Cough w fever and dyspnea

Question 1

What is the common treatment for pneumonia (CAP)

Answer 1

• Ceftriaxone and Azithromycin

Question 2

What bacteria commonly effects COPD pts to cause CAP

Answer 2

M. Catarrhalis
Tx with Ceftriaxone and azithro

Question 3

Tx for Staph aureus following flu infection

Answer 3

Oxacillin or Vanco if MRSA

Question 4

Which bacteria is seen in CF patients

Answer 4

Pseudomonas
- Tx with cefipime or levofloxacin

Question 5

Which bacteria causes CAP in alcoholics, diabetics?
Sputum character?
Tx?

Answer 5

Klebsiella
- Sputum is jelly blood
Tx with Cephalosporin

Question 6

Tx of anarobe pneumonia and cause of it

Answer 6

• Alcoholics, aspiration, drug overdose, cardiac arrest
• In dependent lung lobes, abscesses. Tx with clinda or flagyl

Question 7

Tx for mycoplasma pneumonia

Answer 7

Doxy, Azithro, Levo

Question 8

Atypical pneumonia seen in alcoholics, transplants, COPD, diabetics

Answer 8

Legionella
Water exposure (air conditioner)

Hyponatremia, CNS changes, LDH >700, Diarrhea.
Tx with Doxy, azithro

Question 9

Which atypical pneumonia causes CNS changes, hyponatremia, LDH >700?

Answer 9

Legionella

Question 10

Pneumocystis jirovecii pneumonia sx and tx

Answer 10

• Dry cough, SOB
• Bilateral infiltrates, sputum with SILVER stain, elevated LDH.
  <200 CD4 get bactrim prophy for aids pts

Question 11

Which pna has silver sputum stain

Answer 11

pneumocystis jirovecii

Question 12

Coccidioides pneumonia

Answer 12

San Joaquin valley fever, southwestern USA. Budding yeast

Question 13

Histoplasmosa pna

Answer 13

oHio river valley, Bat caves. Tx with azoles or amphotericin

Question 14

Fungal ball on CXR tx and cause

Answer 14

Caused by aspergillus
Tx with amphotericin

Question 15

4 stages of PNA

Answer 15

1) Consolidation
2) Red hepatitization
3) Grey Hepatitization
4) Resolution (Sputum expectoration to clear debri)

Question 16

Tx for pna besides abx

Answer 16

• Cough suppressants (DM, Guiafinesin)
• antipyretics
• Analgesics
• O2 supplementation

Question 17

Stain for TB

Answer 17

Acid fast bacillus stain

Question 18

Where are macrophages in primary TB

Answer 18

Hilar and mediastinal LNs

Question 19

Latent infection of TB

Answer 19

Granuloma around infection, granuloma dies by caseous necrosis, Ghon focus. Spreads to LNs
Fibrotic, scars, Ranke complex, infection ends.

G comes before R (anke)

Question 20

Active TB sx

Answer 20

• Hemoptysis
• Weight loss
• Night sweats
• Cough
• Cavitated upper lobe lesions

Question 21

Acute bronchitis tx

Answer 21

Viral typically, so treat with OTC cough suppressant, Antipyretics, analgesics

Question 22

Acute bronchitis presentation

Answer 22

• Low grade fever
• Malaise and fatigue
• Yellow suptum with productive cough or dry cough
  Ronchi in lung fields