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Kaplan Qbank USMLE



Author8 Posts
  #1

Which of the following is more frequently associated with Klebsiella
pneumoniae than with Pseudomonas aeruginosa?
A. Artificial ventilation
B. Cystic fibrosis
C. Diabetes mellitus
D. Green-colored sputum
E. Upper lobe cavitation


  #2

C

  #3

agree

Klebsiella often see in Alcoholics, Diabetics, and those with chronic pulmonary disease.


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The Key to Succeed is Patience.

  #4

e

  #5

Here is Upper lobe cavitation skyhigh. I'm not sure about the answer but Goljan explains about aspiration pneumonia that:

Posterobasal segment of right lower lobe: when standing or sitting

Superior segment of lower lobe: when supine lying

Middle lobe and posterior segment of upper lobe: rarely and when lying on the right side




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The Key to Succeed is Patience.

  #6

ans is E.....

  #7

shocked

A classic clinical and radiographic picture of Klebsiella pneumonia has emerged in the literature. Patients are typically male, older than 48 years, and have a history of chronic alcoholism. The majority of these pneumonias are community acquired. Bulging interlobar fissures and cavitation are radiographic findings said to be distinctive for Klebsiella pneumonia. We prospectively studied 15 cases of bacteremically proven Klebsiella pneumonia and found clinical and radiographic features strikingly different from those described in the literature. Immunosuppression (from corticosteroids, cytotoxic chemotherapy, neutropenia, hematologic malignancy, and transplantation) now rivals alcoholism as the primary risk factor. Cases tended to be nosocomial rather than community acquired. Neither bulging interlobar fissure nor cavitation was seen in any case. The right upper lobe was involved in 11 of our 15 cases.

  #8

E cavitation is seen more in klebsella.

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