A 75-year-old man has 3 days of fever, productive cough and dyspnoea and is not fully conscious. T 38.2, RR 28, BP 110/55, HR 110. CXR: left mid and lower zone consolidation. What is the most appropriate management?
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الإجابة: C. Ceftriaxone + azithromycin and admit
CURB-65: confusion (1) + diastolic BP 55 ≤ 60 (1) + age 75 (1) = at least 3 (RR 28 does not score) → admit and treat as severe. Inpatient empiric therapy for typical CAP is ceftriaxone + azithromycin. Oral amoxicillin/doxycycline with discharge is only for score 0–1; cultures alone are not management.
ليش كل خيار صح أو غلط
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A
ليش غلط
Home treatment is only for low-risk CURB-65 (0-1). He is confused, over 65 and has a diastolic BP of 55, so his score is at least 3 and he needs admission.
✓ Pulmonology 🫁.pdf · p. 17 -
B
ليش غلط
Discharge on oral therapy fits only CURB-65 0-1. A score of 3 means admission to the medical ward and managing as severe.
✓ Pulmonology 🫁.pdf · p. 17 -
C
ليش صح
Confusion and age over 65 (plus low diastolic BP) raise CURB-65 enough to need admission; ceftriaxone + azithromycin is the regimen for typical pneumonia.
✓ Pulmonology 🫁.pdf · p. 16 -
D
ليش غلط
Blood and sputum cultures are microbiological studies obtained in all patients with severe CAP, not a management plan on their own. His CURB-65 (impaired consciousness, DBP 55, age 75) is at least 3, and a score of 2 or more means hospitalization is indicated.
✓ Pneumonia (1).pdf · p. 4
- المصدر
- Pulmonology 🫁.pdf · p. 16
Pulmonology 🫁.pdf · p. 17 - المحاضرة
- Pneumonia · Pulmonology · Module B
- ظهر في
- MED41 ♀ EOM B