Community Acquired Pneumonia (CAP) Exam
|Questions with Complete Solutions Rated
A+
What are some common physical findings of CAP? - Ans - fever or hypothermia
- tachypnea
- tachycardia
- arterial oxygen desaturation
- inspiratory crackles
- bronchial breath sounds
Are diagnostic tests for a specific infectious cause of CAP indicated for ambulatory
pts Txed as outpatients? - Ans - NO; b/c antibiotic therapy is almost always
effective in this pop
- Note: diagnostic tests are recommended in hospitalized CAP pts
What are the 3 rapid point-of-care diagnostic tests that may guide initial therapy?
- Ans - the sputum Gram stain
- Urinary antigen tests for S. pneumonia & Legionella species
, - Rapid antigen detection tests for influenza
Is a sputum Gram stain useful in detecting S. pneumonia, the most common
cause of CAP? If not, when is it useful? - Ans - NO
- It is useful in broadening initial coverage in pts to be hospitalized for CAP, most
commonly to cover S. aureus
What must be obtained to confirm a Dx of CAP? - Ans A CXR or CT scan indicating
pulmonary opacity
How might the CXR of a pt infected by viral pneumonias look? - Ans Nothing may
be visible. But a few infiltrates may be visible, and if so, they are almost always
bilateral, perihilar, symmetric, and interstitial.
How might the CXR of a pt infected by bacterial pneumonias look? - Ans -
Bacterial pneumonias have a predominantly focal segmental or lobar distribution.
- Typical or atypical pathogens produce a lobar or segmental pattern
What is CURB-65? - Ans - A simple scoring system used to determine the level
of risk in pts w/CAP. If observed, ea clinical feature gets 1 point.
- C = confusion
- U = blood urea nitrogen >= 20 mg/dL
- R = RR >= 30 breaths/min
- B = systolic BP < 90 mm Hg or diastolic BP <= 60 mm HG
- 65 = age >= 65
|Questions with Complete Solutions Rated
A+
What are some common physical findings of CAP? - Ans - fever or hypothermia
- tachypnea
- tachycardia
- arterial oxygen desaturation
- inspiratory crackles
- bronchial breath sounds
Are diagnostic tests for a specific infectious cause of CAP indicated for ambulatory
pts Txed as outpatients? - Ans - NO; b/c antibiotic therapy is almost always
effective in this pop
- Note: diagnostic tests are recommended in hospitalized CAP pts
What are the 3 rapid point-of-care diagnostic tests that may guide initial therapy?
- Ans - the sputum Gram stain
- Urinary antigen tests for S. pneumonia & Legionella species
, - Rapid antigen detection tests for influenza
Is a sputum Gram stain useful in detecting S. pneumonia, the most common
cause of CAP? If not, when is it useful? - Ans - NO
- It is useful in broadening initial coverage in pts to be hospitalized for CAP, most
commonly to cover S. aureus
What must be obtained to confirm a Dx of CAP? - Ans A CXR or CT scan indicating
pulmonary opacity
How might the CXR of a pt infected by viral pneumonias look? - Ans Nothing may
be visible. But a few infiltrates may be visible, and if so, they are almost always
bilateral, perihilar, symmetric, and interstitial.
How might the CXR of a pt infected by bacterial pneumonias look? - Ans -
Bacterial pneumonias have a predominantly focal segmental or lobar distribution.
- Typical or atypical pathogens produce a lobar or segmental pattern
What is CURB-65? - Ans - A simple scoring system used to determine the level
of risk in pts w/CAP. If observed, ea clinical feature gets 1 point.
- C = confusion
- U = blood urea nitrogen >= 20 mg/dL
- R = RR >= 30 breaths/min
- B = systolic BP < 90 mm Hg or diastolic BP <= 60 mm HG
- 65 = age >= 65
