Podcast
Questions and Answers
Which presentation is LEAST likely to be observed in an elderly patient with pneumonia?
Which presentation is LEAST likely to be observed in an elderly patient with pneumonia?
- Tachypnea
- Productive cough (correct)
- Confusion
- Hypothermia
A patient with a history of alcoholism presents with pneumonia and 'current jelly sputum'. Which pathogen is MOST likely responsible?
A patient with a history of alcoholism presents with pneumonia and 'current jelly sputum'. Which pathogen is MOST likely responsible?
- Moraxella catarrhalis
- Klebsiella pneumoniae (correct)
- Haemophilus influenzae
- Streptococcus pneumoniae
Which of the following pathogens is LEAST likely to be implicated in hospital-acquired pneumonia?
Which of the following pathogens is LEAST likely to be implicated in hospital-acquired pneumonia?
- Oral anaerobes
- Pseudomonas aeruginosa
- Streptococcus pneumoniae (correct)
- Staphylococcus aureus
A patient who recently traveled to the southwestern United States presents with pneumonia. Which organism should be HIGHLY suspected?
A patient who recently traveled to the southwestern United States presents with pneumonia. Which organism should be HIGHLY suspected?
Following a recent influenza infection, a patient develops a secondary pneumonia. Which pathogen is MOST likely responsible for this complication?
Following a recent influenza infection, a patient develops a secondary pneumonia. Which pathogen is MOST likely responsible for this complication?
Which of the following is the MOST likely route of infection in a patient diagnosed with community-acquired pneumonia (CAP)?
Which of the following is the MOST likely route of infection in a patient diagnosed with community-acquired pneumonia (CAP)?
A patient with bronchiectasis develops pneumonia. Which of the following is the MOST likely causative agent?
A patient with bronchiectasis develops pneumonia. Which of the following is the MOST likely causative agent?
A patient with a history of exposure to bird droppings presents with respiratory symptoms. Infection with which of the following organisms is MOST likely?
A patient with a history of exposure to bird droppings presents with respiratory symptoms. Infection with which of the following organisms is MOST likely?
A patient presents with a chronic cough, purulent sputum production and hemoptysis. High-resolution CT imaging reveals bronchial dilation and airway wall thickening. Which condition is MOST consistent with these findings?
A patient presents with a chronic cough, purulent sputum production and hemoptysis. High-resolution CT imaging reveals bronchial dilation and airway wall thickening. Which condition is MOST consistent with these findings?
Which of the following is NOT typically included in the initial management of acute bronchitis?
Which of the following is NOT typically included in the initial management of acute bronchitis?
Which of the following scenarios presents the HIGHEST risk for pneumonia caused by mixed aerobic and anaerobic organisms?
Which of the following scenarios presents the HIGHEST risk for pneumonia caused by mixed aerobic and anaerobic organisms?
In a patient who develops pneumonia while hospitalized, which of the following pathogens would be LEAST likely?
In a patient who develops pneumonia while hospitalized, which of the following pathogens would be LEAST likely?
Which mechanism underlies pneumonia development secondary to aspiration?
Which mechanism underlies pneumonia development secondary to aspiration?
A patient with AIDS presents with dyspnea, fever, and a dry cough with hypoxemia out of proportion. What pulmonary infection is MOST likely?
A patient with AIDS presents with dyspnea, fever, and a dry cough with hypoxemia out of proportion. What pulmonary infection is MOST likely?
A farmer presents with fever, chills, a non-productive cough, and myalgias after assisting with the birthing of lambs. Which pulmonary infection should be suspected?
A farmer presents with fever, chills, a non-productive cough, and myalgias after assisting with the birthing of lambs. Which pulmonary infection should be suspected?
In the context of pneumonia, if a patient is described as having decreased 'cellular and humoral immune response,' which pathogenic mechanism is MOST likely to be implicated?
In the context of pneumonia, if a patient is described as having decreased 'cellular and humoral immune response,' which pathogenic mechanism is MOST likely to be implicated?
A patient presents with a cough productive of red currant jelly sputum. Which organism is classically associated with this presentation?
A patient presents with a cough productive of red currant jelly sputum. Which organism is classically associated with this presentation?
Which of the following physical exam findings would be LEAST likely in a patient with typical pneumonia?
Which of the following physical exam findings would be LEAST likely in a patient with typical pneumonia?
A patient who recently stayed at a hotel presents with pneumonia, accompanied by gastrointestinal symptoms, headache, and CNS symptoms. Which pathogen is MOST likely responsible?
A patient who recently stayed at a hotel presents with pneumonia, accompanied by gastrointestinal symptoms, headache, and CNS symptoms. Which pathogen is MOST likely responsible?
Following a bioterrorism event, several individuals develop pneumonia. Radiographic analysis reveals mediastinal widening without infiltrates. Which pathogen is MOST likely responsible?
Following a bioterrorism event, several individuals develop pneumonia. Radiographic analysis reveals mediastinal widening without infiltrates. Which pathogen is MOST likely responsible?
Which radiographic pattern is LEAST likely to be associated with viral pneumonia?
Which radiographic pattern is LEAST likely to be associated with viral pneumonia?
A patient presents with atypical pneumonia. Which of the following symptoms, if present, would MOST strongly suggest psittacosis?
A patient presents with atypical pneumonia. Which of the following symptoms, if present, would MOST strongly suggest psittacosis?
A patient presents with pneumonia and foul-smelling sputum. Which type of infection is MOST likely?
A patient presents with pneumonia and foul-smelling sputum. Which type of infection is MOST likely?
A patient is suspected of having early-stage community-acquired pneumonia (CAP), but the initial chest radiograph (CXR) is negative. What is the MOST appropriate next step in management?
A patient is suspected of having early-stage community-acquired pneumonia (CAP), but the initial chest radiograph (CXR) is negative. What is the MOST appropriate next step in management?
Which finding is LEAST likely to be associated with typical pneumonia caused by Haemophilus influenzae?
Which finding is LEAST likely to be associated with typical pneumonia caused by Haemophilus influenzae?
Which of the following viruses is typically associated with 'atypical' pneumonia?
Which of the following viruses is typically associated with 'atypical' pneumonia?
A patient presents with pneumonia, diarrhea, and otalgia. Which pathogen is LEAST likely to be the cause?
A patient presents with pneumonia, diarrhea, and otalgia. Which pathogen is LEAST likely to be the cause?
During influenza season, which rapid molecular assay is recommended as part of the initial diagnostic testing for Community-Acquired Pneumonia (CAP)?
During influenza season, which rapid molecular assay is recommended as part of the initial diagnostic testing for Community-Acquired Pneumonia (CAP)?
Which of the following is NOT typically part of the initial standard diagnostic tests for Community-Acquired Pneumonia (CAP)?
Which of the following is NOT typically part of the initial standard diagnostic tests for Community-Acquired Pneumonia (CAP)?
Which characteristic clinical presentation differentiates 'atypical' pneumonia from typical pneumonia?
Which characteristic clinical presentation differentiates 'atypical' pneumonia from typical pneumonia?
The presence of which finding would most strongly suggest a diagnosis of typical pneumonia rather than atypical pneumonia?
The presence of which finding would most strongly suggest a diagnosis of typical pneumonia rather than atypical pneumonia?
Under what condition is lactic acid level testing specifically recommended in patients with suspected Community-Acquired Pneumonia (CAP)?
Under what condition is lactic acid level testing specifically recommended in patients with suspected Community-Acquired Pneumonia (CAP)?
A Gram stain reveals gram-negative encapsulated bacilli. Which organism is MOST likely the causative agent?
A Gram stain reveals gram-negative encapsulated bacilli. Which organism is MOST likely the causative agent?
In a patient presenting with subacute pneumonia and a history of exposure to birds, which pathogen should be HIGHLY suspected?
In a patient presenting with subacute pneumonia and a history of exposure to birds, which pathogen should be HIGHLY suspected?
Which of the following is a characteristic pulmonary finding associated with typical pneumonia?
Which of the following is a characteristic pulmonary finding associated with typical pneumonia?
Which diagnostic method is LEAST effective for directly identifying Mycoplasma pneumoniae?
Which diagnostic method is LEAST effective for directly identifying Mycoplasma pneumoniae?
A previously healthy 25-year-old presents with a two-week history of dry cough, headache, and fatigue, followed by the insidious onset of dyspnea. Auscultation reveals scattered rhonchi, and chest X-ray shows bilateral, patchy infiltrates. Sputum Gram stain is negative for bacteria. Which of the following pathogens is the MOST likely cause?
A previously healthy 25-year-old presents with a two-week history of dry cough, headache, and fatigue, followed by the insidious onset of dyspnea. Auscultation reveals scattered rhonchi, and chest X-ray shows bilateral, patchy infiltrates. Sputum Gram stain is negative for bacteria. Which of the following pathogens is the MOST likely cause?
Which of the following scenarios would MOST warrant a bronchoscopy with bronchoalveolar lavage in a patient diagnosed with pneumonia?
Which of the following scenarios would MOST warrant a bronchoscopy with bronchoalveolar lavage in a patient diagnosed with pneumonia?
A patient's Gram stain shows gram-negative diplococci. Which of the following organisms is the MOST likely cause?
A patient's Gram stain shows gram-negative diplococci. Which of the following organisms is the MOST likely cause?
In the context of pneumonia diagnostics, what is the PRIMARY rationale for measuring procalcitonin and C-reactive protein (CRP), despite their controversial nature?
In the context of pneumonia diagnostics, what is the PRIMARY rationale for measuring procalcitonin and C-reactive protein (CRP), despite their controversial nature?
Which of the following auscultatory findings is LEAST consistent with typical pneumonia, particularly in the context of lobar consolidation?
Which of the following auscultatory findings is LEAST consistent with typical pneumonia, particularly in the context of lobar consolidation?
A patient presents with pneumonia, and lab results identify gram-negative coccobacilli. Which organism is MOST likely responsible?
A patient presents with pneumonia, and lab results identify gram-negative coccobacilli. Which organism is MOST likely responsible?
A patient with pneumonia also exhibits gastrointestinal symptoms and neurological signs. Which of the following pathogens is MOST likely responsible?
A patient with pneumonia also exhibits gastrointestinal symptoms and neurological signs. Which of the following pathogens is MOST likely responsible?
Which of the following viral pathogens is LEAST likely to cause 'atypical' pneumonia with nonlobar infiltrates?
Which of the following viral pathogens is LEAST likely to cause 'atypical' pneumonia with nonlobar infiltrates?
A patient presents with pneumonia following exposure to birds, specifically parrots at home. Which of the following is the MOST likely causative agent?
A patient presents with pneumonia following exposure to birds, specifically parrots at home. Which of the following is the MOST likely causative agent?
In the context of atypical pneumonia, which characteristic is LEAST likely?
In the context of atypical pneumonia, which characteristic is LEAST likely?
Which of the following findings on Gram stain MOST strongly suggests Klebsiella pneumoniae as the causative agent of pneumonia?
Which of the following findings on Gram stain MOST strongly suggests Klebsiella pneumoniae as the causative agent of pneumonia?
A patient with severe CAP is not improving despite broad-spectrum antibiotics. Initial sputum Gram stain was inconclusive. Which test would provide the MOST rapid and specific identification of a potential viral etiology?
A patient with severe CAP is not improving despite broad-spectrum antibiotics. Initial sputum Gram stain was inconclusive. Which test would provide the MOST rapid and specific identification of a potential viral etiology?
A patient presents with suspected Legionella pneumonia. Which unique laboratory finding, though not always present, would provide the STRONGEST supportive evidence for this diagnosis?
A patient presents with suspected Legionella pneumonia. Which unique laboratory finding, though not always present, would provide the STRONGEST supportive evidence for this diagnosis?
A previously healthy adult presents with subacute pneumonia. Initial investigations are unrevealing. Flexible bronchoscopy with bronchoalveolar lavage (BAL) is performed, and the sample undergoes metagenomic next-generation sequencing (mNGS). The mNGS reveals a high abundance of viral sequences, but standard viral PCR is negative. Which pathogen is MOST likely responsible?
A previously healthy adult presents with subacute pneumonia. Initial investigations are unrevealing. Flexible bronchoscopy with bronchoalveolar lavage (BAL) is performed, and the sample undergoes metagenomic next-generation sequencing (mNGS). The mNGS reveals a high abundance of viral sequences, but standard viral PCR is negative. Which pathogen is MOST likely responsible?
In the context of pneumonia diagnosis, what is the PRIMARY utility of measuring procalcitonin levels?
In the context of pneumonia diagnosis, what is the PRIMARY utility of measuring procalcitonin levels?
If a patient presents with pneumonia and a diagnostic workup is initiated, during which season would a rapid influenza molecular assay be MOST critical as part of the initial diagnostic evaluation?
If a patient presents with pneumonia and a diagnostic workup is initiated, during which season would a rapid influenza molecular assay be MOST critical as part of the initial diagnostic evaluation?
Which of the following historical factors is MOST likely to predispose a patient to pneumonia caused by a combination of aerobic and anaerobic organisms?
Which of the following historical factors is MOST likely to predispose a patient to pneumonia caused by a combination of aerobic and anaerobic organisms?
A patient with a known history of COPD is admitted to the hospital with community-acquired pneumonia (CAP). Which of the following organisms is LEAST likely to be the causative agent?
A patient with a known history of COPD is admitted to the hospital with community-acquired pneumonia (CAP). Which of the following organisms is LEAST likely to be the causative agent?
Which Gram stain result is MOST consistent with Moraxella catarrhalis?
Which Gram stain result is MOST consistent with Moraxella catarrhalis?
A patient presents with pneumonia, and initial tests are inconclusive. The patient deteriorates despite broad-spectrum antibiotics. Which invasive diagnostic procedure is MOST appropriate to identify the causative pathogen if less invasive methods have failed?
A patient presents with pneumonia, and initial tests are inconclusive. The patient deteriorates despite broad-spectrum antibiotics. Which invasive diagnostic procedure is MOST appropriate to identify the causative pathogen if less invasive methods have failed?
A patient with a history of frequent antibiotic use develops pneumonia. Which pathogen should be of HIGHEST concern due to its resistance profile?
A patient with a history of frequent antibiotic use develops pneumonia. Which pathogen should be of HIGHEST concern due to its resistance profile?
Which of the following conditions is LEAST associated with an increased incidence of gram-negative bacteria in pneumonia?
Which of the following conditions is LEAST associated with an increased incidence of gram-negative bacteria in pneumonia?
A patient who is suspected of having pneumonia tests negative on a sputum Gram stain. All of the following serology tests require a paired sample EXCEPT:
A patient who is suspected of having pneumonia tests negative on a sputum Gram stain. All of the following serology tests require a paired sample EXCEPT:
What is the MOST appropriate course of action regarding antibiotic therapy and further diagnostic testing in a patient diagnosed with CAP, demonstrating clinical improvement with appropriate antibiotics, and yielding a sputum Gram stain revealing no predominant organism?
What is the MOST appropriate course of action regarding antibiotic therapy and further diagnostic testing in a patient diagnosed with CAP, demonstrating clinical improvement with appropriate antibiotics, and yielding a sputum Gram stain revealing no predominant organism?
Which clinical manifestation is MOST indicative of pneumonia caused by Legionella species rather than other common bacterial pathogens?
Which clinical manifestation is MOST indicative of pneumonia caused by Legionella species rather than other common bacterial pathogens?
A patient presents with pneumonia and a diffuse maculopapular rash. Which of the following underlying conditions would MOST strongly suggest Mycoplasma pneumoniae as the causative agent?
A patient presents with pneumonia and a diffuse maculopapular rash. Which of the following underlying conditions would MOST strongly suggest Mycoplasma pneumoniae as the causative agent?
A patient who works in construction in Arizona presents with pneumonia, arthralgia and painful skin nodules that resemble erythema nodosum. Which of the following is the MOST likely causative organism?
A patient who works in construction in Arizona presents with pneumonia, arthralgia and painful skin nodules that resemble erythema nodosum. Which of the following is the MOST likely causative organism?
Which of the following pathogens is LEAST likely to cause pneumonia in a patient with advanced HIV infection and a CD4 count below 50 cells/µL?
Which of the following pathogens is LEAST likely to cause pneumonia in a patient with advanced HIV infection and a CD4 count below 50 cells/µL?
After suspected exposure to a bioweapon, several patients present with pneumonia, and chest radiographs reveal a widened mediastinum without infiltrates. Which of the following mechanisms is MOST directly causative of the mediastinal widening?
After suspected exposure to a bioweapon, several patients present with pneumonia, and chest radiographs reveal a widened mediastinum without infiltrates. Which of the following mechanisms is MOST directly causative of the mediastinal widening?
A patient presents with pneumonia, and the Gram stain of their sputum reveals encapsulated gram-negative bacilli. Which virulence factor is MOST likely contributing to the pathogenesis of this infection?
A patient presents with pneumonia, and the Gram stain of their sputum reveals encapsulated gram-negative bacilli. Which virulence factor is MOST likely contributing to the pathogenesis of this infection?
A patient with suspected pneumonia is noted to have significant pleuritic chest pain, and auscultation reveals a pleural friction rub over the affected area. Which of the following pathological processes is MOST directly contributing to these findings?
A patient with suspected pneumonia is noted to have significant pleuritic chest pain, and auscultation reveals a pleural friction rub over the affected area. Which of the following pathological processes is MOST directly contributing to these findings?
A patient presents with pneumonia. Sputum culture grows Klebsiella pneumoniae. Which description is MOST consistent with the expected appearance of the patient's sputum?
A patient presents with pneumonia. Sputum culture grows Klebsiella pneumoniae. Which description is MOST consistent with the expected appearance of the patient's sputum?
A patient who recently returned from a cruise presents with pneumonia accompanied by gastrointestinal symptoms and confusion. Which of the following mechanisms is MOST likely implicated in the pathogenesis of disease?
A patient who recently returned from a cruise presents with pneumonia accompanied by gastrointestinal symptoms and confusion. Which of the following mechanisms is MOST likely implicated in the pathogenesis of disease?
A patient presents to the emergency department in early winter with a 3-day history of cough, fever, and malaise. A rapid influenza test is negative. Chest X-ray shows patchy infiltrates. Which of the following pathogens is LEAST likely to be the causative agent of pneumonia in this scenario?
A patient presents to the emergency department in early winter with a 3-day history of cough, fever, and malaise. A rapid influenza test is negative. Chest X-ray shows patchy infiltrates. Which of the following pathogens is LEAST likely to be the causative agent of pneumonia in this scenario?
A homeless patient with a history of chronic alcohol abuse is brought to the ED with cough, fever, and shortness of breath. His sputum is thick, bloody, and has a 'red currant jelly' appearance. Besides pneumonia, which of the following conditions should be HIGHLY suspected in this patient?
A homeless patient with a history of chronic alcohol abuse is brought to the ED with cough, fever, and shortness of breath. His sputum is thick, bloody, and has a 'red currant jelly' appearance. Besides pneumonia, which of the following conditions should be HIGHLY suspected in this patient?
A patient is admitted to the ICU with severe community-acquired pneumonia (CAP). Despite appropriate antibiotic therapy, the patient develops septic shock and acute respiratory distress syndrome (ARDS). Which of the following pathophysiologic mechanisms is MOST likely driving the development of ARDS in this patient?
A patient is admitted to the ICU with severe community-acquired pneumonia (CAP). Despite appropriate antibiotic therapy, the patient develops septic shock and acute respiratory distress syndrome (ARDS). Which of the following pathophysiologic mechanisms is MOST likely driving the development of ARDS in this patient?
Which of the following defense mechanism failures is MOST likely to predispose a patient to pneumonia following aspiration of gastric contents?
Which of the following defense mechanism failures is MOST likely to predispose a patient to pneumonia following aspiration of gastric contents?
A researcher is investigating novel therapies for pneumonia caused by Streptococcus pneumoniae. Which of the following approaches would be MOST likely to directly target a virulence factor SPECIFIC to this pathogen, rather than a general antibacterial mechanism?
A researcher is investigating novel therapies for pneumonia caused by Streptococcus pneumoniae. Which of the following approaches would be MOST likely to directly target a virulence factor SPECIFIC to this pathogen, rather than a general antibacterial mechanism?
A patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital with a diagnosis of community-acquired pneumonia (CAP). Which of the following pathogens is LEAST likely to be the causative agent, assuming no other risk factors are present?
A patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital with a diagnosis of community-acquired pneumonia (CAP). Which of the following pathogens is LEAST likely to be the causative agent, assuming no other risk factors are present?
In the context of hospital-acquired pneumonia, which measure is MOST effective in preventing the spread of infection and reducing the incidence of new cases?
In the context of hospital-acquired pneumonia, which measure is MOST effective in preventing the spread of infection and reducing the incidence of new cases?
You are evaluating a patient with suspected pneumonia. Their chest X-ray shows patchy infiltrates primarily in the lower lobes. Which of the following historical clues would MOST strongly suggest aspiration pneumonia as the underlying cause?
You are evaluating a patient with suspected pneumonia. Their chest X-ray shows patchy infiltrates primarily in the lower lobes. Which of the following historical clues would MOST strongly suggest aspiration pneumonia as the underlying cause?
Which of the following is the MOST critical distinction between the etiologies and treatment strategies of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP)?
Which of the following is the MOST critical distinction between the etiologies and treatment strategies of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP)?
A patient with AIDS presents with dyspnea, fever, and a dry cough. A diagnostic test reveals elevated levels of 1,3-beta-D-glucan in their serum. Which of the following organisms is the MOST likely cause of their pneumonia?
A patient with AIDS presents with dyspnea, fever, and a dry cough. A diagnostic test reveals elevated levels of 1,3-beta-D-glucan in their serum. Which of the following organisms is the MOST likely cause of their pneumonia?
Consider a hypothetical scenario: Researchers develop a novel drug that selectively enhances the activity of pulmonary alveolar macrophages. In the context of pneumonia prevention, which of the following mechanisms would MOST directly contribute to the drug's protective effect?
Consider a hypothetical scenario: Researchers develop a novel drug that selectively enhances the activity of pulmonary alveolar macrophages. In the context of pneumonia prevention, which of the following mechanisms would MOST directly contribute to the drug's protective effect?
A patient presents with pneumonia characterized by 'rusty brown sputum'. Which bacterial structure is MOST likely contributing directly to the sputum's color?
A patient presents with pneumonia characterized by 'rusty brown sputum'. Which bacterial structure is MOST likely contributing directly to the sputum's color?
Which characteristic of Staphylococcus aureus makes it a greater concern in hospital-acquired pneumonia compared to community-acquired pneumonia?
Which characteristic of Staphylococcus aureus makes it a greater concern in hospital-acquired pneumonia compared to community-acquired pneumonia?
In a patient with a history of alcohol abuse and presenting with pneumonia, which virulence factor of Klebsiella pneumoniae MOST directly contributes to its ability to cause extensive lung damage and necrosis?
In a patient with a history of alcohol abuse and presenting with pneumonia, which virulence factor of Klebsiella pneumoniae MOST directly contributes to its ability to cause extensive lung damage and necrosis?
A cystic fibrosis (CF) patient on chronic antibiotics develops pneumonia. Sputum cultures grow Pseudomonas aeruginosa. Which bacterial adaptation is MOST likely confounding treatment efficacy?
A cystic fibrosis (CF) patient on chronic antibiotics develops pneumonia. Sputum cultures grow Pseudomonas aeruginosa. Which bacterial adaptation is MOST likely confounding treatment efficacy?
Why is differentiation between Haemophilus influenzae and Moraxella catarrhalis etiologies important in COPD patients presenting with pneumonia, despite both being Gram-negative organisms commonly associated with COPD exacerbations?
Why is differentiation between Haemophilus influenzae and Moraxella catarrhalis etiologies important in COPD patients presenting with pneumonia, despite both being Gram-negative organisms commonly associated with COPD exacerbations?
Which organism is characterized as Gram-positive diplococci and is the most common cause of community-acquired pneumonia?
Which organism is characterized as Gram-positive diplococci and is the most common cause of community-acquired pneumonia?
In which patient population is Staphylococcus aureus pneumonia MOST commonly observed?
In which patient population is Staphylococcus aureus pneumonia MOST commonly observed?
Which of the following organisms associated with pneumonia is a gram-negative encapsulated rod, often seen in patients with ETOH abuse, DM, or hospital-acquired infections?
Which of the following organisms associated with pneumonia is a gram-negative encapsulated rod, often seen in patients with ETOH abuse, DM, or hospital-acquired infections?
A patient with cystic fibrosis develops pneumonia. Which Gram-negative organism is MOST likely the causative agent?
A patient with cystic fibrosis develops pneumonia. Which Gram-negative organism is MOST likely the causative agent?
Differentiate between Haemophilus influenzae and Moraxella catarrhalis based on their microscopic morphology.
Differentiate between Haemophilus influenzae and Moraxella catarrhalis based on their microscopic morphology.
In the context of hospital-acquired pneumonia, which of the following bacterial pathogens is MOST frequently implicated?
In the context of hospital-acquired pneumonia, which of the following bacterial pathogens is MOST frequently implicated?
A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) presents with pneumonia. Based on their medical history, which of the following pathogens is MOST likely to be the causative agent?
A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) presents with pneumonia. Based on their medical history, which of the following pathogens is MOST likely to be the causative agent?
A patient with a history of chronic alcoholism is admitted with pneumonia and is producing 'current jelly sputum'. Which of the following organisms should be HIGHLY suspected as the causative agent?
A patient with a history of chronic alcoholism is admitted with pneumonia and is producing 'current jelly sputum'. Which of the following organisms should be HIGHLY suspected as the causative agent?
Which of the following clinical presentations would be considered the LEAST typical in an elderly patient experiencing pneumonia?
Which of the following clinical presentations would be considered the LEAST typical in an elderly patient experiencing pneumonia?
A patient who owns a pet parrot develops pneumonia. Which of the following pathogens is MOST strongly associated with bird exposure and should be considered in the differential diagnosis?
A patient who owns a pet parrot develops pneumonia. Which of the following pathogens is MOST strongly associated with bird exposure and should be considered in the differential diagnosis?
Among the atypical pneumonia pathogens, which of the following is specifically known to be associated with confusion and diarrhea as extra-pulmonary symptoms?
Among the atypical pneumonia pathogens, which of the following is specifically known to be associated with confusion and diarrhea as extra-pulmonary symptoms?
A patient who recently traveled to Arizona and New Mexico presents with pneumonia. Which of the following fungal pathogens is MOST likely responsible, given the patient's travel history to the southwestern United States?
A patient who recently traveled to Arizona and New Mexico presents with pneumonia. Which of the following fungal pathogens is MOST likely responsible, given the patient's travel history to the southwestern United States?
Consider a patient with bronchiectasis who develops pneumonia. While Pseudomonas aeruginosa is commonly associated with bronchiectasis, which of the following scenarios would make Staphylococcus aureus a MORE likely causative agent in this specific patient?
Consider a patient with bronchiectasis who develops pneumonia. While Pseudomonas aeruginosa is commonly associated with bronchiectasis, which of the following scenarios would make Staphylococcus aureus a MORE likely causative agent in this specific patient?
Which of the following is the MOST common etiology of acute bronchitis?
Which of the following is the MOST common etiology of acute bronchitis?
According to the provided information, which of the following is a typical sign or symptom of acute bronchitis?
According to the provided information, which of the following is a typical sign or symptom of acute bronchitis?
Pneumonia is defined as an infection affecting which specific part of the respiratory system?
Pneumonia is defined as an infection affecting which specific part of the respiratory system?
Which of the following patient populations is described as being at a particularly high risk of death from pneumonia, according to the content provided?
Which of the following patient populations is described as being at a particularly high risk of death from pneumonia, according to the content provided?
Which of the following is a characteristic pulmonary finding commonly associated with pneumonia caused by Haemophilus influenzae?
Which of the following is a characteristic pulmonary finding commonly associated with pneumonia caused by Haemophilus influenzae?
A patient presents with pneumonia but exhibits minimal respiratory symptoms, nonlobar infiltrates on chest radiography, and diarrhea. Which pathogen is MOST likely responsible?
A patient presents with pneumonia but exhibits minimal respiratory symptoms, nonlobar infiltrates on chest radiography, and diarrhea. Which pathogen is MOST likely responsible?
Among the mechanisms listed for the pathophysiology of pneumonia, which of the following is described as the MOST common?
Among the mechanisms listed for the pathophysiology of pneumonia, which of the following is described as the MOST common?
Which of the following mechanisms of pneumonia development is LEAST likely to occur in an immunocompetent individual?
Which of the following mechanisms of pneumonia development is LEAST likely to occur in an immunocompetent individual?
Which respiratory virus is LEAST likely to be associated with 'atypical' pneumonia?
Which respiratory virus is LEAST likely to be associated with 'atypical' pneumonia?
The classic presentation of 'typical' community-acquired pneumonia (CAP) is characterized by several findings. Which of the following is LEAST consistent with this 'typical' presentation?
The classic presentation of 'typical' community-acquired pneumonia (CAP) is characterized by several findings. Which of the following is LEAST consistent with this 'typical' presentation?
Which of the following pathogens is MOST likely to cause pneumonia with prominent gastrointestinal symptoms, like diarrhea, in addition to respiratory symptoms?
Which of the following pathogens is MOST likely to cause pneumonia with prominent gastrointestinal symptoms, like diarrhea, in addition to respiratory symptoms?
Considering the 'typical' CAP pathogens and presentation described, which of the following pathogens is MOST likely to be associated with 'typical' community-acquired pneumonia?
Considering the 'typical' CAP pathogens and presentation described, which of the following pathogens is MOST likely to be associated with 'typical' community-acquired pneumonia?
A patient presents with pneumonia and a history of recent exposure to birds. Which of the following pathogens should be HIGHLY suspected in this case?
A patient presents with pneumonia and a history of recent exposure to birds. Which of the following pathogens should be HIGHLY suspected in this case?
Which of the following pathogens is LEAST likely to be identified using a Gram stain of sputum?
Which of the following pathogens is LEAST likely to be identified using a Gram stain of sputum?
In a patient presenting with subacute pneumonia, which of the following viruses is LEAST likely to be causative?
In a patient presenting with subacute pneumonia, which of the following viruses is LEAST likely to be causative?
A previously healthy individual develops pneumonia following a recent upper respiratory infection characterized by coryza and mild pharyngitis. Radiography shows bilateral, patchy infiltrates. If initial bacterial cultures are negative, which viral etiology is LEAST likely?
A previously healthy individual develops pneumonia following a recent upper respiratory infection characterized by coryza and mild pharyngitis. Radiography shows bilateral, patchy infiltrates. If initial bacterial cultures are negative, which viral etiology is LEAST likely?
Which sputum characteristic is MOST classically associated with Klebsiella pneumoniae pneumonia?
Which sputum characteristic is MOST classically associated with Klebsiella pneumoniae pneumonia?
A cough lasting longer than two weeks accompanied by whooping sounds or posttussive vomiting is MOST suggestive of pneumonia caused by which organism?
A cough lasting longer than two weeks accompanied by whooping sounds or posttussive vomiting is MOST suggestive of pneumonia caused by which organism?
A patient presents with pneumonia and is noted to have mental confusion. This symptom is MORE characteristic of which type of pneumonia?
A patient presents with pneumonia and is noted to have mental confusion. This symptom is MORE characteristic of which type of pneumonia?
Interstitial infiltrates observed on a chest X-ray of a patient with pneumonia are MOST suggestive of which etiological category?
Interstitial infiltrates observed on a chest X-ray of a patient with pneumonia are MOST suggestive of which etiological category?
A traveler returning from a cruise ship presents with pneumonia, gastrointestinal distress, and headache. Which pathogen is MOST likely responsible?
A traveler returning from a cruise ship presents with pneumonia, gastrointestinal distress, and headache. Which pathogen is MOST likely responsible?
A chest X-ray of a patient with pneumonia reveals mediastinal widening but no pulmonary infiltrates. Which specific pathogen is MOST strongly indicated by this radiographic finding?
A chest X-ray of a patient with pneumonia reveals mediastinal widening but no pulmonary infiltrates. Which specific pathogen is MOST strongly indicated by this radiographic finding?
Green sputum can be observed in pneumonia caused by several pathogens. However, it is LEAST characteristic of pneumonia caused by which of the following organisms listed in the provided text?
Green sputum can be observed in pneumonia caused by several pathogens. However, it is LEAST characteristic of pneumonia caused by which of the following organisms listed in the provided text?
While bronchial breath sounds are a typical finding in pneumonia, in which scenario within the spectrum of pneumonia presentation are they LEAST likely to be prominent or detectable?
While bronchial breath sounds are a typical finding in pneumonia, in which scenario within the spectrum of pneumonia presentation are they LEAST likely to be prominent or detectable?
During which scenario would a sputum Gram stain and culture be MOST critical for guiding pneumonia treatment?
During which scenario would a sputum Gram stain and culture be MOST critical for guiding pneumonia treatment?
What is the expected Gram stain morphology for Moraxella catarrhalis?
What is the expected Gram stain morphology for Moraxella catarrhalis?
Which diagnostic method for pneumonia involves direct examination of the lower respiratory tract and specimen collection?
Which diagnostic method for pneumonia involves direct examination of the lower respiratory tract and specimen collection?
A patient not responding to antibiotics has an unidentified pathogen. Which of the following diagnostic procedures should be performed?
A patient not responding to antibiotics has an unidentified pathogen. Which of the following diagnostic procedures should be performed?
A Gram stain reveals gram-positive cocci in clusters. What is the MOST likely organism?
A Gram stain reveals gram-positive cocci in clusters. What is the MOST likely organism?
A patient presents with suspected pneumonia. Initial sputum Gram stain is inconclusive. Which test would provide the MOST rapid identification of a potential viral etiology?
A patient presents with suspected pneumonia. Initial sputum Gram stain is inconclusive. Which test would provide the MOST rapid identification of a potential viral etiology?
In a patient with severe pneumonia, procalcitonin levels might be measured. What is the PRIMARY utility of this measurement?
In a patient with severe pneumonia, procalcitonin levels might be measured. What is the PRIMARY utility of this measurement?
A patient is suspected of having pneumonia. Which of the following diagnostic tests relies on identifying specific antibodies in the patient's serum rather than directly detecting the pathogen?
A patient is suspected of having pneumonia. Which of the following diagnostic tests relies on identifying specific antibodies in the patient's serum rather than directly detecting the pathogen?
Most cases of acute bronchitis are bacterial
Most cases of acute bronchitis are bacterial
What is pneumonia?
What is pneumonia?
Which of the following is a mechanism for pneumonia?
Which of the following is a mechanism for pneumonia?
Which of the following is considered a typical CAP pathogen?
Which of the following is considered a typical CAP pathogen?
Gram stain is helpful in diagnosing atypical organisms
Gram stain is helpful in diagnosing atypical organisms
Which of the following is true of pneumonia in nursing homes?
Which of the following is true of pneumonia in nursing homes?
Which of the following is associated with Hospital-Acquired Pneumonia?
Which of the following is associated with Hospital-Acquired Pneumonia?
Typical signs and symptoms of pneumonia include:
Typical signs and symptoms of pneumonia include:
Atypical pneumonia symptoms may include:
Atypical pneumonia symptoms may include:
COPD can be associated with what organism?
COPD can be associated with what organism?
Alcoholism or Diabetes Mellitus can be associated with what organism?
Alcoholism or Diabetes Mellitus can be associated with what organism?
Asplenia is associated with what organism?
Asplenia is associated with what organism?
HIV infection is asscoiated with what organism?
HIV infection is asscoiated with what organism?
Bronchiectasis or cystic fibrosis or ventilator related is asscoiated with what organism?
Bronchiectasis or cystic fibrosis or ventilator related is asscoiated with what organism?
Travel to Mississippi, Ohio river valley is associated with what organism?
Travel to Mississippi, Ohio river valley is associated with what organism?
Travel to desert, southwest United State is associated with what organism?
Travel to desert, southwest United State is associated with what organism?
Hotel or cruise ship stay in the previous 2 weeks can be a risk factor for?
Hotel or cruise ship stay in the previous 2 weeks can be a risk factor for?
Which of the following describe S pneumoniae's character of sputum?
Which of the following describe S pneumoniae's character of sputum?
Klebsiella species is what type of sputum?
Klebsiella species is what type of sputum?
What is the first step in treatment for a patient as an Outpatient?
What is the first step in treatment for a patient as an Outpatient?
What is the treatment for pnuemonia during influenza season?
What is the treatment for pnuemonia during influenza season?
Describe first order actions for Inpatient, Non-ICU treatment?
Describe first order actions for Inpatient, Non-ICU treatment?
What is the antibiotic length of treatment for pneumonia?
What is the antibiotic length of treatment for pneumonia?
If a patient is at a high risk of getting pneumonia what drug should you administer?
If a patient is at a high risk of getting pneumonia what drug should you administer?
Mixed ______ bacteria are seen in most cases of lung abscess
Mixed ______ bacteria are seen in most cases of lung abscess
Within the United States, where can infection from Histoplasmosis occur?
Within the United States, where can infection from Histoplasmosis occur?
How to treat a patient that has PCP?
How to treat a patient that has PCP?
Flashcards
Pneumonia
Pneumonia
Infection of the lung parenchyma.
Community-Acquired Pneumonia (CAP)
Community-Acquired Pneumonia (CAP)
Pneumonia acquired outside of a hospital setting.
Hospital-Acquired Pneumonia (Nosocomial)
Hospital-Acquired Pneumonia (Nosocomial)
Pneumonia acquired in a hospital setting.
Acute Bronchitis (Etiology)
Acute Bronchitis (Etiology)
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Acute Bronchitis (Symptoms)
Acute Bronchitis (Symptoms)
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Acute Bronchitis (Treatment)
Acute Bronchitis (Treatment)
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Pneumonia (Mechanisms)
Pneumonia (Mechanisms)
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"Typical" CAP Presentation
"Typical" CAP Presentation
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Bordetella pertussis
Bordetella pertussis
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Legionella spp
Legionella spp
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S pneumoniae
S pneumoniae
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Pseudomonas, Haemophilus, and S pneumoniae
Pseudomonas, Haemophilus, and S pneumoniae
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Klebsiella species pneumonia
Klebsiella species pneumonia
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Anaerobic infections
Anaerobic infections
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Atypical Pneumonia Symptoms
Atypical Pneumonia Symptoms
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Interstitial Infiltrate Pathogens
Interstitial Infiltrate Pathogens
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Common CAP Bacteria
Common CAP Bacteria
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CAP Pulmonary Findings
CAP Pulmonary Findings
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CAP Consolidation Signs
CAP Consolidation Signs
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Atypical Pneumonia Onset
Atypical Pneumonia Onset
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Atypical CAP Pathogens
Atypical CAP Pathogens
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Other Atypical CAP pathogens
Other Atypical CAP pathogens
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Extrapulmonary Manifestations
Extrapulmonary Manifestations
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Endemic Fungi Pneumonia
Endemic Fungi Pneumonia
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Coccidioides immitis
Coccidioides immitis
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Nursing home pneumonia
Nursing home pneumonia
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Hospital-Acquired Pneumonia Pathogens
Hospital-Acquired Pneumonia Pathogens
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COPD-Associated Pneumonia
COPD-Associated Pneumonia
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Pneumonia in Alcoholism/Diabetes
Pneumonia in Alcoholism/Diabetes
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Asplenia-Associated Pneumonia
Asplenia-Associated Pneumonia
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Pulse Oximetry
Pulse Oximetry
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Complete Blood Count (CBC)
Complete Blood Count (CBC)
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Complete Metabolic Profile (CMP)
Complete Metabolic Profile (CMP)
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Rapid Influenza Molecular Assay
Rapid Influenza Molecular Assay
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Sputum Gram Stain
Sputum Gram Stain
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S. pneumoniae Gram Stain
S. pneumoniae Gram Stain
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S. aureus Gram Stain
S. aureus Gram Stain
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Pseudomonas Gram Stain
Pseudomonas Gram Stain
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Hospital-Acquired (Nosocomial) Pneumonia
Hospital-Acquired (Nosocomial) Pneumonia
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Acute Bronchitis Cause
Acute Bronchitis Cause
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Pneumonia Treatment
Pneumonia Treatment
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Haemophilus influenzae
Haemophilus influenzae
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Moraxella catarrhalis
Moraxella catarrhalis
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Subacute/Indolent CAP
Subacute/Indolent CAP
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Mycoplasma pneumoniae
Mycoplasma pneumoniae
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Chlamydophila pneumoniae
Chlamydophila pneumoniae
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Legionella pneumophila
Legionella pneumophila
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Influenza A and B
Influenza A and B
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Rhinovirus
Rhinovirus
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Common Nursing Home Pneumonia Pathogens
Common Nursing Home Pneumonia Pathogens
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Hospital-Acquired Pneumonia (HAP)
Hospital-Acquired Pneumonia (HAP)
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HAP Pathogens
HAP Pathogens
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COPD Pneumonia Pathogens
COPD Pneumonia Pathogens
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Alcoholism/Diabetes Pneumonia Pathogen
Alcoholism/Diabetes Pneumonia Pathogen
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Inhalation Anthrax
Inhalation Anthrax
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Rales
Rales
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Rhonchi
Rhonchi
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Dullness to Percussion
Dullness to Percussion
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Increased Tactile Fremitus
Increased Tactile Fremitus
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Egophony
Egophony
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Bronchophony
Bronchophony
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Whispered Pectoriloquy
Whispered Pectoriloquy
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Procalcitonin & CRP
Procalcitonin & CRP
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Urinary Legionella Antigen
Urinary Legionella Antigen
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PCR Testing
PCR Testing
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Serology
Serology
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Bronchoscopy
Bronchoscopy
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Pleural Fluid Culture
Pleural Fluid Culture
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Transthoracic Aspirate
Transthoracic Aspirate
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Streptococcus pneumoniae
Streptococcus pneumoniae
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Staphylococcus aureus
Staphylococcus aureus
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Klebsiella pneumoniae
Klebsiella pneumoniae
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Pseudomonas aeruginosa
Pseudomonas aeruginosa
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Acute Bronchitis (Tx)
Acute Bronchitis (Tx)
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Pneumonia (Primary Mechanism)
Pneumonia (Primary Mechanism)
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Pneumonia Aspiration
Pneumonia Aspiration
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Typical CAP Symptoms
Typical CAP Symptoms
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S. pneumoniae (in CAP)
S. pneumoniae (in CAP)
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Pneumonia Definition
Pneumonia Definition
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Pneumonia Etiology
Pneumonia Etiology
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CAP Lung Sounds
CAP Lung Sounds
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Consolidation Signs
Consolidation Signs
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Atypical CAP Onset
Atypical CAP Onset
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Atypical Pathogens
Atypical Pathogens
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Common Viral Pathogens
Common Viral Pathogens
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Extrapulmonary Signs
Extrapulmonary Signs
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Pertussis Cough
Pertussis Cough
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Legionella Exposure
Legionella Exposure
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Rust-Colored Sputum
Rust-Colored Sputum
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Relative Bradycardia
Relative Bradycardia
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Cavitary Lung Patterns
Cavitary Lung Patterns
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Interstitial Pneumonia Pathogens
Interstitial Pneumonia Pathogens
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Mediastinal Widening
Mediastinal Widening
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Coccidioides immitis Pneumonia
Coccidioides immitis Pneumonia
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Nursing Home Pneumonia Risk
Nursing Home Pneumonia Risk
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Atypical Pneumonia Features
Atypical Pneumonia Features
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Current Jelly Sputum
Current Jelly Sputum
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Aspiration Pneumonia Pathogens
Aspiration Pneumonia Pathogens
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Klebsiella Gram Stain
Klebsiella Gram Stain
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Moraxella Gram Stain
Moraxella Gram Stain
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Diagnostic Testing
Diagnostic Testing
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Bronchoscopy Use
Bronchoscopy Use
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Lactic Acid Level
Lactic Acid Level
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H. influenzae Gram Stain
H. influenzae Gram Stain
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Pneumonia: Hematogenous Spread
Pneumonia: Hematogenous Spread
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Typical Pneumonia Sputum
Typical Pneumonia Sputum
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Increased Cellular Immunity
Increased Cellular Immunity
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Pneumonia: Aspiration Risk
Pneumonia: Aspiration Risk
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CAP: Streptococcus pneumoniae
CAP: Streptococcus pneumoniae
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Non-responsive Pneumonia
Non-responsive Pneumonia
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Alcohol's Pneumonia Link
Alcohol's Pneumonia Link
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Lobar Consolidation
Lobar Consolidation
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Chlamydophila psittaci Risk
Chlamydophila psittaci Risk
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Adenovirus Link
Adenovirus Link
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Histoplasma capsulatum Source
Histoplasma capsulatum Source
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Coxiella burnetii Association
Coxiella burnetii Association
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Francisella tularensis Vector
Francisella tularensis Vector
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CMV Reactivation
CMV Reactivation
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Histoplasma Location
Histoplasma Location
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"Red Currant Jelly" Sputum
"Red Currant Jelly" Sputum
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Wheezing outside of pneumonia parameters
Wheezing outside of pneumonia parameters
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Cruise Ship Pneumonia
Cruise Ship Pneumonia
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Pneumonia and sputum
Pneumonia and sputum
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Miliary Patterns
Miliary Patterns
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Widened Mediastinum
Widened Mediastinum
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Atypical Pneumonia Signs
Atypical Pneumonia Signs
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Bioterrorism Exposure in a pneumonia case
Bioterrorism Exposure in a pneumonia case
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Urinary Antigen Testing
Urinary Antigen Testing
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Bronchoalveolar Lavage
Bronchoalveolar Lavage
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Needle Aspiration Diagnostic Aid
Needle Aspiration Diagnostic Aid
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S. pneumoniae Serology
S. pneumoniae Serology
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Study Notes
Acute Bronchitis
- Most cases are viral infections.
- Cough, fever, scattered rhonchi, and wheezing are typical signs and symptoms.
- Treatment includes rest, fluids, analgesics, and bronchodilators.
Pneumonia
- Pneumonia is an infection of the lung parenchyma.
- It is a frequent cause of death, especially in older adults with chronic diseases.
- Types of Pneumonia include:
- Community-acquired pneumonia (CAP)
- Nursing home pneumonia
- Hospital-acquired pneumonia (Nosocomial)
- The infection is usually treated empirically
- Mechanisms of pneumonia include:
- Inhalation of infectious particles
- Aspiration of oropharyngeal or gastric contents
- Hematogenous deposition (uncommon)
- Direct inoculation (uncommon)
- Invasion from infection in contiguous structures (rare)
- Re-activation (more common in immunocom promised patients)
- Decreased resistance to pneumonia can occur with the following:
- defects in pulmonary defenses
- Decreased cellular and humoral immune response
“Typical” CAP Pathogens
- Symptoms include: -Fever -A productive cough with purulent sputum -Dyspnea -Pleuritic chest pain
- Tachypnea is present
- Characteristic pulmonary findings: - Rales heard over the involved lobe or segment - Increased tactile fremitus - Bronchial breath sounds -Egophony
- The most common pathogens:
- Streptococcus pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
Atypical CAP Pathogens
- Often subacute and frequently indolent.
- Sublte pulmonary findings such as nonlobar infiltrates on radiography
- Various extrapulmonary manifestations such as diarrhea or otalgia.
- Do not use brochials in atypical pneumonia
- Pathogens include:
- Mycoplasma pneumoniae
- Chlamydophila (Chlamydia) pneumoniae
- Legionella pneumophila
Nursing hone pneumonia
- Increased incidence of gram negative and staph aureus
History and Physical Exam findings for pneumonia
- Typical Symptoms: Hyperthermia or hypothermia, chills, tachypnea, tachycardia or bradycardia, productive cough (Note: elderly may present atypically)
- Atypical pneumonia symptoms may also include: - Confusion (Legionella) - Diarrhea (Legionella) -Rash (Mycoplasma)
- Kids are always tachypnic when infected
History and Associated Pulmonary Pathogen
- COPD is associated with: Haemophilus influenzae or Moraxella catarrhalis
- Alcoholism or Diabetes Mellitus with "current jelly sputum is associated Klebsiella pneumoniae
- Ansplenia : is associated with S. pneumoniae, H. influenzae
- HIV infection is associated with: Typical” bacterial pathogens, M. tuberculosis, Pneumocystis jiroveci, cytomegalovirus, Cryptococcus spp., Histoplasma spp., Coccidioides spp.
- Bronchiectasis or cystic fibrosis or ventilator related Pseudomonas aeruginosa
- Aspiration is associated with Mixed aerobic, anaerobic Exposure to birds: Chlamydia psittaci
- Exposure to rabbits is associated with: Francisella tularensis
- Travel to Mississippi, Ohio river valley is associated with: Histoplasma capsulatum
- Travel to desert, southwest United is associated with: Coccidioides spp., Hantavirus
- Contact with person known to have COVID-19. is associated with :COVID-19
- Postinfluenza is associated with :S. Aureus or S. pneumoniae Cough >2 wk w/ whoop orPosttussive vomiting: Bordetella pertussis
- Hotel or cruise ship stay in the previously 2 weeks is associated with : Legionella spp GI symptoms, headache CNS Bioterrorism:Bacillus anthracis
Character and Sputum
- S pneumoniae is classically associated with a cough productive of rust-colored sputum.
- Pseudomona, Haemophilus, and S Pneumonia: Green Sputum
- Klebsiella apecies pneumonia is classucally associated with cough produce if red current jelly sputum
- Anerobic infections often produce foul-smell or bad-tasting septum
Physical exam
- Typical localized to a specific lungzone.
- May include: Rales Rhonchi Bronchial breth sounds Dullness to percssuion Increased tactile fremitus Positive egophony, bronchophony, and whisper pectorlloquy. Diagnostic Testing for Pneumonia consider a pulse oximetry less than 90% COnsider a complete blood count consider a complete metabolic profile rapid influenza molecular assay if flue szn
Lung Image Patterns
Focal infiltratesare usually bacterial Large pleural effusion are usually batteral Cavity is due to: bacterial abcess, fungal , Nocardia, TB Millary us due to Interstital ussually Viral Pneumocysts pneumonia Mycoplasma, chamodula pstitaci Mediastinal widening Withoutinfiltrate: Inhalation Anthra
lung
Lrl pneumonia or RML pneumonia if in back
Prophylaxis for Pneumonia
consider the pneumonia severity index rather than just CURB65 Class 1 / class II: Outpatien therapy ( assumiin no pervious failure , hypoxia ,ability to tank in PA and comply to Tx)
CURB 65 Criteria
- A score of 2 or more indicates hospital admission
- Recent expansion include LDH, thobolytonemia, and serum albumin
- Confusion Uremia (BUN 20mg/DL) Repirqotry Rate ( 30 min) Low Blood Pressure ( SbP < 90 or DBP < 60) Age ( 65 ya)
Outpatient Treatment Options
- Know these too:
- amoxicillin
- A macrolide (azithromycin 500 mg once and then 250 mg daily or clarithromycin 500 mg twice daily)
- good for S Preemo
- Doxycycline 100 mg twice dailyis also an effective treatment option , good for atypical (pend in mcyin)
- B- lactatam high dose : amoxicillin/ clavulavate 2 g twice 125 mg daily or 500mg 125 mg three the dayy or 875 mg three time daily cefpodimixe 200mg twic daily Respiruqotry florquinulones is muxofacacin + levoglaxacin
Inpatient Treatment Options
- B- Lactas all atypical ampucuklln with sucullbactatame 1.5 gram every 6 hours, ceftriaxone 1 gram twice daily, cefotaxime 1.2 g daily or cell ratlinee 600 mg every 12 hour) plus a microlife + respitory flurquinolone Lactams as above + dxtrucuclune
Inpatient, Non-ICU Treatment
- Beta-lactams (ampicillin/sulbactam 1.5-3 g every 6 hours, ceftriaxone 1-2 daily, cefotaxime 1-2 g every 8 hours, or celftaroline 60 mg every 12hours) plus a macro life
- Respitory fluoroquinlome
ICU Treatment
- beta lactatime+ respitio flu
- beta lactivi + aztrenom
- Beta-lactams (ampicillin/sulbactam 1.5-3 g every 6 hours, ceftriaxone 1-2 g daily, cefotaxime 1-2 g every 8 hours, or celftaroline 600 mg every 12hours) plus a macaroon lie + respitory flurquinolone
- respiratory flurquinolone
Children Pneumonia treatment Considerations
- Know these
- High-dose amoxicillin is used as a first-line agent for children under 5 with uncomplicated community-acquired pneumonia
- AVOID tetracyclines/doxycyline and flouroquinolones Macro lives as the empiric antibiotic choice for children aged 5-16 years (to cover mycoplasm, chamdo pholia leigonell)
During Iflu sneezing szn
- Reasoanlele titatiiate oslatamiv (Tamiflu or relera
COVID-19 Treatment Options for Non-hospitalized patients
- PAXLOviD and molupiravie reduce the risk in Covid related hospitaslziation or death
- Monoclonal antibody bebtelovimab IV - FDA authorized – decreases risk for severe COVID-19 or hospitalization.
- Only for people over age 12 with mild-moderate symptoms
Patient who dont reuspondd in 47 to 72 hrss: be recvaluagted
Special considerations for treatment
Penicillin/amoxicillin or other cell wall inhibitors do not cover atypicals
Special considerations for treatment
For greater gram negative coverage (ie with Klebsiella pneumoniae) RX a fluoroquinolone or a 3rd generation cephalosporin
Special treatment for pesudommaos or MrSA:
RX : Anitpseumonal B lacatam + anglysozde cirpoflaxin (CIPRO) + aninoglcysodie or : Add vancyoicing or linxolid • Anaerobes - RX Clindamycin or B-lactam/B lactamase inhiabiotyr
General treatment considerations
Antbioitics is Unclomaited patients, the Duartion shoul dbe 5 days If a patient is:
- Pesudmonas 7 dys
- MRSA :7 dayy
Atypical bacterial Infections
TB cxl and Sx - latent TB- treat wioth osanaizide 9 months supe,emnt with b
Prophylaxis for Pneumonia
- Vaccinations pneumonia vacine COvid - flu vacine Consider the pneumonia severity index rather than just CURB65
Pulmaory abscess
Pulmonary Abscess
- Patients with no gage reflex that gets aspirated Mixed anaerobic bacteria are seen in most cases
Lung Abscess
- Alterations of consciousness, like alcholism in neroulgic disorders Atered consciousness can be caused by Peridonatal diseases Periodontal idssses are often present Mized anaerobia bacteria are seen in most cases Other conditions to lung broncial obsrution:
Other considerations for lobg abscess development
Nechtrozign baxteria Pneumoccus due to S aries K-o or g ramnegtaiuve Result of bonchual obsrtucio caused by fumors ore gin bldues seoptic pimaionray emboli
lung Abscess
Pulmonary tuberculosis, gung, or actionycises is often the resposblie In the innusupresse hots, nocadiuc andpther ipperutnistic The treatrmtnr conisrders anaerobic coverage: with beta Lactan or beat lactatam inbbitir and Clinimac
Brocasietes
Chasriztied by andquired dusease that leads to amonormal+ permnante dilation of bonichie and
Blatomycosis Considerations
Caused by he dimophic fungus balstonmycelium that lives in soil or decaying the woods or leaves endemiai in Midwest sauth central and southern states Cause symptoms in about 50% of people (pneumonia like symptoms) on cutaneous form & can cause severe illness such as meningtis inn iniummocomprised patient TX-is: antifungyal medication is ampho B and for mode rate to severe disease
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