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Community Acquired Pneumonia Exam Questions And Answers Graded A+ Definition of pneumonia Acute parenchymal infection associated wtih: -2+ symptoms of acute infection (fever, cough, dyspnea) -Presence of acute infiltration on CXR or auscultatory findings consistent with pneumonia (adventitious ...

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  • April 29, 2024
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  • 2023/2024
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Community Acquired Pneumonia Exam
Questions And Answers Graded A+
Definition of pneumonia
Acute parenchymal infection associated wtih:
-2+ symptoms of acute infection (fever, cough, dyspnea)
-Presence of acute infiltration on CXR or auscultatory findings consistent with pneumonia
(adventitious breath sounds)


Categories of pneumonia
Community acquired pneumonia: infection that begins outside the hospital or is diagnosed within 48
hours after admission

Hospital acquired pneumonia: Pneumonia that occurs 48+ hours after admission, which was not
incubating at time of admission

Ventilator associated pneumonia: Pneumonia that arises >48-72 hours after endotracheal intubation



Epidemiology of community acquired pneumonia
-#1 cause of death by infectious disease, 8th leading cause overall
-Incidence and mortality greatest in <5yrs, and >65yrs


Pathogenesis of community acquired pneumonia
-Bacterial are deposited in terminal bronchioles/alveolar spaces by aspiration or inhalation
-Infection leads to alveolitis with subsequent accumulation of exudates in alveoli --> spreads to
interstitum and possibly pleura


Typical pneumonias
Acquired via aspiration from a previously colonized oropharynx (ex: breath in the air of another's
cough --> aspirate it at night --> pneumonia)

Pathogens:

-Streptococcus pneumoniae

-Haemophilus influeznae

-Moraxella catarrhalis

*Typically gram stain, present like pneumonia, and will see consolidation of CXR



Atypical pneumonias
Acquired by inhalation of bacterial laden aerosols (air is breathed in and does not stop at upper
airway)

Pathogens:

-Legionella pneumophilia

-Mycoplasma pneumoniae

, -Chlamydophilia pneumoniae

-Most viurses: influenza, RSV, parainfluenza, RSV

*Won't gram stain, don't present typically, and don't consolidate on CXR



What does severity of pneumonia depend on?
-Amount of material aspirated/inhaled
-Quantity of bacteria in aspirate/inhalation
-Virulence of organism
-Integrity of host defenses: cough reflex, mucociliary mechanism, phagocytic cells, immune response


Most common causative pathogen of pneumonia
-Historically: strep pneumoniae was most common in all age groups (other than newborns and AIDS
pts)
-Human rhinovirus may be a main player
-Mixed etiologies are common --> bacterial plus viral

*NOTE: etiology is only documented 50% of the time


Which organisms are ALWAYS pathogenic (not colonizers) when isolated from the lower respiratory
tract?
-Legionella
-Mycoplasma
-M. tuberculosis
-Influenza
-RSV
-P. jiroveci
-Histoplasma capsulatum
-Coccidioides immitis
-Blastomyces dermatitidis


Clinical presentation of pneumonia
Symptoms:

-Cough +/- sputum production (>90%)

-Dyspnea (65%)

-Pleuritis chest pain (50%)

-Fever or hypothermia, chills/rigors sweats

-Non-specific symptoms: fatigue, myalgias, abdominal pain, anorexia, headache

Signs:

-Bronchial breath sounds

-Dullness to percussion

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