Community acquired pneumonia Exam Questions with Verified Solutions Rated A+ (Already Passed)

Community acquired pneumonia Exam Questions with Verified Solutions Rated A+ (Already Passed) What general categories can increase the likelihood of CAP? - Answers decreased mucociliary transport decreased host immune response decreased cough reflex (aspiration risk) List factors that decrease mucociliary transport. - Answers smoking COPD CF viral infection elderly List factors that decrease host immune response. - Answers ethanol abuse viral infection elderly hypoxemia DM, AIDS, cancer pulmonary edema malnutrition bacterial endotoxin immunosuppressants List factors that increase G- colonization. - Answers malnutrition chronic ilness elderly/nursing home resident surgery or prolonged hospitalization smoking antacids, H2 blockers, PPIs List factors that decrease cough reflex and thereby increase aspiration risk. - Answers ethanol intoxication stroke general anesthesia drugs that impair mental status Explain the classic presentation of pneumococcal pneumonia. - Answers follows respiratory viral illness abrupt onset of severe chill high fever chest pain productive cough T/F: the classic presentation of CAP is seen in all age groups. - Answers False young or middle aged [elderly have mental status changes instead] List lab test findings for CAP. - Answers increased WBC w/ left shift (15-40,000) CXR inflitrates decreased PO2 on ABG blood cultures of pneumonia causing bacteria +- sputum culture and gram stain Why is a sputum culture not always helpful in diagnosis of CAP? - Answers often contaminated by natural flora of the mouth List some bacteria that commonly cause CAP. - Answers strep pneumo (pneumococcal pneumonia) - G+ diplococci staph - G+ cocci in clusters h. flu - small G- coccobacilli klebsiella - short plump G- bacilli mycoplasma - unremarkable anaerobic - foul smelling, polymicrobial How would mycoplasma CAP present? - Answers "walking pneumonia" low grade fever, non-productive cough Anaerobic pneumonia is often secondary to ________. - Answers Anaerobic pneumonia is often secondary to *peridontal disease*. How are patients evaluated for seriousness of pneumonia? - Answers CURB-65 scale Confusion Uremia (BUN>20) Respiratory rate (>=30) low Blood pressure (SBP<90 or DBP=<60) 65 y/o or greater Using the CURB-65 scale, determine where a patient should be treated. - Answers 1 point for each letter/number 0-1: outpatient 2: inpatient, general ward >=3: inpatient, ICU How should a CAP be treated if outpatient and previously healthy, no ABx in past 3mos? - Answers *macrolide*