Commonly Used Resp Abx Flashcards Preview

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Flashcards in Commonly Used Resp Abx Deck (19):
1

atypical pneumo

mycoplasma pneumoniae

chlamydia pnuemoniae

chlamydia tachomatis (newborns)

Legionella penumophila

2

PCN resistant and drug resistant pneumococci risk factors

>65

Beta lactam in last 3 months

alcoholism

immunosuppresed

comorbiditieis

exposure to child at daycare

3

nursing home

cardiopulmonary disease

multiple medical comorbidities

recent ABx therapy

infection most likely

enteric gram negatives

4

bronchiectasis

steroids > 10mg/d

BSA >7d in past month

malnutrition 

infection most likely

P aeruginosa

5

CAP in outpatient without modifying risk factors or cardiopul disease 
infection most likely

S pneuo

Mycoplama pneumo

H influenza

virus

Legionell,

mycoplasma TB

endemic fungi

6

Outpation CAP with modifying risk factors or cardiopulmonary disease
add in ___ for ddx

DRSP

enteric gram negatives

moraxella catarrhalis 

aspiration

7

outpatient without modifying risk factors or cardiopulmonary disease CAP

treat with

Advanced generation macrolide or doxycycline

8

outpatient CAP with modifying risk factors or cardiopulmonary disease

treat with

Oral beta-lactam plus macrolide or doxycycline

OR

antipneumococcal flouroquinolone

9

CURB criteria for CAP

Confusion

Urea (>19.1mg/dL)

Resp Rate >30/min

BP <90 Systolic or <60mm diastolic

Age >65

10

in CAP, if first dose of Abx is given ___ after presentation, mortalitiy decreased

<8hours

11

diagnositc evaluations for CAP

CXR

2 sets of pre-treatment cultures

Sputum gram stain with culutre if productive cough

12

Hospitalized nonICU CAP with and without risk factors

treat with

IV macrolid (or Beta lactam plus doxy)

or Antipneumococcal flouroquinolone

 

IV beta lactam plus macrolid or doxy

or antipneumococcal flouroquinolone

13

ICU patient with and without pseudomonas risk factors

treat with

 

IV Beta-lactam (cefotaxime, ceftriaxone) AND IV macrolide

Antipnuemococcal Flouroquinolone

UVa - if MRSA gram stain pos > IV VANCO

With risk factors

IV beta-lactam AND flouroquinolone (both with antipseudomonal)

IV beta lactam with antipseudomonal AND aminoglycoside AND IV atypical 

14

signs of resolved CAP in uncomplicated patients after 72 hours

Fever resolves 2-4d after Abx

WBC resolves by 4 days after ABx

PEx findings can persist 7d in 20-40%

Opacities 75% cleared on CXR in 6 weeks

15

move pt to oral therapy in CAP if

improvement of fever

improvement in cough and resp distress

improvement in leukocytosis

normal GI tract

16

Lights criteria for transudate vs eduate

PF-LDH > 2/3 of upper serum normal limit

PF/S-LDH?0.6

PF/S-Protein > 0.5

(Any ONE of three)

17

interstitial causes of dypsnea

Sarcoidosis
Hypersensitivity pneumonitis
idiopathic pulmonary fibrosis
tuberculosis and tumor
Fungi
Absestosis
collagen vascular disease
eosinophilic granuloma
drug induced lung disease

18

differential alveolar disease dypsnea

Pus - infectious pneumonia
Cells - eosinophils, blood, tumor

Proteins - pulmonary alveolar proteinosis
Inflammatory process - AIP, BOOP
Edema 

19