 3-6 months of Fluconazole (Diflucan)

Question 34

Fungal Pneumonia - Cryptococcus is found in

Answer 34

Bird droppings

Question 35

Fungal Pneumonia - cryptococcus can cause _________ in HIV pts with CD4+ counts < 50

Answer 35

Meningitis