Urgent Care For Pneumonia 4

Question 1

A 55-year-old alcoholic presents with a chest X-ray showing a cavitary lesion in the right upper lobe. Which organism is most likely responsible?

Accepted Answer

Klebsiella pneumoniae

Answer

Klebsiella pneumoniae classically causes cavitary pneumonia in alcoholics, often involving the upper lobes with 'currant jelly' sputum.

Question 2

Which of the following indicates the need for ICU admission in a pneumonia patient per ATS/IDSA major criteria?

Accepted Answer

Requirement for vasopressors or mechanical ventilation

Answer

ATS/IDSA major criteria for ICU admission include need for vasopressors (septic shock) or requirement for mechanical ventilation.

Question 3

A 30-year-old construction worker who worked at an excavation site presents with fever, cough, and mediastinal lymphadenopathy on chest X-ray. Which fungal infection should be suspected?

Accepted Answer

Histoplasma capsulatum

Answer

Histoplasma capsulatum is endemic in the Ohio and Mississippi River valleys and associated with disturbed soil or bird/bat droppings.

Question 4

Which finding on a pleural fluid analysis would indicate an exudative effusion requiring further workup for empyema?

Accepted Answer

pH < 7.20, glucose < 40 mg/dL, LDH > 1000 U/L

Answer

Empyema or complicated parapneumonic effusion is suggested by pH < 7.20, low glucose, and markedly elevated LDH in pleural fluid.

Question 5

An immunocompromised patient with pneumonia has a CT chest showing a nodule with a 'halo sign.' Which organism is most likely?

Accepted Answer

Aspergillus fumigatus

Answer

The halo sign — a nodule surrounded by ground-glass opacity — is the classic CT finding of invasive pulmonary aspergillosis in immunocompromised patients.

Urgent Care Practice Test

Urgent Care Practice Test

Urgent Care For Pneumonia 4