Community Acquired Pneumonia Exam
Questions And Answers Graded A+
Explain the difference between community acquired pneumonia, hospital acquired pneumonia, and
ventilator associated pneumonia.
1. CAP- community-dwelling outpatient or inpatient if diagnosis is within 48 hours of admission
2. HAP- patient has been in the hospital more than 48 hours before diagnosis
3. VAP- 48-72 hours after endotracheal intubation patient is diagnosed
What are the signs and symptoms of pneumonia?
1. fever / chills
2. SOB / hypoxemia
3. cough / sputum production / purulent sputum
4. leukocytosis or leukopenia
5. pleuritic chest pain
6. tachypnea
7. uremia
8. hypotension
9. confusion
What criteria does the CURB-65 use?
1. confusion
2. uremia ( BUN >20 mg / dL )
3. increased respiratory rate (>30 / min)
4. low blood pressure (< 90 SBP or <60 DBP)
5. age 65 years or greater
What criteria does the Pneumonia Severity Index use?
1. age
2. mental status
3. pulse
4. respiratory rate
5. fever
6. past medical history
7. sex
8. glucose
9. hematocrit
10. serum sodium
How does the CURB-65 scoring work?
-1 point per each category
0-1 points then treat outpatient
2 points requires short hospital stay
3-5 points requires hospital stay and possibly ICU
What are the physical exam findings for pneumonia?
1. auscultatory findings
-dullness to percussion
-change in breath sounds
-wheezes
-crackles
-egophony
, -increased tactile remits
-whisper pepctoriloquy
2. tachypnea and tachycardia
3. chest wall retractions and grunting respirations
4. diminished breath sounds over affected area
5. inspiratory crackles during lung expansion
What are the most common causes of CAP that can be treated outpatient?
1. strep. pneumoniae
2. mycoplasma pneumoniae
3. chlamydophilia pneumoniae
4. H. influenzae
5. respiratory viruses
What are the most common causes of CAP that need hospitalization (non-ICU)?
1. strep. pneumoniae
2. mycoplasma pneumoniae
3. chlamydophilia pneumoniae
4. H. influenzae
5. legionella species
6. respiratory viruses
What are the common causes of CAP that need hospitalization (ICU)?
1. strep. pneumoniae
2. staph. aureus
3. H. influenzae
4. legionella species
5. gram negative bacilli
What is the first line treatment for CAP in patients that were previously healthy and no use of
antimicrobials within the past 3 months?
1. macrolide such as azithromycin or erythromycin
2. doxycycline (not preferred due to high resistance)
What is the first line treatment for CAP in patients that have the presence of comorbidities or recent
antimicrobial use?
1. respiratory fluoroquinolone (moxifloxacin or levofloxacin)
2. beta lactam (3rd gen ceph.) plus macrolide
What is the first line treatment for CAP in patients requiring hospitalization but not ICU?
1. respiratory fluoroquinolone (moxifloxacin or levofloxacin)
2. beta lactam (3rd gen ceph.) plus macrolide
What is the first line treatment for CAP in patients requiring hospitalization in the ICU?
1. beta lactam (cefotaxime, ceftriaxone, or Unasyn) plus azithromycin or respiratory fluoroquinolone
(moxifloxacin or levofloxacin)
*patients with penicillin allergy use aztreonam
*if covering for MRSA add linezolid or vancomycin
Questions And Answers Graded A+
Explain the difference between community acquired pneumonia, hospital acquired pneumonia, and
ventilator associated pneumonia.
1. CAP- community-dwelling outpatient or inpatient if diagnosis is within 48 hours of admission
2. HAP- patient has been in the hospital more than 48 hours before diagnosis
3. VAP- 48-72 hours after endotracheal intubation patient is diagnosed
What are the signs and symptoms of pneumonia?
1. fever / chills
2. SOB / hypoxemia
3. cough / sputum production / purulent sputum
4. leukocytosis or leukopenia
5. pleuritic chest pain
6. tachypnea
7. uremia
8. hypotension
9. confusion
What criteria does the CURB-65 use?
1. confusion
2. uremia ( BUN >20 mg / dL )
3. increased respiratory rate (>30 / min)
4. low blood pressure (< 90 SBP or <60 DBP)
5. age 65 years or greater
What criteria does the Pneumonia Severity Index use?
1. age
2. mental status
3. pulse
4. respiratory rate
5. fever
6. past medical history
7. sex
8. glucose
9. hematocrit
10. serum sodium
How does the CURB-65 scoring work?
-1 point per each category
0-1 points then treat outpatient
2 points requires short hospital stay
3-5 points requires hospital stay and possibly ICU
What are the physical exam findings for pneumonia?
1. auscultatory findings
-dullness to percussion
-change in breath sounds
-wheezes
-crackles
-egophony
, -increased tactile remits
-whisper pepctoriloquy
2. tachypnea and tachycardia
3. chest wall retractions and grunting respirations
4. diminished breath sounds over affected area
5. inspiratory crackles during lung expansion
What are the most common causes of CAP that can be treated outpatient?
1. strep. pneumoniae
2. mycoplasma pneumoniae
3. chlamydophilia pneumoniae
4. H. influenzae
5. respiratory viruses
What are the most common causes of CAP that need hospitalization (non-ICU)?
1. strep. pneumoniae
2. mycoplasma pneumoniae
3. chlamydophilia pneumoniae
4. H. influenzae
5. legionella species
6. respiratory viruses
What are the common causes of CAP that need hospitalization (ICU)?
1. strep. pneumoniae
2. staph. aureus
3. H. influenzae
4. legionella species
5. gram negative bacilli
What is the first line treatment for CAP in patients that were previously healthy and no use of
antimicrobials within the past 3 months?
1. macrolide such as azithromycin or erythromycin
2. doxycycline (not preferred due to high resistance)
What is the first line treatment for CAP in patients that have the presence of comorbidities or recent
antimicrobial use?
1. respiratory fluoroquinolone (moxifloxacin or levofloxacin)
2. beta lactam (3rd gen ceph.) plus macrolide
What is the first line treatment for CAP in patients requiring hospitalization but not ICU?
1. respiratory fluoroquinolone (moxifloxacin or levofloxacin)
2. beta lactam (3rd gen ceph.) plus macrolide
What is the first line treatment for CAP in patients requiring hospitalization in the ICU?
1. beta lactam (cefotaxime, ceftriaxone, or Unasyn) plus azithromycin or respiratory fluoroquinolone
(moxifloxacin or levofloxacin)
*patients with penicillin allergy use aztreonam
*if covering for MRSA add linezolid or vancomycin
