Answer 5

5.  Choice D is the correct answer.  Bacterial pneumonias are usually found in the middle and lower lobes.  They are usually lobar.  Upper lobes pneumonia should make the clinician suspicious for tuberculosis.  

Question 5

5.  Which of the following is not a characteristic of bacterial pneumonias?

A.  Usually lobar pneumonias

B.  Usually accompanied by a pleural effusion

C.  Usually have bulging fissures

D.  Usually are in the upper lobes

Answer 4

4.  Choice D is the correct answer.  Influenza pneumonia causes significant morbidity and mortality in children.  It usually presents as more of an interstitial pneumonia.  The most common viral pneumonia in children is RSV.  Ceftriaxone is a third generation cephalosporin and is not effective against influenza.  Tamiflu is the drug of choice in the appropriate age group and if started in the first 48 hours of onset of symptoms.

Question 4

4.   Which of the following is true regarding influenza pneumonia?

1. It presents with as a lobar pneumonia
2. It is the most common cause of viral pneumonia in children
3. Ceftriaxone is the drug of choice
4. It causes significant morbidity and mortality

Answer 3

3.  Choice D is the correct answer.  Staphylococcus on gram stain are cocci that occur in pairs.  Influenza would not grow on gram stain.  Mycoplasma can be confirmed by sputum culture or cold aglutin titer.  Hemophilius is usual in vaccinated individuals.

Question 3

3.  A 34 year old with multiple comorbidities presents with "flu like" symptoms that resolved 48 hours ago.  He has a high fever and cough still.  His chest exam reveals rales and rhonchi throughout. His gram stain reveals large gram positive cocci occurring in pairs.  Which of the following is the most likely diagnosis?

A.  Influenza pneumonia
B.  Mycoplasma Pneumonia
C.  Hemophilius Influenza
D.  Staphylococcal Pneumonia

Answer 2

2.  Choice B is the correct answer.  Pneumococcal pneumonia presents usually in young, health individuals with a lobar pneumonia.  Patients frequently will have chills and shakes.  Tuberculosis presents with hemoptysis, night sweats, weight loss, and cavitary lesions in the upper lobes on chest x-ray.  Pulmonary emboli typically will not have a lobar pneumonia with it.