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ABIM Critical Care > Pneumonia > Flashcards

Flashcards in Pneumonia Deck (13)
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1
Q

In outpatient Tx (CAP), what are the indications for SCx?

A

risk factors for MRSA or empiric treatment of MRSA

2
Q

Patient specific risk factors for Strep Pneumo as etiology of CAP?

A

Neutropenia, asplenia, EtOH

3
Q

Components of CURB-65 score?

A

-Congusion.
-Urea >20.
-RR>=30.
-BP<90/60.
-65yo+

4
Q

CURB-65 score & plan?

A

0-1 = OP.
2 = IP.
3-5 = ICU.

5
Q

PSI (Pneumonia Severity Score) indicating IP treatment?

A

> =70

6
Q

Minor risk factors for “Severe” CAP (need 3+)?

A

-RR>=30.
-P/F<=250.
-Multilobar infiltrates.
-AMS.
-Urea >=20.
-WBC<4.
-Plt<100.
-Temp<36.
-Hypotension requiring aggressive IVF.

7
Q

Abx for inpatient, non-severe CAP?

A
  1. Macrolide + Ceftriaxone/Amp-Sulbactam
  2. FQ
8
Q

Indications for anaerobic coverage for CAP?

A

Empyema or abscess

9
Q

Abx for inpatient, severe CAP?

A

B-lactam (Rocephin, Cefoxatime, Amp/Sul) + Azithro/FQ. Note: FQ not monotherapy anymore.

10
Q

Dx if (+) SCx, on vent, but no clinical PNA?

A

Ventilator-associated tracheobronchitis. No Abx needed.

11
Q

Tx (VAP)

A

MRSA Coverage, plus Gm(-) coverage. 2 agents if high risk features.

12
Q

4 interventions to prevent VAP?

A

-HOB > 30*.
-SBTs daily.
-+/- Selective decontamination of oropharynx.
-+/- Subglottic suctioning.

13
Q

Difference in outcomes in HFNC vs NIPPV?

A

NIPPV benefits mortality, HFNC doesn’t. Both improve ETT, Los, etc.