Add: create pneumonia case question with management options and expla…

…nations

.copilot-instructions.md

@@ -102,5 +102,17 @@ Example balance for 20 questions:
 - D: 3-4 questions
 - E: 3-4 questions
 
+### Correct Answer:
+- State why it's correct
+- Link to relevant guidelines/evidence
+- Explain key clinical reasoning
+
+### Incorrect Answers:
+For each wrong option, explain:
+- Why it's incorrect
+- Common misconception it represents
+- Potential harm if selected
+- Clinical scenarios where it might be considered
+
 ## Tags
-Use standardized tags from tags.md for consistency
+Use standardized tags from tags.md for consistency

questions/pulmonology/infections/pneumoniaCase.md

@@ -0,0 +1,52 @@
+
+---
+id: PULM003
+specialty: pulmonology
+topic: pneumonia
+difficulty: medium
+tags: [respiratory, treatment, clinicalCase]
+created: 2025-01-04
+lastUpdated: 2025-01-04
+---
+
+# Community-Acquired Pneumonia
+
+## Question
+A 55-year-old man presents with a 3-day history of productive cough, fever, and pleuritic chest pain. Physical exam reveals:
+- Temperature: 39°C (102.2°F)
+- RR: 28/min
+- HR: 115/min
+- BP: 110/70 mmHg
+- Crackles over the right lower lung field
+
+Chest X-ray: Right lower lobe consolidation
+WBC: 15,000/µL (15 x 10⁹/L)
+
+Which initial management strategy is most appropriate?
+
+## Options
+| Option | Description                                     |
+|--------|-------------------------------------------------|
+| A)     | Oral azithromycin only                          |
+| B)     | IV ceftriaxone plus azithromycin                |
+| C)     | High-dose IV vancomycin + piperacillin-tazobactam |
+| D)     | Oral amoxicillin-clavulanate + expectorants     |
+| E)     | Inhaled bronchodilators without antibiotics     |
+
+<details>
+<summary>View Answer</summary>
+
+## Correct Answer
+B
+
+## Explanation
+1. Community-acquired pneumonia in a moderately severe presentation often requires combination therapy.  
+2. Ceftriaxone covers typical organisms, azithromycin covers atypicals.  
+3. Higher-level antibiotics (C) are for suspected resistant or hospital-acquired pathogens.  
+4. Outpatient therapy (A, D) inappropriate due to vitals, possible sepsis.  
+5. Inhaled agents alone (E) are insufficient.  
+
+## References
+- IDSA/ATS Guidelines for CAP (2019)
+- NEJM 2020: "Management of Community-Acquired Pneumonia"
+</details>