38 Questions
Pneumococcal resistance to βlactams can be overcome by increasing βlactam doses EXCEPT for:
Meningitis
A 34-year-old patient visited the local hospital complaining of dry cough and malaise. What type of organism is most likely seen in his case?
Mycoplasma pneumonia
A patient with a dry cough and malaise can be treated with which of the following drugs?
Macrolide
A 43-year-old male suffering from headache and sore throat, which developed gradually, came to the hospital. What is the most causative agent in his case?
Mycoplasma pneumoniae
A 42-year-old shepherd came to the primary care with chest pain and cough. What type of pneumonia does he have?
VAP
A person with Legionella pneumophila can be best treated with:
Erythromycin
What is the most common causative agent in ventilated patients with late-onset pneumonia?
Acinetobacter
A 35-year-old male presents with fever and cough. He was well until 3 days earlier, when he suffered the onset of nasal stuffiness, mild sore throat, and a cough productive of small amounts of clear sputum. What is the likely diagnosis?
Mycoplasma pneumonia
What is the most common organism causing community-acquired pneumonia?
Mycoplasma pneumoniae
What is the most common nosocomial infection?
Surgical site infection (SSI)
What is the most likely causative agent in a 31-year-old male with chronic lung disease and taking corticosteroids?
P. aeruginosa
What is NOT a feature of Community-Acquired Pneumonia (CAP)?
Usually caused by Pseudomonas aeruginosa
What is the most common causative agent of early-onset nosocomial pneumonia?
P. aeruginosa
What is the most appropriate antibiotic for MRSA infection?
Vancomycin
What is the advantage of combining vancomycin with linezolid?
Both a and b
What is the most common pathogenicity of pneumonia?
Microaspiration of upper airway secretions, through inapparent aspiration
What type of pneumonia does the patient with a clean history of familial illness, hospitalizations, or trauma have?
Community acquired Pneumonia
What is the most common pathogen that causes Community Acquired Pneumonia?
Streptococcus pneumoniae
What type of antibiotic is suitable for a patient with Community Acquired Pneumonia?
β-lactam antibiotic
What type of pneumonia does a patient with underlying chronic obstructive pulmonary disease and poor oxygenation have?
Ventilator-Associated Bacterial Pneumonia
What is one of the important processes in the pathogenesis of Ventilator-Associated Bacterial Pneumonia?
Bacterial colonization of the aerodigestive tract
Which pathogen can cause Ventilator-Associated Bacterial Pneumonia?
Pseudomonas aeruginosa
How can Ventilator-Associated Bacterial Pneumonia be prevented?
By maintaining good hygiene practices
What is a symptom of the patient with Community Acquired Pneumonia?
Spasms of coughing that produce purulent secretions
What is the typical cause of bacterial pneumonia?
Staphylococcus aureus
What is the most likely causative organism in a child with CAP?
H.influenzae type B
Can a 28-year-old female with atypical CAP be treated with penicillin?
b & c
What is not used to diagnose atypical CAP?
All the above
What is the traditional approach to antipseudomonal drugs combination?
Antipseudomonal Beta-lactam with Aminoglycoside
What is a major factor that increases the resistance of gram-negative bacilli?
Both a & b
What is the most likely causative organism in a child with CAP?
H.influenzae type B
What is not a typical cause of bacterial pneumonia?
Mycoplasma pneumonia
What is the most likely diagnosis for a patient with an enlarged right anterior lobe of the lung and increased WBC level?
Lobar pneumonia
What is the primary cause of lobar pneumonia?
Streptococcus pneumoniae
What is the best antibiotic to treat Mycoplasma pneumonia?
Macrolide
Why are β-lactams not effective against Mycoplasma pneumonia?
Because Mycoplasma pneumonia has no cell wall
What is the best method to diagnose lobar pneumonia?
Sputum Gram stain
What topical regimen is effective against MRSA?
Topical Gentamicin, Colistin, Vancomycin cream
Study Notes
Pneumonia
- Pneumonia is a type of infection that can be caused by various organisms, including bacteria, viruses, and fungi.
- The most common causative agents of pneumonia include:
- Streptococcus pneumoniae (most common cause of Community Acquired Pneumonia (CAP))
- Pseudomonas aeruginosa (most common cause of Ventilator-Associated Pneumonia (VAP))
- Methicillin-resistant Staphylococcus aureus (MRSA) (common cause of Hospital-Acquired Pneumonia (HAP))
- Mycoplasma pneumoniae (common cause of atypical CAP)
Community Acquired Pneumonia (CAP)
- Definition: Pneumonia acquired by a person with little contact with the healthcare system
- Most common cause: Streptococcus pneumoniae
- Treatment: β-lactam antibiotics (e.g., amoxicillin) are usually effective
Hospital-Acquired Pneumonia (HAP)
- Definition: Pneumonia acquired by a person who has been hospitalized for at least 48 hours
- Most common cause: Pseudomonas aeruginosa, MRSA
- Treatment: Antibiotics effective against Pseudomonas aeruginosa (e.g., antipseudomonal beta-lactam with a quinolone)
Ventilator-Associated Pneumonia (VAP)
- Definition: Pneumonia acquired by a person who is on mechanical ventilation
- Most common cause: Pseudomonas aeruginosa
- Prevention: Oral regimen (topical Gentamicin, Colistin, Vancomycin cream given every 6h for 3 weeks)
Atypical Pneumonia
- Definition: Pneumonia caused by Mycoplasma pneumoniae, Legionella pneumophila, or Chlamydophila pneumoniae
- Symptoms: Dry cough, fever, malaise
- Treatment: Macrolide antibiotics (e.g., erythromycin)
Microbiology
- Mycoplasma pneumoniae: bacteria with no cell wall, β-lactams are not effective
- Legionella pneumophila: bacteria that can cause severe pneumonia, often requires combination therapy with a macrolide and a rifampicin
- Pseudomonas aeruginosa: bacteria that can cause severe pneumonia, often requires combination therapy with an antipseudomonal beta-lactam and a quinolone
Pathogenesis
- Impairment of host defenses can increase the risk of pneumonia
- Microaspiration of upper airway secretions, through inapparent aspiration, can lead to pneumonia
- Bacterial colonization of the aerodigestive tract and aspiration of contaminated secretion into the lower airway can lead to VAP
Diagnosis
- Sputum Gram stain, blood culture, and pleural effusion culture can help diagnose pneumonia
- ESR and C-reactive protein can be used to diagnose atypical CAP
- Chest X-ray can help diagnose lobar pneumonia
A quiz on pneumonia, covering causative agents, ventilated patients, and late-onset pneumonia. Includes SAQ scenarios and MCQs.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
