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Role 2 > Acute Lower Respiratory Problems > Flashcards

Acute Lower Respiratory Problems Flashcards

1
Q

What types of Bronchitis are there?

A

Allergic, Non-allergic and Asthmatic

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2
Q

Acute Bronchitis s/s and what one thing will NOT be present

A

cough with mucus, chest discomfort, soreness, fever, wheezing, fatigue, SOB, NO PULMONARY CONSOLIDATION

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3
Q

How does asthma effect the airways in bronchitis

A

it can lead to narrowing of the muscles around the airways

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4
Q

Chronic Bronchitis cough that is different than acute bronchitis

A

mucus-producing cough that lasts longer that 3 months and for more than 2 years

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5
Q

What if chronic bronchitis occurs with emphysema, what does it become then?

A

COPD

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6
Q

rales is usually heard with what condition?

A

pneumonia

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7
Q

what diagnostic workup do you want to do for bronchitis?

A

CBC (look for leukocytosis), Sputum culture (if xray normal), influenza titer, chest xray, urine antigen test (can diagnose two types of pna)

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8
Q

which two types of pneumonia can a urine antigen test find?

A

Streptococcus pneumoniae and legionella pneumophila

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9
Q

What kind of medication can you give for bronchitis?

A

Antitussives, decongestants, antivirals (only within 24-48 hours of onset), Steroids

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10
Q

Which over the counter medications should you avoid with bronchitis and why>

A

Antihistamines because they dry out secretions

cough suppressants- only take at night if needed

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11
Q

which types of antibiotics should not be given to pregnant people

A

Tetracyclines and quinolones

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12
Q

Treatable cause of bronchitis

A

Pertussis

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13
Q

which antibiotics are top choice for pertussis?

A

Clarithomycin (Biaxin) 500mg q12 hr or Azithromycin (Zithromax)

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14
Q

which antibiotic can you use for Moraxella, chlamydia or mycoplasma infection is suspected?

A

Doxycycline 100mg/day for 10 days

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15
Q

which type of antibiotic are good for the elderly with pertussis?

A

Quinolones

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16
Q

Bordetella Pertussis 3 phases

A

URI with rhinorrhea, mild grade fever and congestion lasting 1-2 weeks. sudden nonproductive coughing lasts 2-4 weeks with 10-30 coughs in a row

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17
Q

CURB-65 score range

A

0-5 (5 bad)

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18
Q

which factors does the CURB-65 take into consideration?

A 
confusion
BUN>19
RR>30
SBP <90 or DBP <60
Age >65
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19
Q

what is the most consistent presenting symptom of bacterial pna and may suggest a particular pathogen?

A

cough

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20
Q

gold standard for diagnosing pna

A

chest xray

21
Q

Level 1 evidence for treatment of pna

A

Macrolide or fluoroquinolone

22
Q

what does necrotizing/cavitary pna raise suspicion for?

A

MRSA pna especially if they have a history of MRSA lesions

23
Q

when should you offer antibiotic therapy for a c-reative protein level?

A

if its >100mg litre

24
Q

if c reative protein level is 20-100 mg litre what should you do?

A

consider delayed antibiotic prescription (a prescription for use at a later date if symptoms worsen)

25
Q

Procalcitonin

A

can help tell if antibiotic therapy is working. More sensitive than a c-reactive protein

26
Q

mycoplasma pna is also called?

A

walking pna

27
Q

streptococcus pneumonia colored sputum

A

rust-colored

28
Q

Pseudomonas, Haemphilus and peumococcal species colored sputum

A

green

29
Q

Klebsiella species colored sputum

A

red currant-jelly

30
Q

Anaerobic infections sputum characteristics

A

foul-smelling, bad tasting sputum

31
Q

Most common cause of community acquired pna?

A

Streptococcus pneumonia

32
Q

Staphylococcus Aureus characteristics

A

follows a viral respiratory infection (flu), patient usually extremely ill, can cause lung abscesses so send to hospital

33
Q

Group A Streptococci characteristics

A

occurs in closed groups (military), begins abruptly with fever, cough, chest pain and debility

34
Q

Klebsiella Pneumoniae characteristics

A

found in debilitated patients like alcoholics, gram negative pna

35
Q

Haemohilus influenzae is seen with which type of people

A

smokers, even tho its a form of flu it is still a bacteria

36
Q

Do mycoplasma pneumoniae and chlamidophila pneumoniae require hospital admission?

A

no, they are a form of CAP but don’t usually need to hospitalize them

37
Q

Atypical CAP is usually caused by which bacteria?

A

Staphylococcus aureus

38
Q

If patient has resistance to antibiotics what antibiotic should you put them on?

A

Doxycycline

39
Q

If patient has comorbidities (chronic heart, lung, liver or renal disease, diabetes, alcoholism, malignancies, asplenia, immunosuppression) then what antibiotics should you use for pna?

A

fluoroquinolone OR

beta-lactam (amoxicillin, augmentin) PLUS a macrolide

40
Q

How many days should a patient be treated minimally for pna?

A

5 days

41
Q

How long after starting antibiotics should you start to feel better with pna?

A

3-5 days

42
Q

when do you do a repeat chest xray with pna?

A

4-6 weeks

43
Q

How long do you reevaluate a patient who is not responding to therapy?

A

48-72 hours

44
Q

Aspiration pna is usually found on what side?

A

right side

45
Q

Bronchiolitis is usually affects which type of patients?

A

newborn-2 years old

46
Q

How to treat Bronchiolitis?

A

supportive care unless extreme then send to ER

47
Q

what extreme symptoms are needed to be present for you to send child with Bronchiolitis to ER?

A

Toxic appearance, Hypoxic (<94%), RR >45 with distress and apnea, underlying heart conditions

48
Q

Constrictive Bronchiolitis usually effects which type of patients?

A

Iraq and Afghan vets

49
Q

Constrictive Bronchiolitis is characterized by?

A

progressive, absence of parenchyma infiltrates on chest xray, mosaic appearance of perfusion on CT scan, poor response to therapy

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