CMN 568 EXAM 2 QUESTIONS & VERIFIED ANSWERS
What is the typical antibiotic treatment for CAP in adults? pt is healthy and NO Abx use
in 90 days
Amoxicillin or doxycycline
If a patient has persistent pleural collections, what will you do?
Send to ER for possible thoracentesis
If CXR says "cavitary lesions or opacities", what will you do?
ISOLATE and send to ER for TB workup
Abx for CAP in pt >65/use of abx in 90 days/hx of drug resistance, what Abx will you
give?
Macrolide or doxycycline
T/F: Is it uncommon for a cough to last up to 4 weeks after covid/PNA?
F - it is common for a cough to last up to 4 weeks
CURB-65 criteria
Confusion
Urea: BUN >7mmo/L (20mg/dl)
RR >30
BP: systolic <90 or diastolic <60
AgeL >65
How do you score CURB-65 and how is each score treated?
0: outpatient tx is most likely safe
1-2: admit to hospital for care
3-4: URGENT referral. Admit to ICU!
Key indicator of lung abscess
Cough with foul-smelling sputum --> send for CXR
Most common cause of pleural effusion
CHF
,Treatment for OSA
- Weight loss
- Strict avoidance of ETOH
- Avoidance of hypnotic meds
- Nasal CPAP (can be curative for many pts)
- UPPP (uvopalatopharyngoplasty) --> resection of pharyngeal soft tissue which
eliminates snoring
What can cause a falsely elevated d.dimer?
Cancer & pregnancy
Most common cause of a PE?
DVT
Most common ages for those with RSV?
< 5 or
> 65
In a patient who has recently traveled to Southeast Asia/Egypt, what would you be
concerned for?
Avian flu
Stage 1 of Pertussis
Catarrhal
Insidious onset of the following:
- Lacrimation
- Sneezing
- Coryza
- Anorexia
- Malaise
- Hacking in night cough that becomes diurnal (starts at night then occurs during the
daytime)
Stage 2 of Pertussis
Paroxysmal stage
- Bursts of rapid, consecutive coughs followed by deep, high-pitched inspiration (whoop)
, Stage 3 of Pertussis
Convalescence
- Begins at 4 weeks after onset with decrease in frequency and severity of paroxysms of
cough
How long do symptoms of Pertussis last?
6 weeks and has 3 stages
An adult with a cough lasting more than 2 weeks could be indicative of what?
Pertussis
What should you be concerned about if a pt presents with a high fever, chronic
headache and states they were recently at a resort and spent most of their time in the
hot tub?
Leigonnaires disease
What is pneumonia?
Infection of the pulmonary parenchyma
Risk factors of CAP
- Advanced age
- Smoking
- Alcoholism
- Co-morbid conditions: especially COPD and asthma
- Immunosuppression
Common S/S of CAP
- Cough with or without sputum production
- Fever (may be present in 80%. Can be low or absent, especially in the elderly)
- Tachypnea (most sensitive sign in elderly)
- Tachycardia
- Ill appearing
- Nausea, anorexia, diarrhea
- Rhales, inspiratory crackles or bronchial breath sounds
- Dullness to percussion over areas of consolidation
- Mental status changes
Most common bacterial cause of CAP
What is the typical antibiotic treatment for CAP in adults? pt is healthy and NO Abx use
in 90 days
Amoxicillin or doxycycline
If a patient has persistent pleural collections, what will you do?
Send to ER for possible thoracentesis
If CXR says "cavitary lesions or opacities", what will you do?
ISOLATE and send to ER for TB workup
Abx for CAP in pt >65/use of abx in 90 days/hx of drug resistance, what Abx will you
give?
Macrolide or doxycycline
T/F: Is it uncommon for a cough to last up to 4 weeks after covid/PNA?
F - it is common for a cough to last up to 4 weeks
CURB-65 criteria
Confusion
Urea: BUN >7mmo/L (20mg/dl)
RR >30
BP: systolic <90 or diastolic <60
AgeL >65
How do you score CURB-65 and how is each score treated?
0: outpatient tx is most likely safe
1-2: admit to hospital for care
3-4: URGENT referral. Admit to ICU!
Key indicator of lung abscess
Cough with foul-smelling sputum --> send for CXR
Most common cause of pleural effusion
CHF
,Treatment for OSA
- Weight loss
- Strict avoidance of ETOH
- Avoidance of hypnotic meds
- Nasal CPAP (can be curative for many pts)
- UPPP (uvopalatopharyngoplasty) --> resection of pharyngeal soft tissue which
eliminates snoring
What can cause a falsely elevated d.dimer?
Cancer & pregnancy
Most common cause of a PE?
DVT
Most common ages for those with RSV?
< 5 or
> 65
In a patient who has recently traveled to Southeast Asia/Egypt, what would you be
concerned for?
Avian flu
Stage 1 of Pertussis
Catarrhal
Insidious onset of the following:
- Lacrimation
- Sneezing
- Coryza
- Anorexia
- Malaise
- Hacking in night cough that becomes diurnal (starts at night then occurs during the
daytime)
Stage 2 of Pertussis
Paroxysmal stage
- Bursts of rapid, consecutive coughs followed by deep, high-pitched inspiration (whoop)
, Stage 3 of Pertussis
Convalescence
- Begins at 4 weeks after onset with decrease in frequency and severity of paroxysms of
cough
How long do symptoms of Pertussis last?
6 weeks and has 3 stages
An adult with a cough lasting more than 2 weeks could be indicative of what?
Pertussis
What should you be concerned about if a pt presents with a high fever, chronic
headache and states they were recently at a resort and spent most of their time in the
hot tub?
Leigonnaires disease
What is pneumonia?
Infection of the pulmonary parenchyma
Risk factors of CAP
- Advanced age
- Smoking
- Alcoholism
- Co-morbid conditions: especially COPD and asthma
- Immunosuppression
Common S/S of CAP
- Cough with or without sputum production
- Fever (may be present in 80%. Can be low or absent, especially in the elderly)
- Tachypnea (most sensitive sign in elderly)
- Tachycardia
- Ill appearing
- Nausea, anorexia, diarrhea
- Rhales, inspiratory crackles or bronchial breath sounds
- Dullness to percussion over areas of consolidation
- Mental status changes
Most common bacterial cause of CAP
