Clinical management scenarios for pneumonia, COPD exacerbation, and respiratory failure tested on USMLE Step 2 CK.
35 cards · mixed cards · AI-written, checked twice. Edit anything.
- CURB-65 criteria for pneumonia severity assess Confusion, Urea, Respiratory rate, Blood pressure, and ____.
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age 65 or older- What disposition does a CURB-65 score of 2 typically suggest?
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Hospital admission (or closely supervised outpatient management)- What disposition does a CURB-65 score of 0-1 typically suggest?
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Outpatient treatment- What is first-line empiric outpatient antibiotic therapy for a previously healthy adult with CAP and no comorbidities?
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Amoxicillin (or a macrolide/doxycycline where local pneumococcal resistance is low)- What is empiric outpatient antibiotic therapy for CAP in a patient with comorbidities (heart, lung, liver, or renal disease)?
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A beta-lactam plus a macrolide, or a respiratory fluoroquinolone alone- What is empiric antibiotic therapy for a hospitalized non-ICU CAP patient?
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A beta-lactam (e.g., ceftriaxone) plus a macrolide, or a respiratory fluoroquinolone alone- What is empiric antibiotic therapy for an ICU-admitted CAP patient?
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A beta-lactam plus either a macrolide or a respiratory fluoroquinolone, always as combination therapy- Which patient risk factors prompt adding antipseudomonal coverage in CAP treatment?
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Structural lung disease (e.g., bronchiectasis) or prior isolation of Pseudomonas from the respiratory tract- Which patient risk factors prompt adding MRSA coverage (vancomycin or linezolid) in CAP treatment?
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Prior MRSA respiratory isolation or recent hospitalization with IV antibiotics- Name the three classic atypical pneumonia pathogens.
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Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila- Which clinical clues suggest Legionella pneumonia rather than typical CAP?
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GI symptoms (diarrhea), hyponatremia, high fever, and confusion- What is the standard rapid diagnostic test for Legionella pneumonia?
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Urine antigen test- What clinical criteria support switching a CAP patient from IV to oral antibiotics?
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Hemodynamic stability, clinical improvement, ability to tolerate oral intake, and a normally functioning GI tract- What is the minimum recommended duration of antibiotic therapy for uncomplicated CAP?
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5 days, provided the patient has been afebrile for 48 to 72 hours- Hospital-acquired pneumonia (HAP) is defined as pneumonia occurring ____.
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48 hours or more after hospital admission
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