A pneumonia that occurs 48 hours or more after admission to the hospital is considered:

Hospital-acquired pneumonia

Immunocompromised pneumonia

Community-acquired pneumonia

Viral pneumonia

Answer and Explanation

The Correct Answer is A

A. Hospital-acquired pneumonia: Pneumonia that develops 48 hours or more after hospital admission is classified as hospital-acquired pneumonia (HAP). It is caused by pathogens acquired in the hospital setting, often involving multidrug-resistant organisms such as Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), and Klebsiella pneumoniae. Patients who are intubated, have prolonged hospital stays, or have weakened immune defenses are at higher risk.

B. Immunocompromised pneumonia: Pneumonia in immunocompromised patients occurs due to weakened host defenses, such as in individuals with HIV/AIDS, those undergoing chemotherapy, or transplant recipients on immunosuppressive therapy. While these patients can develop HAP, pneumonia due to opportunistic infections like Pneumocystis jirovecii or fungal infections is categorized separately.

C. Community-acquired pneumonia: Pneumonia acquired outside the hospital or within the first 48 hours of admission is classified as community-acquired pneumonia (CAP). Typical pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. CAP is usually less resistant to antibiotics compared to HAP.

D. Viral pneumonia: Pneumonia caused by viral pathogens such as influenza, respiratory syncytial virus (RSV), or SARS-CoV-2 is classified based on the causative agent rather than the setting in which it was acquired. Although viruses can cause both CAP and HAP, the classification of pneumonia is determined by the timing of onset and exposure risks.

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Correct Answer is C

Explanation

A. It does not remain dormant but some host defenses can kill the bacteria: While the immune system can kill some of the Mycobacterium tuberculosis bacilli, in many cases, the bacteria evade complete eradication and persist in a dormant state within the lungs. This does not mean the infection is fully eliminated, as it can reactivate later.

B. Virulence factors in the bacilli weaken over time, leading to apoptosis: Mycobacterium tuberculosis does not naturally lose its virulence over time. Instead, it can persist in a latent state due to immune containment, not because of a reduction in its ability to cause disease.

C. The bacilli can become isolated within tubercles in the lungs, possibly encapsulated: In latent tuberculosis, the immune system walls off the bacilli within granulomas (tubercles), preventing active disease. These granulomas may be encapsulated with fibrous tissue, restricting bacterial growth and spread. The bacteria remain dormant but can reactivate if the immune system weakens.

D. Macrophages attack and phagocytize new areas of infection: While macrophages do play a role in the immune response to tuberculosis, they are often unable to completely eradicate the bacilli. Instead, the bacteria can survive within macrophages and trigger the formation of granulomas, which help contain but not eliminate the infection.

A. A 79 year old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration B. An 88 year old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke C. An 81 year old smoker who has increased exercise intolerance, a fever and increased white blood cells D. An 81 year old male who has a productive cough and recurrent respiratory infections

Correct Answer is A

Explanation

A. A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration: Chronic obstructive pulmonary disease (COPD) is most commonly seen in individuals with a significant smoking history. Progressive shortness of breath is a hallmark symptom of COPD, resulting from chronic airway inflammation and airflow limitation. While pain on deep inspiration is not a classic COPD symptom, it could indicate pleuritic involvement or hyperinflation-related chest discomfort.

B. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke: Acute shortness of breath and airway constriction in response to tobacco smoke suggests an asthma-like reaction rather than COPD. COPD symptoms tend to be persistent and progressive rather than episodic.

C. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells: Fever and increased white blood cells indicate an acute infection rather than chronic lung disease. While COPD exacerbations can cause worsening symptoms, an isolated fever and elevated white blood cells suggest pneumonia or another infectious process rather than COPD alone.

D. An 81-year-old male who has a productive cough and recurrent respiratory infections: A productive cough and recurrent respiratory infections are common in chronic bronchitis, a component of COPD. However, this presentation alone is not specific to COPD, as other conditions, such as bronchiectasis, can also cause these symptoms.

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A pneumonia that occurs 48 hours or more after admission to the hospital is considered:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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