Goroll Ch 52- Bronchitis and Pneumonia

Question 1

What does “classic” CAP present like?

Answer 1

sudden chill followed by fever, pleuritic pain, productive cough

Question 2

What does atypical pneumonia typically present as?

Answer 2

sore throat and HA then nonproductive cough and dyspnea

Question 3

Are there infiltrate or signs of consolidation in an acute bronchitis x-ray?

Answer 3

NO

Question 4

What is the most common cause of pneumonia?

Answer 4

Strep peneumoniae

Question 5

What are classic clinical features of pneumococcal pneumonia?

Answer 5

abrupt onset of fever w/ single rigor, cough with rusty sputum, pleuritic chest pain

Lobar consolidation on x-ray

Question 6

What is the most common complication of pneumococcal pneumonia?

Answer 6

bacteremia

Question 7

What is the distinctive feature of pneumonia from S. aureus?

Answer 7

multiple small lung abscesses

Question 8

How does pneumonia from GAS present?

Answer 8

begins abruptly with fever, cough, and severe debility

CP is prominent in most patietns

Question 9

What is the distinctive lcinical feature of GAS pneumonia?

Answer 9

rapid spread in the lung with resultant early empyema formation

Question 10

What population is prone to Klebsiella pneumonia?

Answer 10

alcoholics

Question 11

What does the sputum from Klebsiella pneumonia look like?

Answer 11

dark red and mucoid (“currant jelly” sputum)

Question 12

what are risk factors for moraxella catarrhalis pneumonia?

Answer 12

Diabetes, alcoholism, malignancy, and steroid use

Question 13

What are the 3 stages of pertussis?

Answer 13

1. catarrhal phase (URI, rhinorrhea, low-grade fever, mild congestion x1-2 weeks)
2. Paroxysmal phase (last 2-4 weeks; severe nonproductive coughing, posttussive syncope and vomiting; whoop sound)
3. convalescent phase (symptoms resolve over 1-3 months)

Question 14

How does Legionnaires’ Disease present? (type of CAP caused by Legionella pneumophilia)

Answer 14

acutely high fever, nonproductive cough, dyspnea; sometimes pleuritic chest pain

Question 15

What is atypical pneumonia syndrome?

Answer 15

fever, dry cough, nonspecific infiltrate on chest film

Question 16

What is the prodrome for mycoplasma pneumonia?

Answer 16

HA, sore throat, malaise

Question 17

What is the most common cause of acute bronchitis?

Answer 17

viral

Question 18

What is the cause of SARS?

Answer 18

novel coronavirus

Question 19

How does SARS present?

Answer 19

fever, myalgias, cough and progresses to worsening respiratory distress

Multilobar infiltrates on chest x-ray

Question 20

How does someone contract Q fever?

Answer 20

spread through inhalation of infected dust particles

Farm animal contact

Question 21

What are the typical symptoms of pneumonia?

Answer 21

productive cough, chills, pleurisy

Question 22

What are the atypical symptoms of pneumonia?

Answer 22

nonproductive cough with a prodrome of HA and sore throat

Question 23

What problem is associated with birds?

Answer 23

Psittacosis

Question 24

What is used to treat pertussis?

Answer 24

erythromycin

Question 25

What is the preferred empiric treatment for CAP in healthy young adults?

Answer 25

macrolide

Question 26

What is the preferred empiric treatment for acute exacerbation of chronic bronchitis?

Answer 26

2nd generation cephalosporin

Question 27

What is the preferred empiric treatment for CAP in elderly or comorbid disease?

Answer 27

second generation macrolid plus beta-lactam

Question 28

What is the preferred empiric treatment for CAP in hospitalized patient?

Answer 28

3rd generation cephalosporing plus second generation macrolide

Question 29

What are methods of scoring pneumonia severity?

Answer 29

Pneumonia Severity Index (PSI) PORT study CURB-65