WorksheetsPneumonia
Total questions: 32
Worksheet time: 20mins
Which route of infection does not belong to pneumonia?
Aspiration
Inhalation
Contact
Hematogenous spread
What is Hospital-Acquired Pneumonia?
Occurs 48+ hours of intubation
Patient has not been hospitalized for 14 days or in long-term facility
Patient drank a lot of water at the hospital and it’s went went straihjt to the lungs.
Occurs 48+ hours after hospitalization with no signs/symptoms present on admission
This infection results from microorganisms that do not normally cause disease in healthy adults
Aspiration
Opportunistic
Community-Acquired
Medical Care-Associated
What is pleuritic chest pain?
Pain that worsens when you sit down
Pain that hurts when you poke your chest
Pain that hurts more on the affected side
Pain that gets worse when breathing
BONUS:
What score would this patient receive from the CURB-65 scale AND what would the recommended treatment be?
68 year old male, alert and confused but baseline met, BP 88/58, Temp 36.8*C, RR 34, HR 88, O2 97% on RA, BUN 14, CrCl 0.9, RBC 5, WBC 14
3 with admit to ICU
2 with hospital admission
2 with treat at home
3 with hospital admission
Which one of the following types of pneumonia was removed from the 2016 guidelines?
Community-acquired pneumonia
Hospital-acquired pneumonia
Ventilator-associated pneumonia
Healthcare-associated pneumonia
Patient JP was admitted to the hospital Friday night and intubated shortly after. During rounds Saturday morning he presented with symptoms of pneumonia. What is the most likely type of pneumonia?
CAP
HAP
VAP
What is the gold standard for diagnosing pneumonia?
Chest x-ray
Sputum culture
Blood cultures
Ultrasound
Which organisms are likely to cause outpatient CAP?
Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa
Confusion: No
BUN: 25
Respiratory rate: 30
Blood Pressure: 100/70
Age: 60
CURB-65 Score?
0
1
2
3
Which of the following are risk factors for S. pneumo resistance?
Age < 2 or age >65
B-lactam in past 3 months
Immunosuppression
Exposure to children in daycare
Which of the following is not a risk factor for P. aeruginosa?
Structural lung disease
Prior antibiotic therapy
Severe COPD with exacerbations
Exposure to a child in a daycare center
Which of the following is not a risk factor for MRSA?
ESRD
Alcoholism
IVDU
Prior ABX therapy
Prior influenza
What are procalcitonin levels used for?
To assist with decision to initiate antibiotics
To assist with decision to discontinue antibiotics
To assist with empiric therapy selection
To assist with directed therapy selection
Causes of Atypical pneumonia: Select all that apply
Mycoplasma Pneumonia
Influenza
Chlamydophila pneumonia
Legionella species
Someone who has HIV and develops Pneumocystis carinii pneumonia would be diagnosed with:
opportunistic infection.
septic infection.
congenital disorder.
viral infection.
How is MTB transmitted?
Person-to-person via aerosolized droplets
Animal-to-person via aerosolized droplets
Person-to-person via fecal matter
Animal-to-person via fecal
(T/F) Latent MTB infection is still contagious to others
True
False
What is the difference between latent and active TB?
In latent MTB, macrophages and T-lymphocytes successfully impair bacilli replication
In active MTB, macrophages and T-lymphocytes successfully impair bacilli replication
In latent MTB, host’s cell-mediated immunity has failed
Latent MTB does not need to be treated, while active TB does need to be treated
What is the difference between latent and active TB?
In latent MTB, macrophages and T-lymphocytes successfully impair bacilli replication
In active MTB, macrophages and T-lymphocytes successfully impair bacilli replication
In latent MTB, host’s cell-mediated immunity has failed
Latent MTB does not need to be treated, while active TB does need to be treated
How can you detect latent MTB?
Skin test
Blood assay
Chest x-ray
AFB smear/culture
What is the most contagious type of TB?
Primary
Reactivation/secondary
Pulmonary
Disseminated/Miliary
(T/F) In extrapulmonary TB, virtually all organ systems can be affected including the genitourinary and skeletal system.
True
False
Which patients would you interpret to have a positive PPD test with an induration of > 10mm
Recent close contacts of active TB patients
Patients with no risk factors for TB
Residents and employees of high-risk congregate settings
Residents and employees of high-risk congregate settings
Which of the following is a benefit of the tuberculin skin test?
Not influenced by prior BCG vaccine
More sensitive/specific than IGRA
No follow-up to have test read
Non-invasive
(T/F) TB cases must be reported to local public health department
True
False
Which rifamycin is the strongest inducer of CYP enzymes (especially 3A4 and 2C8/9)?
Rifampin
Rifapentine
Rifabutin
Roxithromycin
Which drug in RIPE therapy requires a baseline visual acuity test and testing for color discrimination?
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
Which of the following is NOT a disadvantage of Directly Observed Treatment (DOT)?
Time consuming
Insulting to patients
Labor intensive
Decreases propagation of drug resistance
Total treatment duration for TB can usually range from _________________.
2-4 months
4-7 months
6-9 months
6-12 months
What is the gold standard for LTBI treatment?
RIPE 9 months
Rifampin for 4 months
Isoniazid for 9 months
Isoniazid for 6 months
(T/F) An evidence-based TB regimen should be started immediately regardless of treatment status (ART therapy) in a patient with HIV.
True
False
