73 Questions
Which of the following is a common cause of pneumonia?
Streptococcus pneumoniae
What is the typical incidence of pneumonia in the general population?
1-3 per 1000
Which of the following is a classification of pneumonia based on anatomical location?
Lobar pneumonia
Which type of pneumonia develops more than 48 hours after hospital admission?
Ventilator-associated pneumonia
What is the main symptom of pneumonia?
Shortness of breath
Which type of pneumonia occurs in ambulatory patients who are not hospitalized and have had extensive healthcare contact within the last 3 months?
Healthcare-associated pneumonia
Which type of pneumonia is the most common?
Community-acquired pneumonia
Which of the following invasive approaches should be considered if thoracoscopy is unavailable?
Both A and B
What is the definition of Health care associated pneumonia (HCAP)?
Pneumonia that occurs in ambulatory patients who are not hospitalized and have had extensive healthcare contact within the last 3 months
Which of the following refers to a milky white effusion high in triglycerides?
Chylous effusion
Which of the following is NOT a type of fluid that can accumulate in the pleural space?
Urine
Which of the following is a relative contraindication for thoracentesis?
Patients on mechanical ventilation
Which of the following is a clue to the common etiology of pleural effusion?
Distended neck veins
Which of the following is a characteristic of exudative pleural effusion?
Pleural fluid LDH more than two-thirds normal upper limit for serum
Which of the following is a common bacterial cause of pneumonia?
Streptococcus pneumoniae
What is the typical incidence of pneumonia in the general population?
1-3 per 1000
Which of the following is a common symptom of pneumonia?
Cough
Which of the following invasive procedures should be considered if thoracoscopy is unavailable?
CT-guided biopsy
What is the definition of Health care associated pneumonia (HCAP)?
Pneumonia that occurs in ambulatory patients who are not hospitalized and have had extensive healthcare contact within the last 3 months
Which of the following is a characteristic of exudative pleural effusion?
High protein content
Which of the following is NOT a risk factor for pneumonia?
Obstruction of bronchi from tumors
Which of the following is a characteristic of red hepatization/early consolidation in pneumonia?
Firm liver-like consistency
Which of the following is a symptom of pneumonia in infants and the elderly?
Fever
Which of the following is a recommended therapy for inpatient non-ICU management of pneumonia?
Combination of beta-lactam/second or third-generation cephalosporin and a macrolide
Which of the following is the most common cause of exudative pleural effusion?
Pulmonary embolism
Which of the following is the most sensitive and specific marker for tuberculosis in pleural fluid analysis?
PCR for mycobacterial DNA
Which of the following is the best screening test for pulmonary embolism in a patient with pleuritic chest pain, hemoptysis, or dyspnea?
D-dimer in the peripheral blood
Which of the following cell types in pleural fluid analysis indicates an acute process affecting the pleura?
Neutrophils
Which of the following is a common bacterial cause of pneumonia?
Streptococcus pneumoniae
What is the typical incidence of pneumonia in the general population?
0.1-0.3%
Which type of pneumonia develops more than 48 hours after hospital admission?
Hospital-acquired pneumonia (HAP)
Which of the following is NOT a risk factor for pneumonia?
Malnutrition
Which of the following is a common symptom of pneumonia?
Loss of appetite
What is the typical treatment for outpatient management of pneumonia?
Macrolides
Which of the following is a complication of pneumonia?
All of the above
Which of the following is a contraindication for thoracentesis?
Active skin infection at the port of entry
Which of the following is a common cause of exudative pleural effusion?
Congestive heart failure
Which of the following is the most sensitive and specific marker for tuberculosis in pleural fluid analysis?
PCR for mycobacterial DNA
Which of the following is the best screening test for pulmonary embolism in a patient with pleuritic chest pain, hemoptysis, or dyspnea?
D-dimer in the peripheral blood
Which of the following is NOT a cause of pneumonia?
Haemophilus influenzae
Which of the following is a typical bacterial cause of pneumonia?
Staphylococcus aureus
Which of the following is a common symptom of pneumonia?
Cough with sputum production
Which of the following is a potential alternative invasive approach if thoracoscopy is unavailable for diagnosing pleural effusion?
Both A and B
What is the approximate percentage of patients with exudative effusions for whom no known etiology is found?
15%
Which of the following definitions best describes Health care associated pneumonia (HCAP)?
Pneumonia that occurs in ambulatory patients who are not hospitalized and have had extensive healthcare contact within the last 3 months
Which of the following is a potential cause of exudative effusions in patients who do not respond to conservative treatment?
Both A and B
Which of the following is a potential alternative invasive approach if thoracoscopy is unavailable?
Both A and B
What percentage of patients do not have a diagnosed cause for their condition despite invasive procedures?
15%
Which of the following is NOT a type of fluid that can accumulate in the pleural space?
Lymph
Which of the following is a common cause of exudative pleural effusion?
Pulmonary embolism
Which of the following cell types in pleural fluid analysis indicates an acute process affecting the pleura?
Neutrophils
Which of the following is the best screening test for pulmonary embolism in a patient with pleuritic chest pain, hemoptysis, or dyspnea?
D-dimer test
Which of the following is a common predisposing condition for pneumonia?
Cigarette smoking
Which of the following is a characteristic of grey hepatization/late consolidation in pneumonia?
Microscopically marked cellular exudate of neutrophils
What is the first choice therapy for outpatient management of pneumonia?
Macrolides, such as azithromycin and clarithromycin
Which of the following is a complication of pneumonia?
Pleural Effusion
Which of the following invasive procedures is recommended if thoracoscopy is unavailable?
Both needle biopsy and open biopsy of the pleura
What percentage of patients with exudative effusions have no known etiology?
15%
Which of the following is a characteristic of chylous effusion?
Milky white effusion high in triglycerides
Which of the following is a common bacterial cause of pneumonia?
Streptococcus pneumoniae
What is the typical incidence of pneumonia in the general population?
1-3 per 1000
Which of the following is a common symptom of pneumonia?
Cough
Which of the following is a potential cause of exudative effusions in patients who do not respond to conservative treatment?
A. Cancer
Which of the following invasive approaches should be considered if thoracoscopy is unavailable?
A. Needle biopsy
What is the approximate percentage of patients with exudative effusions for whom no known etiology is found?
A. 15%
Which of the following is NOT a type of pneumonia?
Healthcare-associated pneumonia (HCAP)
Which of the following is NOT a common predisposing condition for pneumonia?
Obstruction of bronchi from tumors
Which of the following is a characteristic of red hepatization/early consolidation in pneumonia?
Fibrin strands replace the edema fluid of the previous phase.
Which of the following is NOT a potential complication of pneumonia?
Atrial Fibrillation
Which of the following conditions is NOT a potential cause of pleural effusion?
Myxedema
Which of the following is a potential cause of chylothorax?
Pancreatitis
Which of the following is a potential cause of pyothorax or empyema?
Urinary tract infection
Which of the following is a potential cause of urinothorax?
Urinary tract infection
Study Notes
Pneumonia
- A common cause of pneumonia is Streptococcus pneumoniae.
- Typical incidence of pneumonia in the general population is 5-6 cases per 1,000 people per year.
- Main symptom of pneumonia is cough.
Classification of Pneumonia
- Classification of pneumonia based on anatomical location: community-acquired pneumonia, hospital-acquired pneumonia, and healthcare-associated pneumonia (HCAP).
- HCAP develops more than 48 hours after hospital admission.
Types of Pneumonia
- Community-acquired pneumonia: occurs in ambulatory patients who are not hospitalized and have not had extensive healthcare contact within the last 3 months.
- Hospital-acquired pneumonia: develops more than 48 hours after hospital admission.
Pleural Effusion
- Definition of exudative pleural effusion: high protein content and lactate dehydrogenase (LDH) levels, and low glucose levels.
- Characteristics of exudative pleural effusion: high protein content, high LDH levels, and low glucose levels.
- Typical cause of exudative pleural effusion: bacterial infection.
- Chylous effusion: milky white effusion high in triglycerides.
Diagnosis and Treatment
- Thoracentesis: a relative contraindication is bleeding diathesis.
- Invasive approach if thoracoscopy is unavailable: ultrasound-guided thoracentesis or CT-guided thoracentesis.
- Recommended therapy for inpatient non-ICU management of pneumonia: macrolides, fluoroquinolones, or beta-lactam antibiotics.
- First choice therapy for outpatient management of pneumonia: macrolides or fluoroquinolones.
Complications
- Complications of pneumonia: respiratory failure, sepsis, and empyema.
- Potential cause of exudative effusions in patients who do not respond to conservative treatment: malignancy or tuberculosis.
Miscellaneous
- Approximate percentage of patients with exudative effusions for whom no known etiology is found: 20%.
- Typical bacterial cause of pneumonia: Streptococcus pneumoniae.
- Common symptom of pneumonia: cough.
Test your knowledge on pleural effusion and its various types of fluid accumulation. Learn about the causes, symptoms, and evaluation of this condition through this informative quiz.
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