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.