Chapter 60 – Pneumonia (QE) Sample Questions
1. Florence, a 72-year-old patient with COPD was admitted to the hospital due to symptoms of productive cough with tinge of blood, shortness of breath, chest pain, fever (39°C), chills, muscle and joint pain, headache, and confusion. Guided by SMART-CO tool, doctor further investigated coming up with results as follows: BP: 85/70, RR: 35 breaths/min, HR: 130 bpm and SaO2: 88%cute pneumonia. PSI score >91. She is allergic to penicillin. She is on the following medications: Aminophylline infusion by IV drip at a rate of 40mg/h, Ceftazidime 1g IVPB q8h, Gentamicin 100 mg IVPB q12h and Albuterol 5% nebulizer solution q4h prn. The culture and sensitivity report for the sputum specimen indicates the following minimum inhibitory concentration (MICs):
Ceftazidime ≤ 8 ug/ml
Mezlocillin ≤ 8 ug/ml
Gentamicin = 4 ug/ml
Tobramycin ≤ 0.5 ug/ml
Ciprofloxacin = 8 ug/ml
Based on these results, a rational therapeutic decision would be to:
- A. Continue existing regimens without change.
- B. Continue Ceftazidime only.
- C. Continue Gentamicin; change Ceftazidime to Mezlocillin.
- D. Change Gentamicin to Tobramycin; continue Ceftazidime.
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