American Board of Internal Medicine (ABIM) Certification Practice Exam

In hospitalized patients with community-acquired pneumonia, what does glucocorticoid use decrease the need for?

1. Mechanical ventilation

2. Intensive care unit admission

3. Antibiotic therapy

4. Supplemental oxygen

The correct answer is: Mechanical ventilation

In the context of hospitalized patients with community-acquired pneumonia, the use of glucocorticoids has been shown to reduce the need for mechanical ventilation. This effect is primarily due to glucocorticoids' anti-inflammatory properties, which help to mitigate the excessive inflammatory response that can occur in pneumonia. By dampening this inflammatory response, glucocorticoids can result in improved oxygenation, reduction of lung inflammation, and overall enhancement of respiratory function, thus potentially decreasing the progression to respiratory failure that might otherwise necessitate mechanical ventilation. While the other options may pertain to aspects of pneumonia management, they do not have the same direct correlation with glucocorticoid therapy as the need for mechanical ventilation. For example, while glucocorticoids may help improve clinical outcomes, they do not necessarily reduce the need for intensive care unit admission or change the requirements for antibiotic therapy, as these are essential components in treating pneumonia. Similarly, although glucocorticoids can assist with pulmonary function, supplemental oxygen usage may still be required based on the patient's existing respiratory status and needs.