Egan’s Chapter 22 Practice Questions:
1. Aspirations of organisms colonizing the oropharynx: ComAcquired Bacterial Pneumonia, Aspiration Acquired Pneumonia, HAPs, VAPs
2. Cavitary infiltrates are seen where?: in Reactivation Pulmonary TB, Fungal pneumonia and rarely p. jiroveci
3. Community Acquired Pneumonia – Acute: Streptococcus Pneumoniae, Haemophilus Influenzae, Moraxella Catarrhalis, S. Aureus
4. Community Acquired Pneumonia – Atypical: Legionella Pneumophila, Chlamydophila Pneumoniae, Mycoplasma Pneumonia, Coxiella Burnetii(Viral)
5. Community Acquired Pneumonia – Chronic: Mycobacterium Tuberculosis, Histoplasma Capsilatum, Blastomyces Dermatitidis, Coccidioides Immitis
6. Direct inoculation of organisms in the lower airways: HAPS, VAPS
7. Gram-negative positive helps with what?: Antibiotic selection.
8. HAP: is a lower respiratory tract infection and develops in patients hospitalized for more than 48 hours after an ET tube is placed.
9. HCAP is: any person who is hospitalized for 2 or more days and in the past 90 days or a person who has in the past 30 days resided in a nursing facility, attended a hospital or clinic hemodialysis, iv antibiotics, chemo, or wound care, and gets an infection
10. Health Care Associated Pneumonia: Mixed aerobic and anaerobic mouth flora, S. Aureus, Enteric gram-negative bacilli, Influenza, M. Tuberculosis
11. hematogenous dissemination is?: transmission through the bloodstream from a remote site
12. Immunocompromised host: Pneumocystis Carinii, Cytomegalovirus, Aspergillus sp., Cryptococcus, Neoformans, reactivation TB or histoplasmosis
13. Inhaled particles: TB, Histoplasmas, Cryptococcus, Blastomycosis, Coccidioidomycosis, Q fever, Legionellosis
14. In HIV urban settings what is the most common cause of pneumonia?: P. Jiroveci
15. Nosocomial: Aspiration – Mixed aerobes and anaerobes, Gram-negative bacilli, Healthcare associated – S. Aureus, Vent associated – pseudomonas aeruginosa, acinetobacter sp., enterobacter sp., klebsiella sp., stenotrophomonas maltophilia, S. Aureus
16. What are pneumatoceles?: small cavities developed from severe staph or gram-negative bacteria
17. Reactivation of latent infections: Pneumocystis jiroveci pneumonia, Reactivation of TB, Cytomegalovirus
18. Spread of infection to lungs from adjacent structures: Mixed aerobic and anaerobic pneumonia from a subdiaphragmatic abscess. Amebic pneumonia from rupture of amebic liver abscess into the lung.
19. Spread of infection to the lungs through blood: S. Aureus Pneumonia from right sided bacterial endocarditis. Parasitic pneumonia: strongyloidiasis, ascariasis, hookworm
20. What is MRSA?: Methicillin resistant S. Aureus
21. What is the most common Community-acquired Pneumonia?: S. Pneumonia 20-75 of all cases. Atypical account for 10%.
22. What percentage of pneumonia goes undiagnosed?: 25-50%
23. Why is there a 50% rate of microbiologic diagnosis?: No sputum production, Failure to perform serological tests on patients, Many organisms are not routinely sought, Failure to recognize new pneumonia pathogens.