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Clin Med II > Pneumonnia > Flashcards

Pneumonnia Flashcards

1
Q

what should you do if you have a high clinical suspicion but CXR is negative?

A

get serial xrays, the disease may blossom

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2
Q

what do you do if the CXR shows what looks like pneumonia but the clinical picture doesn’t fit?

A

think of something else

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3
Q

what are classic presentation of legionella pneumonia?

A

GI sxs

hyponatremia

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4
Q

what is drug of choice for legionnella?

A

azithromycin

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5
Q

what are drugs that get good atypical coverage?

A

macrolides
doxycyline
fluorquinolones

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6
Q

what is proper dosing of levaquin for pneumonia?

A

750mg IV

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7
Q

what do you do with pleural fluid with a pneumonia?

A

tap it if there is enough (antibiotics won’t be enough)

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8
Q

what do you do with pts with pneumonia in flu season?

A

flu swab and if you still think they have it do a PCR

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9
Q

what are DOC in outpatient previously healthy pt with pneumonia?

A

macrolide

tetracycline

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10
Q

what are DOC in outpatient with comorbid dz with pneumonia?

A 
levaquin, moxiflox, 
combo therapy (aug + azithromycin)
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11
Q

what are DOC in inpatient non ICU pneumonia?

A

levaquin, moxiflox,
ceftaroline OR
combo (rocephin PLUS azithro)

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12
Q

what are DOC in inpatient, ICU pneumonia?

A

zosyn 4.5 PLUS cipro PLUS vanc

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13
Q

what type of pneumonia hits hard and very abrupt?

A

strep pneumonia

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14
Q

what is the criteria for sepsis?

A

10% bands on WBC count

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15
Q

how can you evaluate for a pleural effusion?

A

US or CT without contrast

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16
Q

how long might a pneumonia take to get better radiographically?

A

2-4 weeks

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17
Q

always, always follow pneumonia until it does what?

A

clears up radiographically

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18
Q

what is the definition of an MDR pathogen?

A

bug with resistance to 2 or more of the abx typically used to treat it (esp important in regards to Gram negative bacilli)

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19
Q

what is the leading cause of death of nosocomial infections?

A

hospital acquired pneumonia

20
Q

what are common HAP bugs?

A 
klebsiella
e. coli
pseudomonas
acinetobacter
enterobacter

MRSA

21
Q

what are clinical signs of HAP?

A 
fever
purulent sputum
decline in oxygenation
leukocytosis
new infiltrate on CXR
22
Q

what is zosyn?

A

pipercillin and BL inhibitor

23
Q

people die because of what?

A

they don’t get abx quickly enough or the right kind

24
Q

what should you do when you go to a new job/hospital?

A

learn your bugs so you can tailor abx choices based on where you are

25
Q

what is the trough that you want for vanc?

A

15-20

26
Q

what are good/bads with linezolid for MRSA?

A

expensive, easier to dose, GI issues

27
Q

what are good/bad with vancomycin for MRSA?

A

nephrotoxic, harder to dose, cheaper

28
Q

what is the timing goal for abx therapy?

A

direct approach at 72hrs

29
Q

what time frame determines a chronic lung absess?

A

> 1month

30
Q

what is a common cause of a lung abscess?

A

aspiration

31
Q

what defines a primary abscess?

A

healthy host

32
Q

what defines a secondary abscess?

A

immunocompromised

33
Q

what are most bugs that cause lung abscess?

A

anaerobes from the mouth

34
Q

what is Lemierre’s syndrome?

A

thrombophlebitis of the IJ
can cause lung abscess
fusobacterium

35
Q

what are classic sxs of lung abscess?

A

cough, fever, wt loss, purulent sputum, bad taste in mouth, poor dentition

36
Q

what bug is a/w DM and lung abscess?

A

klebsiella

37
Q

nocardia

A

bactrim

38
Q

actinomyces

A

penicillin

39
Q

think about these bugs in PING and lung abscess?

A

mycobacterium
nocardia
aspergillus
rhodococcus

40
Q

where is TB usually located in the lungs?

A

upper lobes with associated parenchymal involvement

41
Q

what type of carcinoma of the lung cavitates?

A

squamous cell

42
Q

what causes multifocal lesions, recurrent sinusitis, renal failure, and hematuria?

A

wegner’s granulomatous

43
Q

txment of lung abscess with no MDR risks

A

unasyn and clinda

44
Q

txment of lung abscess with no MDR risks and PCN allergy

A

fluorquinolones

45
Q

once off IV abx continue treatment with

A

augmentin

PCN fluor + clinda

46
Q

how long do you treat with abx?

A

6-8 weeks with serial images to ensure resolution

47
Q

what is the last, last choice with lung abscess?

A

no abx choices and can not tolerate surgery

Clin Med II (23 decks)

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