CAP Pre Reading

What are the 3 types of pnuemonia

community, hospital, ventilator

Presentation of pneuonia:

abrupt onset of ____

______ cough

pleuritic _______

SOB

tachy____ and _____

fever, productive, chest pain, cardia, pnea

What 3 things are used to diagnosed pneumonia outpatient

signs, symptoms, chest x ray

What 5 things can be used to diagnose pneumonia inpatient

signs, symptoms, chest x ray, blood cultures, sputum cultures

Level if care is determined by ____ or ___

PSI, CURB-65

Severe CAP: -___ major criteria or ___ minor criteria

1, 3

Major criteria:

• ____________ with vasopressors

• respiratory failure needing _______

septic shock, ventilation

Minor criteria:'

• RR >___

• PaO2/FlO2 < ____

• _______ infiltrates

• confusion

• uremia >____

• leukopenia <____

• thrombocytopenia <____

• hypothermia <____

• _______ requiring aggressive fluid resuscitation

30, 250, multilobar, 20, 4000, 100k, 36C, hypotension

Most common bacteria (7)

1. S. pneumoniae

2. H. influenza

3. M. catarrhalis

4. M. pneumoniae

5. C. pneumoniae

6. Legionella species

7. S. aureus

Outpatient treatment - no comorbidities, no risk factors for S. aureus or Pseudomonas

amoxicillin or doxycycline or macrolide (if local resistant is <25%)

outpatient treatment with comorbidities

1. beta lactam + macrolide OR doxycycline

2. levo- or moxi- or gemi- floxacin

What are the 6 comorbidities highlighted in the reading

diabetes, alcoholism, maligancy, asplenia, heart/lung/renal disease, immunosuppresion

Non-severe inpatient treatment

1. Beta-lactam + macrolide

2. antipneumococcic fluoroquinolone (levo- or cipro)

Severe inpatient treatment

1. beta lactam and macrolide

2. beta-lactam and antipneumococcal fluoroquinolone

Under which 2 scenarios should you considered covering for MRSA or P. aeruginosa

1. isolation within 1 year

2. recent hospitalization and exposure to IV antibiotics within 90 days

What is the duration of pneumonia antibiotic treatments

no less than a total of 5 days