Pneumonia Lecture

Question 1

3 types of pneumonia

Answer 1

CAP
HCAP
Aspiration

Question 2

CRB-65 Score:

1pt for confusion (delirium)
1 pt for RR>30
1 pt for BP< 90 systolic or 60 diastolic

Answer 2

Score 0-1: manage at home

Score >1: inpatient management

Question 3

True or False…

A pneumonia pt with hypoxia is an automatic admission

Answer 3

TRUE

Question 4

Empiric abx
O2 if sats <90%
Nebulized inhalation tx (albuterol Q2hrs, duoneb Q4-6 hrs)

Answer 4

Pneumonia tx

Question 5

Frequent vitals (fever, BP, HR, RR)
Daily labs (CBC, BMP, blood cultures)
Repeat imaging is NOT necessary if clinical improvement is seen

Answer 5

Monitoring of pneumonia pt

Question 6

If pneumonia pt is not improving, what image can you get to rule out empyema or lung abscess

Answer 6

chest CT

Question 7

pneumonia…

within 48 hrs after admission
48-72 hrs after endotracheal intubation
IV, wound care, IV chemo in prior 30 days

Answer 7

Health care associated pneumonia (HCAP)

Question 8

1 or more…

• abx in last 90 days
• current hospitalization >5 days
• high freq abx resistance in community
• immunosuppressive dz and or tx
• severe septic shock

Answer 8

assume multi-drug resistant (MDR) pneumonia

Question 9

Ceftriaxone
Levaquin or Avelox

..for MDR risk or non MDR risk pts?

Answer 9

Non MDR risk pts

Question 10

“triple abx therapy” IV

1. zosyn
2. fluoroquinolone
3. vanco

for MDR risk or non MDR risk pts?

Answer 10

MDR risk pts!

Question 11

HCAP tx is for a minimum of…

Answer 11

7 days

Question 12

If pt is imporving after IV therapy for 48-72 hours, what can you do?

Answer 12

switch to PO abx

Question 13

What abx should you give for aspiration pneumonia?

Answer 13

Clindamycin IV

Question 14

True or false…

For aspiration pneumonia, NPO until speech therapy consult

Answer 14

TRUE