Community-Acquired Pneumonia Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Community-Acquired Pneumonia flashcards as text
A 72-year-old with COPD develops CAP. Which outpatient antibiotic regimen is recommended by IDSA guidelines?
Answer: Respiratory fluoroquinolone OR beta-lactam + macrolide
Patients with comorbidities (COPD, DM, heart failure, etc.) should receive a respiratory fluoroquinolone or beta-lactam/macrolide combination to cover resistant organisms.
Which criterion defines 'severe CAP' requiring ICU admission per IDSA/ATS major criteria?
Answer: Need for mechanical ventilation OR septic shock requiring vasopressors
IDSA/ATS major criteria for severe CAP are: need for invasive mechanical ventilation OR septic shock requiring vasopressors.
Procalcitonin (PCT) is most useful in CAP management for which purpose?
Answer: Guiding antibiotic duration and de-escalation
Serial PCT measurements guide antibiotic duration — declining PCT levels support stopping antibiotics, reducing unnecessary therapy.
A healthy 30-year-old college student develops low-grade fever, dry cough, and diffuse bilateral interstitial infiltrates over 2 weeks. Which pathogen is most likely?
Answer: Mycoplasma pneumoniae
M. pneumoniae causes 'walking pneumonia' in young adults — insidious onset, dry cough, mild symptoms, and interstitial infiltrates out of proportion to clinical severity.
Which vaccine has the greatest impact on reducing CAP incidence in adults over 65?
Answer: PCV15 or PCV20 (pneumococcal conjugate vaccine)
Higher-valency pneumococcal conjugate vaccines (PCV15, PCV20) are now preferred over PPSV23 alone for adults ≥65, providing superior immunogenicity and protection.
A 58-year-old with CAP is switched from IV to oral antibiotics. Which criteria must be met before this transition?
Answer: Clinical stability: improving symptoms, HR <100, RR <24, O2 sat ≥90%, tolerating oral intake
IV-to-oral switch is guided by clinical stability criteria — hemodynamic improvement, reduced fever, normal mentation, and ability to take oral medications.
Which organism causing CAP is classically associated with 'currant jelly' sputum and upper lobe cavitation in alcoholic patients?
Answer: Klebsiella pneumoniae
Klebsiella pneumoniae causes a severe necrotizing pneumonia in alcoholics with characteristic bloody mucoid ('currant jelly') sputum and upper lobe cavitation.