Urgent Care For Pneumonia 3

Question 1

A 60-year-old diabetic returns from a Caribbean cruise with fever, diarrhea, and a chest X-ray showing a patchy right lower lobe infiltrate. Which organism should be highest on the differential?

Accepted Answer

Legionella pneumophila

Answer

Legionella pneumophila is associated with water-cooling systems on cruise ships and presents with GI symptoms alongside pneumonia.

Question 2

Which diagnostic test has the highest sensitivity for diagnosing Legionella pneumonia in the urgent care or ED setting?

Accepted Answer

Urinary antigen test

Answer

The Legionella urinary antigen test is rapid, highly sensitive for serogroup 1 (the most common), and the preferred initial test.

Question 3

In a pediatric patient with 'walking pneumonia,' which organism is most commonly responsible?

Accepted Answer

Mycoplasma pneumoniae

Answer

Mycoplasma pneumoniae is the classic cause of atypical or 'walking' pneumonia, particularly in school-age children and young adults.

Question 4

Which of the following is the most appropriate empiric antibiotic regimen for a hospitalized non-ICU patient with CAP?

Accepted Answer

Beta-lactam + macrolide, or respiratory fluoroquinolone alone

Answer

IDSA/ATS guidelines recommend a beta-lactam plus macrolide combination or a respiratory fluoroquinolone alone for non-ICU hospitalized CAP.

Question 5

Which CURB-65 score indicates the patient should be considered for hospitalization?

Accepted Answer

Score of 2 or more

Answer

A CURB-65 score of 2 or higher indicates increased mortality risk and should prompt consideration for hospitalization.

Urgent Care Practice Test

Urgent Care Practice Test

Urgent Care For Pneumonia 3