Respiratory medicine: ventilator-associated pneumonia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: ventilator-associated pneumonia

Sample item

A patient on a ventilator for 6 days develops fever, purulent tracheal secretions and a new infiltrate. Which empirical approach is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Broad-spectrum antibiotics covering Pseudomonas and MRSA risk based on local antibiogram

Onset after 48 hours of intubation defines ventilator-associated pneumonia, usually from Gram-negative bacilli and Staphylococcus aureus. Empirical therapy should be broad and guided by local resistance patterns, then de-escalated after cultures. Delay in effective therapy raises mortality.

Option by option

  • A. Oral amoxicillin alone

    Oral amoxicillin is inadequate for VAP.

  • B. Azithromycin alone

    Azithromycin alone does not cover typical VAP pathogens.

  • C. Broad-spectrum antibiotics covering Pseudomonas and MRSA risk based on local antibiogram (correct)

    Correct. Cover resistant Gram-negatives and MRSA according to local data.

  • D. Observation without antibiotics

    Withholding antibiotics increases mortality.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Broad-spectrum antibiotics covering Pseudomonas and MRSA risk based on local antibiogram. Onset after 48 hours of intubation defines ventilator-associated pneumonia, usually from Gram-negative bacilli and Staphylococcus aureus.

Why is "Oral amoxicillin alone" not the answer?

Oral amoxicillin is inadequate for VAP.

Why is "Azithromycin alone" not the answer?

Azithromycin alone does not cover typical VAP pathogens.

Why is "Observation without antibiotics" not the answer?

Withholding antibiotics increases mortality.

What concept does this question test?

It tests Respiratory medicine: ventilator-associated pneumonia in General Medicine. Empirical therapy should be broad and guided by local resistance patterns, then de-escalated after cultures. Delay in effective therapy raises mortality.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: ventilator-associated pneumonia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.