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38 Cards in this Set
- Front
- Back
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What are ways that microbes can enter the lung the produce infection?
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• aspiration of oropharyngeal secretion (most common)
• hematogenous spread • inhalation of aerosolized particles • spread from a contiguous focus of infection |
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Patient has pneumonia and a history of exposure to cattle, goats, or sheep. What is the most likely cause?
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• Q Fever
• Brucellosis |
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Patient has pneumonia and exposure to rabbits. What is the most likely cause?
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Tularemia
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What has pneumonia and history of exposure to birds. What is the most likely cause?
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• Psittacosis
• Histoplasmosis |
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Patient has pneumonia and exposure to rodents. What is the most likely cause?
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Hantavirus
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What can cause a pneumonia for a person who recently traveled to the southwestern US?
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Coccidiomycosis
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Which pneumonia develops from the Mississippi & Ohio River Walley OR cave diving/sperlunking?
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• Histoplasmosis
• Blastomycosis |
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Patient has a pneumonia that develops from travel to a developing country. What is a possible cause?
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Tuberculosis
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What is a likely cause of pneumonia from a dog tick?
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Ehrlichiosis
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Patients with pneumonia and fever without a rise in pulse suggest what etiology?
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• Legionellosis
• Mycoplasma |
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Patients with pneumonia and foul breath suggest what etiology?
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anaerobic infection
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What are physical findings of bacterial pneumonia?
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• bronchial breath sounds
• crackles • dullness to percussion • evidence of consolidation • increased fremitus • whispered pectoriloquy |
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What does a chest cray of a patient with Mycoplasma pneuomia look like?
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• patchy infiltrates (esp. in lower lobes)
• appears much more severe on CXR than symptoms suggests |
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True/False: A negative radiograph can rule-out the possibility of acute bacterial pneumonia
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• A "negative" radiograph can never rule out the possiblity of acute bacterial pneumonia when the patient's symptoms and signs point to this diagnosis
• The correct answer is: False |
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The presence of cavitation on chest xray helps indentify what type of pneumonia?
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necrotizing pneumonia
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What are common causes of necrotizing pneumonias?
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• anaerobes
• fungi • gram-negative bacilli • Pneumocystis carinii • Staphylococcus • Tuberculosis |
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A patient presents with symptoms of pneumonia. Sputum gram stain shows inflammatory cells and no organisms. What are possible etiologies?
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• Chlamydia psittaci
• Chlamydia pneumoniae • Legionella • Mycoplasma pneumoniae • prior antibiotic treatment • Q Fever • Viral pneumonia |
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The demonstration of elastin fibers in a KOH prep of sputum establishes a diagnosis of what type of pneumonia?
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necrotizing pneumonia
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What is the most common cause of pneumonia in children?
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• Viruses
• most frequent viral cause is RSV |
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What is the most common viral cause of pneumonia in adults?
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• influenza (most common)
• adenovirus • parainfluenza • RSV |
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Which patients are at an increased risk for influenzal pneumonia?
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• elderly
• patients with chronic disease of heart, lung, kidney • women in last trimester of pregnancy |
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What does a chest xray show in patients with a viral pneumonia?
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• interstitial pattern
• patchy infiltrates |
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What are predisposing risk factors for developing pneumococcal pneumonia?
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• alcoholism
• chronic lung disease • hematologic malignancy • HIV infection • prior splenectomy • renal failure • sickle cell disease |
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What does chest xray show in patients with pneumococcal pneumonia?
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lobar consolidations w/ air bronchograms after 2nd to 3rd day
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What are features of Staph aureus pneumonia that differentiate it from pneumococcal pneumonia?
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• development of parenchymal necrosis and abscess formation in up to 25% of patients
• development of empyema in 10% |
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What is the treatment for pneumonia caused by H. Flu?
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• ampicillin + ß-lactamase inhibitor
OR • 2nd or 3rd generation cephalosporin |
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Patient presents with pneumonia and a history of alcoholism. What is the most likely etiology?
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Klebsiella pneumoniae
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Patients with a recent history of bacteremias resulting from intestinal or urinary tract infection that develop pneumonia are most likely cause by what organism?
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E. coli
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Intubated patients or patients with a history cystic fibrosis most likely develop pneumonia from what bacteria?
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Pseudomonas
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What are characteristic presenting symptoms of Mycoplasma pneumonia?
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• hacking, non-productive cough
• non-pulmonary features - myalgias - arthralgias - skin lesions • neurologic complications (ex. meningitis, encephalitis, transverse myelitis) |
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What clinical presentation suggest Legionella pneumonia?
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• rapidly progressive pneumonia
• dry cough • multi-organ involvement |
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What are 4 methods to diagnose Legionella pneumonia?
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• indirect fluorescent antibody
• direct florescence abntibody • Legionella antigen (detected in urine) • culture on charcoal yeast extract |
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What are treatment options for Legionella pneumonia?
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• Macrolides
• Tetracyclines • Fluoroquinolones |
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What is the initial antibiotic used to treat Chlamydia pneumoniae?
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Erythromycin 500 mg PO QID
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How long is the pneumococcal vaccine effective in individuals with normal immune response?
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5 years
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What are bacterial causes of anaerobic pneumonia?
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• Bacteroides
• Fusobacterium • Prevotellta • Peptostreptococcus |
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What are does a lung abscess look like on chest xray?
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• a thick-walled solitary cavity sourrounded by consolidation
• air-fluid level is usually present |
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What does necrotizing pneumonia look like on chest xray?
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multiple areas of cavitation within an area of consolidation
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