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Chapter 71. Lower Respiratory Tract Infections

Student Questions

Which of the following statements regarding the epidemiology of community-acquired pneumonia is correct?

A. Streptococcus pneumoniae and Mycoplasma pneumoniae are the most prevalent pathogens

B. Influenza virus is a common pathogen in adults who smoke tobacco

C. Necrotizing CAP which is common in children is caused by CA-MRSA and associated with a high (42%) mortality rate

D. Mixed infections with bacteria and viruses are an uncommon cause of CAP in adults, incidence less than 5%

Answer: A

Option A: Correct.A. Streptococcus pneumoniae and Mycoplasma pneumoniae are the most prevalent pathogens

Option B: Incorrect. It is Haemophilus influenza not influenza virus.

Option C: Incorrect. Necrotizing CAP is not common.

Option D: Incorrect. Mixed bacterial and viral pneumonia is fairly common up to about 40%.

CD is a 66-year-old woman admitted to the hospital for respiratory failure. Upon admission she was intubated. She was improving and on day 6 was starting to be weaned off the ventilator; however, her respiratory symptoms were worsening and full ventilator settings were required. She was diagnosed with ventilator-associated pneumonia. Which of the following organisms are most likely associated with her pneumonia?

A. S. pneumoniae, H. influenzae, MRSA, and MSSA

B. H. influenzae, enteric GNB, anaerobes, and MSSA

C. Pseudomonas aeruginosa, Acinetobacter spp., and MRSA

D. P. aeruginosa, Acinetobacter spp., anaerobes, and S. pneumoniae

Answer: C

Option A: Incorrect. S. pneumoniae and H. influenzae are not ventilator pathogens, they are community pathogens

Option B: Incorrect. H. influenzae is a community pathogen, anaerobes are pathogens with aspiration pneumonia.

Option C: Correct. Pseudomonas aeruginosa, Acinetobacter spp., and MRSA are most likely associated with her pneumonia.

Option D: Incorrect. S. pneumoniae is a community pathogen, anaerobes are pathogens with aspiration pneumonia.

PF is a 59-year-old woman who smokes two packs of cigarettes per day. Which of the following host defenses that protect the lung are known to be impaired by the smoke?

A. Decrease mucous production

B. Decrease alveolar macrophages

C. Increase immunoglobulin (IgA, IgG, and IgM) production and inflammation

D. Decrease cilia movement

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