A 78-year-old heavy smoker man has fever, headache, muscle aches, cough and diarrhea for 1 week. He has tried amoxicillin for 4 days but has not improved, his temp 37.8C, HR 110/min, BP 125/80mmHg, RR 19/min and oxygen saturation on room air 91%. His chest auscultation reveals right basal crepitation. He has WBC 12000, sodium 130 mg/dl, potassium 3.6 mg/dl, urea 53 mg/dl, and creatinine 1.2mg/dl. His CXR shows right lower lobe infiltrate. Which of the following is the most likely causative organism of the patient's condition?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. legionella pneumonia
Pneumonia that fails amoxicillin, with diarrhoea, hyponatraemia, headache and myalgia in an elderly smoker, points to Legionella. Atypical organisms do not respond to beta-lactams, and Legionella is linked to GI symptoms and hyponatraemia. S. pneumoniae would usually respond to amoxicillin. (The bank note mentions Mycoplasma, but its key C, Legionella, is correct.)
ليش كل خيار صح أو غلط
-
C
ليش صح
Atypical bacteria do not respond to beta-lactams such as amoxicillin, and Legionella is associated with hyponatremia and GI symptoms, as in this smoker with diarrhea and Na 130.
✓ Pulmonology 🫁.pdf · p. 15 -
D
ليش غلط
S. pneumoniae causes typical pneumonia with sudden onset; a slow illness with extrapulmonary symptoms that fails amoxicillin fits an atypical organism instead.
✓ Pulmonology 🫁.pdf · p. 15
- المصدر
- Pulmonology 🫁.pdf · p. 15
Step Up To Medicine 6th Edition 2024 (Pneumonia).pdf · p. 6 - المحاضرة
- Pneumonia · Pulmonology · Module B
- ظهر في
- Respi bank