Exam 1 Reverse Flashcards
(215 cards)
1
Q
Jaw thrust
A
Pt comes in with neck trauma, how do you open their airway?
2
Q
Oropharyngeal
A
What type of airway do you use in an obtunded Pt?
3
Q
(Age + 16)/4
A
How do you determine size of orotracheal tube in a kid?
4
Q
Uses paralysis + sedation to intubate ptDON’T use if difficult/distorted airway
A
What is rapid sequence intubation?
5
Q
Ketamine - relaxes bronchial smooth muscle
A
You need to RSI, & Pt is an asthatic, which sedation should you use?
6
Q
- Fentanyl2. Midazolam3. Etomidate4. Propofol5. Ketamine - good for asthma
A
Sedation meds
7
Q
- Succinylcholine2. Vecuronium
A
Paralysis meds
8
Q
- Mechanical failure2. Tension pneumo3. ARDS4. CHF
A
Causes of failure to oxygenate/ventilate?
9
Q
> 80
A
If you can palpate a radial pulse, what must SBP at least be?
10
Q
> 70
A
If you can palpate a femoral pulse, what must SBP at least be?
11
Q
> 60
A
If you can palpate a carotid pulse, what must SBP at least be?
12
Q
25-30%
A
How much cardiac output does chest compressions provide?
13
Q
Defibrillation
A
What is the only intervention consistently proven to improve outcome in cardiac arrest?
14
Q
- Refractory tachycardia2. Torsades3. Unstable bradycardia
A
When do you use electrical pacing?
15
Q
CAD - MI
A
MCC sudden cardiac death?
16
Q
Morning MC in winter, home, males 50-75Beta-blockers protective
A
When does sudden cardiac death usually occur?
17
Q
Pulseless VT or VF
A
Which arrhythmias usually cause sudden cardiac death?
18
Q
- Witnessed collapse2. Prompt CPR3. Early defibrillation4. Younger 5. Arrest occurring away from home6. Initial rhythm was VF/VT
A
What factors inc. your chance of survival if you go into VF?
19
Q
Vent rate <60 &/or periods of asystole Rarely survives
A
What is bradyasystole?
20
Q
Bradycardia or asystole
A
The SA node experienced ischemia/infarction…what rhythm would you typically see?
21
Q
AV block
A
The AV node experienced ischemia/infarction…what rhythm would you typically see?
22
Q
- Age2. Male3. CAD4. Cardiomegaly w/ LVH5. Impaired LV function, EF<30%, CHF6. Long QT7. Vent. arrhythmias
A
Risk factors for sudden cardiac death in adults >35y/o
23
Q
Coarse
A
Is coarse or fine VF better?
24
Q
Circulatory insufficiency that creates imbalance btwn tissue Ox supply & demand Causes anaerobic metabolism which creates lactic acid
A
What is shock?
25
1. Inc. oxygen demand - Status epilepticus2. Impaired tissue Ox use - septic shock, postresuscitation phase of cardiac arrest
Causes of lactic acidosis
26
Systemic Infammatory Response Syndrome - from shock Need 2 or more1. Temp >100.4 or 90bpm3. RR >20 4. WBC >12 or <4 or 10% immature forms or bands
Dx SIRS
27
1. Hypovolemic2. Cardiogenic3. Obstructive4. Distributive
Classification of shock
28
AirwayBreathingCirculationDelivery of OxEnd points of resuscitation
Tx shock
29
When volume resuscitation not adequate or contraindicated (cardiogenic shock)1. Dopamine2. NE3. Phenylephrine4. Vasopressin5. Epi6. Dobutamine
When do you use vasopressors & name them
30
1. Maternal age2. Inc. live birth order3. Lack of prenatal care4. Unwed mother
Risk factors for maternal death
31
1. PE2. Hemorrhage3. Pregnancy-induced HTN4. Infection
What are the leading causes of maternal death?
32
>20 wksUterus compresses IVC
When shouldn't you use a femoral vein for IV access in a pregnant woman?
33
Supine but elevate R hip to prevent vascular compression
What position should a pregnant lady be in if you're intubating?
34
22-26 wks
When is the fetus viable?
35
Tilt PtC-section if baby >20wks after 5 minOpen chest CPR after 15 min
If a pregnant lady goes into cardiac arrest, what should you do?
36
CT b/c D-dimer inc. w/ pregnancyTx w/ Heparin
Pregnant lady gets PE, what tests should you do?
37
VF/VT
What is the MCC of global brain ischemia in adults?
38
Asphyxia
What is the MCC of global brain ischemia in kids?
39
Pts who remain in coma after resuscitation from arrest 1. Reduces neuronal cell death2. Beneficial to heart, lungs, kidneys & intestines ROSC 34 C
When should you induce therapeutic hypothermia?
40
1. Trauma2. Sepsis3. Advanced dementia4. Active bleeding5. CA w/ brain mets6. DNR
Contraindications of therapeutic hypothermia
41
33 C Cool for 24h then rewarm over 24h
What temp do you cool Pt to in therapeutic hypothermia?
42
1. Morphine2. Hydromorphone3. Fentanyl4. Meperidine5. Oxycodone6. Hydrocodone7. Codeine8. Tramadol
Name some opiates
43
1. Buprenorphine2. Butorphanol3. Nalbuphine4. Pentazocine
Name some opiate agonists-antagonists
44
Egg or soy protein allergy
Contraindications to propofol
45
Etomidate - amnestic not analgesic
Which sedative has a risk of myoclonic jerking?
46
Sensation from heart, blood vessels, pericardium, lungs & esophagus Pain poorly localized, dull, heavy or achy
Visceral pain fibers
47
Sensation from pleura, peritoneum, muscle, skeleton & skinPain well localized & sharp
Somatic pain fibers
48
Visceral pain signals perceived in somatic structures - arms, neck & jaw
Referred pain
49
1. Radiation to R arm/shoulder***2. Radiation to both arms/shoulders3. Worse w/ exertion4. Radiation to L arm5. Diaphoresis6. N&V7. Worse than previous angina/similar to previous MI8. Pressure
Factors that inc. likelihood of acute MI
50
1. Pleuritic2. Positional3. Sharp4. Reproducible w/ palpation5. Inframammary location6. Not exertional
Factors that dec. likelihood of acute MI
51
Inflammation of costal cartilage Sharp, dull &/or worse w/ breathing
What is costochondritis & S/S?
52
Sharp pain at xyphoid
What is xiphodynia?
53
1. Tachyarrhythmias2. LVH3. Myocarditis4. Pericarditis5. Cardiac contusion6. HF7. PE8. Sepsis
Troponin is elevated, but no MI, what could it be?
54
Duration of diastolic relaxation of the heart, coronary vascular resistance
What influences coronary artery blood flow?
55
PCI w/in 90mins or Fibrinolysis w/in 30 minAntiplatelets, antithrombins, beta-agonists, nitrates
Tx STEMI
56
1. Prior intracranial hemorrhage2. Known structural cerebral vascular lesion (ex. AV malformation)3. Known intracranial CA4. Ischemic stroke w/in 3 mo5. Active internal bleeding6. Suspected aortic dissection/pericarditis
Absolute contraindications to fibrinolytics
57
with PCI 1. Abciximab2. Eptifibatide3. Tirofiban
When would you use a glycoprotein IIb/IIIa inhibitor with an MI?
58
Inferior MI - nitrates dec. preload & may cause HOTN due to RV involvement Do not use w/in 24h of Viagra or 48h of tadalafil use
When should you use caution with nitrates?
59
1. Signs of HF2. Low cardiac output3. Inc. risk for cardiogenic shock4. Prolonged PR, 2/3rd degree heart block, active asthma, reactive airway disease
You should start oral beta-blockers in MI Pts unless...
60
Get EKG, Troponin1. Aspirin2. Nitrates3. Benzos4. PCIDO NOT use beta-blockers - will inc. BP
STEMI from crack...what is the Tx?
61
Dec. cardiac output leading to inadequate tissue perfusion despite adequate or excessive circulating volume (pump problem)
Define cardiogenic shock
62
1. Old2. Female3. Acute/prior ischemic event4. PMH5. CHF6. Diabetes
Risk factors for cardiogenic shock
63
Large MI
MCC of cardiogenic shock?
64
Hypoperfusion1. AMS2. Dec. urine output3. Ashen/cyanotic, cool skin, mottled extremities, weak pulses4. Weak pulses due to sympathetic nervous system 5. HOTN6. Sinus tachycardia7. Tachypnea8. JVD9. Rales10. Loud/new systolic murmur11. Cardiac PMI moved
S/S Cardiogenic shock
65
1. PCI usually 2. Correct hypoxia, hypovolemia, rhythm disturbances, electrolyte abnormalities, acid base abnormalities3. Foley-cath to monitor output
Tx cardiogenic shock
66
Tx same way as w/o shock except1. No NTG if SBP <902. No beta-blockers for Pts in shock or at risk for shock
Tx cardiogenic shock + MI
67
1. Myocardial ischemia2. Cardiomyopathy3. HTN4. Cardiac dysrhythmias 5. Noncompliance
MCC HF & Pulmonary edema
68
60%
What is normal ejection fraction?
69
1. EF <40%2. Impaired contractility - difficulty ejecting blood3. Leads to inc. intracardiac volumes & pressures, pulm. congestion & edema
Describe systolic dysfunction
70
1. EF normal/higher2. Impaired vent relaxation - difficulty receiving blood3. Atrial pressures inc. inc. w/ age, womenOften due to chronic HTN & LVH, sometimes CAD
Describe diastolic dysfunction
71
1. Cardiomegaly2. Interstitial edema3. Effusions4. Kerley B lines5. Cephalization6. Bat wing pattern
CXR - L-sided CHF
72
always inc. - but change of 40% from baseline = acute exacerbation
BNP in chronic HF?
73
1. Noncompliance - excess salt, meds2. Raid AFib3. Acute MI4. Renal failure
MC precipitants of acute HF syndrome
74
1. O2, SL NTG2. BP >150/100 - add IV NTG/nitroprusside3. IV diuretic - furosemide4. If severe dyspnea - begin BiPAPAdmit PRN
Tx HTN HF
75
1. RV infarction2. Aortic stenosis3. Volume depletion4. Hypertrophic cardiomyopathy
When should you avoid nitrates w/ HF?
76
SBP<901. Inotrope - dobutamine/dopamine until SBP 90-100Admit - may need vasodilator
Tx HOTN HF
77
1. CCB 2. NSAIDs3. Antiarrythmics - quinidine, procainamide
Drugs to avoid in HF
78
Only Tx if hypoperfusion or risk of AV block1. TransQ pacing at 100 May need sedation w/ narcotics/benzos
Tx bradyarrhythmias
79
1. Vagal maneuvers2. Adenosine Tx underlying cause
Tx regular stable narrow tachyarrhythmias
80
1. Control rate - diltiazem or beta-blockersTx underlying cause
Tx irregular stable narrow tachyarrhythmias
81
If VT - amiodaroneConsider synch. cardioversion SVT - adenosine
Tx regular stable wide tachyarrhythmias
82
If WPW w/ AF - amiodarone/procainamideIf Torsades - MgIf VT - synch. cardioversion
Tx irregular stable wide tachyarrythmias
83
4
If defibrillator Pt is in cardiac arrest, how many shocks have they already had?
84
60-80 mins
When a Pt presents to the ED, at what time are their BP measurements most representative?
85
Noncompliance w/ meds
MCC hypertensive urgencies?
86
Reduce BP w/in 24-48h Commonly use Clonidine
Tx hypertensive urgency
87
Elevated BP w/ papilledema
What is malignant HTN?
88
1. HA2. N/V3. Visual complaints4. AMS - encephalopathy - cardiac Sx, confusion, lethargy, coma 5. Eyes - hemorrhages, exudates, papilledema6. Acute CHF
S/S hypertensive emergency
89
NonspecificUsually HA
S/S hypertensive urgency
90
Lower MAP ASAP by 20-25% Use Labetalol/Metoprolol/Esmolol Nicardipine/NTG/sodium nitroprusside Benzos
Tx hypertensive emergency
91
Esmolol - short acting
If a Pt has asthma & presents w/ hypertensive emergency, what should you use to lower BP?
92
goal SBP <140-110Morphine Labetalol
Tx aortic dissection w/ HTN emergency?
93
NTG then diuretics
Tx pulm edema w/ HTN emergency
94
NTGbeta-blockers
Tx acute MI w/ HTN emergency
95
BenzosDO NOT use beta-blockers
Tx cocaine intox. w/ HTN emergency
96
LabetalolNicardipine
Tx eclampsia w/ HTN emergency
97
Nicardipine/Labetalol
Tx HTN encephalopathy w/ HTN emergency
98
Labetalol/Nicardipine Oral nimodipine
Tx SAH w/ HTN emergency
99
LabetalolNicardipine
Tx intracranial hemorrhage w/ HTN emergency
100
Labetalol
Tx acute ischemic stroke w/ HTN emergency
101
Tx pain & anxiety firstNicardipine/Labetalol
Tx acute postop HTN
102
Labetaol & Nicardipine
When in doubt w/ HTN emergency on test, use what??
103
If significantly elevated but no S/S - start meds & arrange follow upHCTZ or Lisinopril
Do you treat ED identified HTN?
104
Unknown - have inc. risk of death
MCC syncope
105
Cardiac 1. Structural Old people? Aortic stenosis2. Dysrhythmias - usually no prodrome
What is the most dangerous type of syncope?
106
Brief tonic clonic mvmts may occur w/ syncope
Why are seizures usually confused with syncope?
107
CV risk
What is a good predictor of syncope in old people?
108
Cardiac & neuro
Which types of syncope need admitted?
109
1. Sharp, stabbing, severe retrosternal CP2. Sudden/gradual onset3. Worse w/ inspiration or mvmt4. Referred to back/trapezius5. Worst when supine, better when leaning forward6. Fever, malaise, dyspnea, dysphagia 7. Pericardial friction rub
S/S pericarditis & pericardial effusion
110
1. Diffuse ST elevation2. PR depression (II, aVF, V4-V6)3. Later see T wave inversion & ST normalization4. ST to T amplitude >0.25CXR usually normal
EKG changes w/ pericarditis & CXR
111
Low QRS - pulsus alternans CXR - enlarged heart w/ water bottle appearance
EKG changes w/ pericardial effusion & CXR
112
EchoTx - pericardiocentesis Treat underlying cause
How do you diagnose pericardial effusion & Tx?
113
TraumaMetastatic effusion MC non-traumatic cause
MCC tamponade in ED?
114
1. Dyspnea at rest2. Fatigue3. Beck's triad - neck vein distention, HOTN, muffled heart sounds4. Tachycardia5. Pulsus paradoxus
S/S tamponade
115
Echo -DxRA compression, RV diastolic collapse, hyperdynamic heartEKG - low voltage, electrical alternansCXR - may be normal
Dx tamponade
116
1. Neck vein distention2. HOTN3. Muffled heart soundsseen w/ tamponade
What is Beck's triad & when is it seen?
117
1. IV fluids2. Dobutamine3. PericardiocentesisTraumatic - surgery
Tx tamponade
118
Pericardium becomes thickened & scarred preventing diastolic filling1. Trauma w/ intrapericardial hemorrhage2. Pericardiotomy3. Chronic renal failure4. Fungal/TB pericarditis5. Idiopathic
What is constrictive pericarditis & when is it seen?
119
1. DOE, orthopnea2. Fatigue, weakness3. JVD4. Inspiratory neck vein distension - Kussmaul sign5. Paradoxical pulse6. Pericardial knock7. Hepatomegaly8. Ascites
S/S constrictive pericarditis
120
Constrictive pericarditisEarly diastolic sound just after S2
What is a pericardial knock & when is it seen?
121
EKG - low voltage QRS, inverted T wavesCXR - pericardial calcification on lateral**Doppler echo, CT or MRI preferred
Dx constrictive pericarditis
122
1. Fluid restriction & diuretics2. Pericardiectomy
Tx constrictive pericarditis
123
1. Fever2. Fatigue3. Myalgias4. HA 5. CP6. Palpitations7. Dyspnea
S/S myocarditis
124
Labs - inc. WBC, ESR & troponinMay need nuclear imaging/Bx
Dx myocarditis
125
Supportive
Tx myocarditis
126
1. Dilated - Most common 2. Hypertrophic3. Restrictive
Types of cardiomyopathies
127
Dilated cardiomyopathydeath w/in 2 years w/o transplant
What is the main indication for heart transplantation?
128
1. DOE2. Orthopnea3. PND4. Bibasilar rales5. Dependent edema6. CP
S/S dilated cardiomyopathy
129
CXR - CMG, pulm congestionEKG - LVH, LAE, Afib, AV conduction abnormalities, vent. arrhythmiasEcho - Chamber enlargement, dec. vent. function
Dx dilated cardiomyopathy
130
1. Nitrates, diuretics2. Anticoagulation3. Antiarrhythmics PRN
Tx dilated cardiomyopathy
131
& diminished vent. contractile force - low CO & HFDilated
Which cardiomyopathy shows systolic & diastolic dysfunction?
132
HypertrophicMuscular hypertrophy of nondilated LV - muscle becomes stiffRestricted vent. filling
Which cardiomyopathy shows diastolic dysfunction?
133
EKG - LVH, LAE, deep septal Q wavesEcho*** - disproportionate septal hypertrophy
Dx hypertrophic cardiomyopathy
134
Emergent? Beta-blockers for CPArrhythmias? AmiodaroneDO NOT give digoxin, nitrates, diuretics or beta-agonists
Tx hypertrophic cardiomyopathy
135
Restrictive May be from amyloidosis, sarcoidosis, hemochromatosis, scleroderma
Which cardiomyopathy shows elevated venous pressures?
136
Mitral Then aortic, tricuspid then pulmonic
Which valve is most often infected w/ endocarditis?
137
a - S. aureus High fever, systemic toxicity s - Strep. ViridansGradual onset
MCC endocarditis acute & subacute
138
EndocarditisO - painful nodules on pads of digitsJ - nontender hemorrhagic plaques on palms/solesBacteria seeds & heart spits out little clots
When are Osler nodes & Janesway lesions seen?
139
1. Cultures - 3 diff sites 2. Inc. ESR, CRP 3. UA - hematuria, proteinura, pyuria 4. EKG - conduction abnormalities5. Echo 6. TEE better - can rule in but not out Dx 7. Duke criteria
Dx endocarditis
140
1. ABCs2. Abx Sick - Nafcillin + GentamicinSubacute - PCN + GentamicinProsthetic valve - Vanco + Gentamicin + Rifampin
Tx endocarditis
141
NO mammary glands
Should you anticoagulate an endocarditis Pt?
142
you die
During aortic dissection, what happens if the blood dissects through the adventitia?
143
HTNPrego MCC women <40
MCC thoracic aortic dissection?
144
A - ascending, surgeryB - below, medical mgmt
Type A vs. B aortic dissections
145
1. Abrupt severe onset CP that radiates to back/abdomen2. Ripping/tearing3. Diaphoresis, N/V4. FH5. Migratory findings6. SBP diff. >15mm btwn each arm 7. Unilat pulse deficit/absent8. Diastolic murmur9. Neuro deficits10. Neuro deficits/dysphagia, Horner syndrome
S/S aortic dissection
146
CXR - mediastinal widening, obliteration of aortic knob, tracheal displacement to the R, Pleural effusion to LCT
Dx aortic dissection
147
Tx HTNBeta-blockers - Labetalol, EsmololNitroprusside
Tx aortic dissection
148
Thrombotic occlusion
MCC acute limb ischemia?
149
Heart
Where do most emboli from arterial occlusion come from?
150
Lower extremities at the bifurcation of the common femoral arteryThen poplitealArm - brachial artery
MC locations for arterial occlusion
151
1. Pain 2. Pallor3. Paralysis4. Pulselessness5. Paresthesias6. Poikilothermia
S/S arterial occlusion
152
ABI 30mm = obstructionUS - most accurate above knee CT angio
Dx acute arterial occlusion
153
Supportive1. Aspirin2. Heparin3. Analgesia4. Fluids Revascularization1. Thrombolytics2. Embolectomy3. PTCA4. Bypass graft5. Amputation
Tx arterial occlusion
154
Stasis & endothelial injury
What does dysfunction of venous valves cause?
155
Not really
Are distal DVTs bad?
156
Iliofemoral thrombosis causing edema of extremityPale, cool, possible limb loss
Define phlegmasia alba dolens
157
Iliofemoral thrombosis that inclues all collateral veins of extermityArterial ischemia & cyanosis, possible limb loss
Define phlegmasia cerulea dolens
158
1. Pain, tenderness, swelling2. Upper extremity - hand swelling3. Swelling, edema, tenderness in calves & thighs4. Arm - distended superficial veins that don't collapse when arm is raised5. Measure - diff. >2 cm6. Homan's sign7. US - better above knee
Dx DVT
159
1. Heparin/Lovenox then switch to POContraindicated? IVC filter/umbrella2. Thrombolytic therapySuperficial thrombophlebitis - NSAID, warm compressesCalf vein? Watch
Tx DVT
160
SystolicDiastolic not good
What murmurs do you usually hear with prosthetic aortic valves?
161
Loud holosystolic murmur
What murmurs should you worry about with prosthetic mitral valves?
162
S. epidermidis
MC organism for prosthetic valve endocarditis?
163
Men commit 4x more but women attempt 4x more
Who commits more suicides, men or women?
164
SexAgeDepressionPrevious attemptEthanol useRational thinking lossSocial supports lackingOrganized planNo spouseSickness>5 = high risk
Screening for suicide
165
1. Diabetes2. Thyroid disorders3. Intoxications4. Withdrawal5. AIDS6. Head injury
What medical conditions can cause mental status changes?
166
Sleep disturbanceInterestGuiltEnergyConcentrationAppetitePsychomotor slowingSuicidal thoughtsMood 5or+ = major depression
Screening for depression
167
school year
When are there more psych emergencies for kids?
168
Afib
MCC CHF
169
Oxygen
What is the best Tx for COPD to extend life?
170
CO2Ox in COPD Pts
What is your drive for breathing?
171
Thorazine
Tx hiccups
172
p >0.5 L >0.6
Exudate - protein & LDH levels
173
Exudative - amiodarone
What drug commonly causes pleural effusions?
174
1. +/- dyspnea2. Dullness to percussion & dec. breath sounds3. CXR4. Thoracentesis
Dx pleural effusion
175
1. Diuretics 2. Thoracentesis if <1-1.5L
Tx pleural effusion
176
Bronchitis
MCC hemoptysis?
177
1. CXR2. Bronchoscopy if >600mL3. CT
Dx hemoptysis
178
Late evenings & early mornings
When is asthma worse during the day?
179
Smokinggggggggggnext is asthma
MCC COPD
180
1. Asthma2. Emphysema3. Bronchitis
3 diseases of COPD
181
FEV1
How is staging of COPD determined?
182
1. Exertional dyspnea***2. Chronic productive cough***3. Minor hemoptysis4. Tachypnea, accessory muscle use5. Pursed lip breathing6. Wheezing7. Prolonged expiratory time 8. Crackles/rhonchi9. Barrel chest/reduced diagphragmatic motion10. Displacement of PMI - R HF & R axis dev. 11. Dec. breath sounds
S/S COPD
183
1. Distended neck veins2. Passive hepatic congestion3. Peripheral edema
S/S pulm. HTN/Cor Pulmonale
184
1. Confusion2. Tremor3. Plethora4. Stupor5. Hypopnea/apnea
S/S hypercarbia
185
1. Dyspnea2. Pleuritic CP worsened w/ cough/breathing 3. Referred pain4. Neuro Sx5. Tachypnea6. Hypoxia7. LCTA usually 8. R vent. S3 or split S2
S/S PE
186
1. S1Q3T3 - McGinn White sign 2. Sinus tachycardia MC** w/ R axis dev.
EKG PE
187
1. Ox<93%2. Dec. end tidal CO23. CXR - westermark, CMG, Hampton, Fleischner4. Sinus tach, S1Q3T3 5. CT angio6. V/Q scan7. Pulm. angiography***gold std
Dx PE
188
PEPeripheral dome shaped dense opacification on CXR
When is Hampton's hump sign seen?
189
PElocal widening of artery at site of occlusion on CXR
When is Fleischner's sign seen?
190
PEWedge shaped oligemia on CXR
When is Westermark sign seen?
191
Pulm angioBut you'll prob get CT angio
Gold Std for Dx PE?
192
1. UFH/LMWH2. Coumadin3. +/- fibrinolytics
Tx PE
193
1. Massive - BP t give fibrinolytics
3 categories of PE
194
Pneumococcus
MCC PNA
195
1. Cough2. Fatigue3. Fever4. Dyspnea5. Sputum6. Pleuritic CP
S/S PNA
196
1. Sudden onset w/ fever2. Rigor3. Dyspnea4. Hemoptysis5. CP6. Tachycardia7. Tachypnea8. Abnormal lung sounds
Classic S/S Pneumococcus PNA
197
KlebsiellaPulm. abscess common CXR - necrotizing lobar PNA
Currant jelly sputum?
198
Bullous myringits from Mycoplasm Tx - Azithromycin (Macrolide) common in young adults confirm w/ cold agglutinin
PNA w/ ear problems?
199
1. Bronchial breath sounds2. Egophony3. Inc. tactile & vocal fremitus4. Pleuritic friction rubs5. Cyanosis & jaundice6. Abdominal distention
S/S consolidation
200
Immunocompromised & unvaccinatedCXR - patchy infiltrates
Who gets H. flu PNA?
201
1. CF2. Hospitalized3. Central venous catheters4. Burn wounds5. Bronchiectasis6. HIV
Who should you consider pseudomonas PNA in?
202
After viral illnessIVDU, hospitalized Pts, debilitated
Who usually gets Staph PNA?
203
Chlamydia psittaci
PNA & contact w/ pigeons?
204
Legionella
Old person w/ PNA, GI Sx & bradycardia?
205
Azithromycin
Tx PNA in healthy PT
206
Levaquin
Tx PNA w/ comorbidites
207
No - wait 24-48h
If Pt aspirates - should you give abx?
208
S. aureus
MCC empyema
209
1. Thoracentesis2. Fluid w/ +GS/culture3. Glucose 1000
Dx empyema
210
Aspiration
MCC lung abscess
211
Several weeks of 1. Cough2. Fever3. Pleuritic CP4. Wt loss5. Night sweats
S/S lung abscess
212
CXR - dense consolidation w/ air-fluid level inside thick walled cavitary lesion
Dx lung abscess
213
Clindamycin + FlagylMight need bronchoscopic drainage/surgery
Tx lung abscess
214
AsymptomaticActive1. Fever2. Malaise3. Wt loss4. CP Reactivation has same Sx w/ extrapulm - Lymph MC
Primary TB S/S
215
Culture
Gold Std for Dx TB?
