CPHON AND APHON PACKAGED EXAMS
CLOSING SCRIPT UPDATED QUESTIONS
AND ANSWERS VIEW AHEAD PREP
MATERIAL SOLVED
⩥ Pneumonia atypical organisms? (3).
Answer: Mycoplasma pneumoniae (16%) (the other most common
pathogen) Walking pneumonia!
Chlamydophila pneumoniae (12%) Other bugs including viral
pathogens...
⩥ A 54 year old patient who is otherwise healthy and takes no meds has
been diagnosed with CAP. What's an appropriate treatment for her?
1. Levofloxacin 750mg daily x 5days
2. Azithromycin 500 mg day 1, 250 mg days 2-5
3. Amox/clavulanate 875 mg BID x 5 days
4. Treat symptomatically.
Answer: 2
⩥ What characteristic should make the nurse practitioner suspect that a
pneumonia is secondary to DRSP? (4).
Answer: 1. Recent air plane travel
,2. Exposure to another patient who has DRSP
3. Adolescence
4. Recent antibiotic exposure
⩥ Suspect DRSP (drug resistant Strept pneumo) if: (6 Things)
(AAAMIC)
symptoms?.
Answer: • Age > 65 years
• Antibiotic use: Beta-lactam, macrolide, or respiratory quinolone
therapy in the last 3 months
• Alcoholism
• Medical co-morbids
• Immunosuppressive illness or therapy
• Exposure to CHILD in daycare
2. Abrupt onset with fever, chills,
cough, pain in side or chest, rust colored sputum, *Older patients exhibit
fewer symptoms (confusion, absence of fever)
⩥ A 55 year old patient was diagnosed with pneumonia 7 days ago and
was started on levofloxacin. He has had normal temperature for the past
2 days but complains that he feels tired and is still coughing. How
should this be handled?
1. Order a chest x-ray
2. Continue antibiotic for 3 more days
, 3. Start a different antibiotic
4. Have him continue to rest for another 3-5days.
Answer: 4
⩥ IDSA and ATS 2007 Guidelines for Treatment of Pneumonia
Summary of Treatment Options:
1. for most patients?
2. If DRSP is suspected?.
Answer: 1. Macrolide or doxycycline
2. Resp quinolone: Moxifloxacin, Gemifloxacin, Levofloxacin
OR . Beta lactam (PCN or Ceph) plus macrolide or doxy
⩥ Suspect atypical pneumonia if what?
1. age?
2. presentation?
3. treatment?.
Answer: 1. Young, otherwise healthy, non-smokers, community outbreak
2. Low grade fever, cough,
chills, HA, malaise, rash, joint aches, arrhythmias
⩥ What are usual clinical symptoms in a patient who has pneumonia?
(8).
CLOSING SCRIPT UPDATED QUESTIONS
AND ANSWERS VIEW AHEAD PREP
MATERIAL SOLVED
⩥ Pneumonia atypical organisms? (3).
Answer: Mycoplasma pneumoniae (16%) (the other most common
pathogen) Walking pneumonia!
Chlamydophila pneumoniae (12%) Other bugs including viral
pathogens...
⩥ A 54 year old patient who is otherwise healthy and takes no meds has
been diagnosed with CAP. What's an appropriate treatment for her?
1. Levofloxacin 750mg daily x 5days
2. Azithromycin 500 mg day 1, 250 mg days 2-5
3. Amox/clavulanate 875 mg BID x 5 days
4. Treat symptomatically.
Answer: 2
⩥ What characteristic should make the nurse practitioner suspect that a
pneumonia is secondary to DRSP? (4).
Answer: 1. Recent air plane travel
,2. Exposure to another patient who has DRSP
3. Adolescence
4. Recent antibiotic exposure
⩥ Suspect DRSP (drug resistant Strept pneumo) if: (6 Things)
(AAAMIC)
symptoms?.
Answer: • Age > 65 years
• Antibiotic use: Beta-lactam, macrolide, or respiratory quinolone
therapy in the last 3 months
• Alcoholism
• Medical co-morbids
• Immunosuppressive illness or therapy
• Exposure to CHILD in daycare
2. Abrupt onset with fever, chills,
cough, pain in side or chest, rust colored sputum, *Older patients exhibit
fewer symptoms (confusion, absence of fever)
⩥ A 55 year old patient was diagnosed with pneumonia 7 days ago and
was started on levofloxacin. He has had normal temperature for the past
2 days but complains that he feels tired and is still coughing. How
should this be handled?
1. Order a chest x-ray
2. Continue antibiotic for 3 more days
, 3. Start a different antibiotic
4. Have him continue to rest for another 3-5days.
Answer: 4
⩥ IDSA and ATS 2007 Guidelines for Treatment of Pneumonia
Summary of Treatment Options:
1. for most patients?
2. If DRSP is suspected?.
Answer: 1. Macrolide or doxycycline
2. Resp quinolone: Moxifloxacin, Gemifloxacin, Levofloxacin
OR . Beta lactam (PCN or Ceph) plus macrolide or doxy
⩥ Suspect atypical pneumonia if what?
1. age?
2. presentation?
3. treatment?.
Answer: 1. Young, otherwise healthy, non-smokers, community outbreak
2. Low grade fever, cough,
chills, HA, malaise, rash, joint aches, arrhythmias
⩥ What are usual clinical symptoms in a patient who has pneumonia?
(8).
