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Flashcards in COPD/Pneumonia/Asthma Deck (67)
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1

PNE- Organism- Streptococcus Pneumonia

Most common, rust colored sputum

2

PNE- Organism- H. Influenzae

2nd Most common in smokers and COPD

3

PNE- Organism- Staph Aureus

Rarely in younger adults, mostly older adults, usually after influenza

4

PNE- Organism- Mycoplasma Pneumonia

Walking Pneumonia- usually in younger adults

5

Signs and symptoms of Pneumonia

Sudden, rust color sputum, myalgia, prouctive cough, crackles, egophony, dense shadows on CXR, putrid sputum, Fever >100

6

How often is a causative organism found in PNE?

Rarely

7

What two things are needed to diagnose pneumonia?

1. CXR
2. Clinical findings

8

Evaluation of sputum sample for PNE?

>25% of epithelial cells suggests contamination; correct specimen should show polymorphonuclear leukocytes

9

Differential Diagnosis for PNE?

Bacterial Bronchitis, lung cancer, exposure to moldy hay

10

When does PNE need O2?

PaO2 < 55 or O2 <90%

11

What does CURB 65 measure?

C-confusion
Bun >19
RR >30
BP 65
>65 y.o.

12

CURB 65 recommendations?

1- home treatment
3- severe, hospital treatment

13

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

14

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)

15

PNE Treatment with MRSA?

Linezolid

16

When do you do a follow CXR on patients with PNE?

If they smoke. If it has not cleared, reevaluate ABX and possible cancer

17

Classic chronic bronchitis

Blue bloaters

18

Classic emphysema?

Pink puffers

19

Physical Assessment for COPD?

barrel chest, prominent palpable heart, wheezes, clubbing of nails

20

Differential dx of COPD?

Bronchitis vs emphysema and if it's reversible

21

What is the FEV1/FVC in COPD?

22

GOLD stages of COPD with FEV1 ?

All have FEV/FVC 80%- Mild
2- 50-79%- Moderate
3- 30-49%- Severe
4- <30%- Very Severe

23

Diagnostics in COPD?

ABG, PFTs, not usually CXR; A1 antitrypsin in patients less than 45 y.o.

24

When do you start patients on oxygen for COPD?

PaO2 <55 or Saturation < 88%

25

Lines of Therapy in COPD? There are 4

1. short SABA
2. Anticholinergic Bronchodilators
3. Long acting BA
4. Steroids

26

How often do you check theophylline levels? and Correct levels?

Every 6-12 months.

27

What is a short acting B2 Agonist?

Albuterol

28

What is a long acting B2 Agonist? x2

Formeterol, salmeterol

29

What is an anticholinergic bronchodilator?x2

Ipratropium, tiotropium

30

Examples of inhaled steroids? x3

Beclomethasone, budesonide, fluticasone