LRTI Flashcards

1
Q

CAP
out patient
Healthy no risk

A

Amoxicillin 1g TID [strongest evidence]

Doxycycline 100mg BID

Macrolide (pneumococcal resistance <25%)
▪ Azithromycin 500mg once then 250mg daily
▪ Clarithromycin 500mg BID (1000mg ER daily)

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2
Q
A
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3
Q

CAP
Outpatient
Comorbidities

A

Amoxicillin/clavulanate OR cephalosporin (cefpodoxime/cefuroxime)

PLUS

Macrolide (azithromycin/clarithromycin) OR doxycycline

Respiratory fluoroquinolone (levofloxacin/moxifloxacin) ALONE

If recent exposure to one class of antibiotics recommended above, select an antibiotic from a different class

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4
Q

CAP

A

symptoms begin in an outpatient setting or within 48 hrs of hospital admission of hospital

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5
Q

HAP

A

at admissions that occurs >= 48 hrs after admission

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6
Q

VAP

A

occurs > 48 hrs after endotracheal incubation

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7
Q

clinical presentation of pneumonia

A

cough+/- sputum
fever, sweats, chills,
pleuritic chest pain

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8
Q

Gold standard diagnosis for pneumonia

A

chest x ray

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9
Q

Causative pathogens of CAP

A

Streptococcus pneumoniae
H. influenzae
Mycoplasma pneumoniae
Staphylococcus aureus
Legionella species
Chlamydia pneumoniae
Moraxella catarrhalis

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10
Q

Validated clinical prediction rule preferred

A

pneumonia severity index (PSI)

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11
Q

PSI
<90

A

out patient
Risk class I, II, II

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12
Q

PSI
>90

A

inpatient
Risk class IV,V

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13
Q

Severe CAP

A

1 major criteria
3 minor criteria

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14
Q

urinary antigen testing
severe CAP

A

Pneumococcal
legionella

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15
Q

CAP
non severe

A

b- lactam + macrolide

or respiratory fluroquinolone

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16
Q

CAP
severe

A

b- lactam + macrolide

or b- lactam + respiratory fluroquinolone

17
Q

empiric MRSA

A

add on vancomycin, adjust based on levels

linezolid

18
Q

empiric p.aeruginosa

A

REPLACE b-lactam
piperacillin/taz
cefepime’cefttazidime
aztreonam
meropenem
imipenem

19
Q

is steroids recommended for CAP

A

no

20
Q

Duration of Treatment for CAP

A

minimum 5 day
7 day for proven MRSA or P.aeruginosa

21
Q

HAP/VAP
etiology

A

s.aureus
p.aeruginosa
enteric gram negative bacilli
acinetobacter baumannii

22
Q
A