Flashcards in COPD/Pneumonia/Asthma Deck (67)
PNE- Organism- Streptococcus Pneumonia
Most common, rust colored sputum
PNE- Organism- H. Influenzae
2nd Most common in smokers and COPD
PNE- Organism- Staph Aureus
Rarely in younger adults, mostly older adults, usually after influenza
PNE- Organism- Mycoplasma Pneumonia
Walking Pneumonia- usually in younger adults
Signs and symptoms of Pneumonia
Sudden, rust color sputum, myalgia, prouctive cough, crackles, egophony, dense shadows on CXR, putrid sputum, Fever >100
How often is a causative organism found in PNE?
What two things are needed to diagnose pneumonia?
2. Clinical findings
Evaluation of sputum sample for PNE?
>25% of epithelial cells suggests contamination; correct specimen should show polymorphonuclear leukocytes
Differential Diagnosis for PNE?
Bacterial Bronchitis, lung cancer, exposure to moldy hay
When does PNE need O2?
PaO2 < 55 or O2 <90%
What does CURB 65 measure?
CURB 65 recommendations?
1- home treatment
3- severe, hospital treatment
Treatment for uncomplicated PNE? with no recent use or comorbidities
Macrolid or doxycycline
1. Azyithromycin 500 mg QD x 3 days
2. Doxycycline 100 mg BID x 7 days
Treatment for PNE with recent ABX in last three months? or Comorbidities
1. Levofloxacin 750 mg x 7 days;
2. Azithromycin 500 + amoxicillin 750 mg 93-4 g/day)
PNE Treatment with MRSA?
When do you do a follow CXR on patients with PNE?
If they smoke. If it has not cleared, reevaluate ABX and possible cancer
Classic chronic bronchitis
Physical Assessment for COPD?
barrel chest, prominent palpable heart, wheezes, clubbing of nails
Differential dx of COPD?
Bronchitis vs emphysema and if it's reversible
What is the FEV1/FVC in COPD?
GOLD stages of COPD with FEV1 ?
All have FEV/FVC 80%- Mild
2- 50-79%- Moderate
3- 30-49%- Severe
4- <30%- Very Severe
Diagnostics in COPD?
ABG, PFTs, not usually CXR; A1 antitrypsin in patients less than 45 y.o.
When do you start patients on oxygen for COPD?
PaO2 <55 or Saturation < 88%
Lines of Therapy in COPD? There are 4
1. short SABA
2. Anticholinergic Bronchodilators
3. Long acting BA
How often do you check theophylline levels? and Correct levels?
Every 6-12 months.
What is a short acting B2 Agonist?
What is a long acting B2 Agonist? x2
What is an anticholinergic bronchodilator?x2