Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Infectious Diseases > Exam 3 - LRTI > Flashcards

Exam 3 - LRTI Flashcards

1
Q

when does CAP occur

A

outside the hospital or within the first 48 hours of admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the three main ways CAP can occur

A

aspiration
aerosolization
blood born

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the main bacterial pathogens for CAP

A

strep pneumo
h. influenzae
Mycoplasma pneumo
legionella pneumo
chlamydia pneumo
staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what tests should be completed to assess risk for staph aureus in CAP patients

A

MRSA nasal pcr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are additional risk factors for CAP patients

A

alcoholism
COPD/smoker
lung disease
ABX recently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is more common for CAP bacteria or virus

A

virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the classic presentation for CAP

A

sudden fever, chills, dyspnea, productive cough, chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do the elderly present with CAP

A

may not have classic signs of fever and leukocytosis
more likely to have altered mental status, weakness, functionality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the typical presenting vitals for a CAP patient

A

febrile (>38 degrees celsius)
tachycardia
hypotensive
tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what tests should be done for CAP diagnosis

A

chest x-ray for all suspicious cases
WBC w/ differential
SCr, BUN, electrolytes
PCR swabs
pulse ox
cultures (save for more severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how many minor criteria do you need to meet in order to have severe CAP

A

need at least 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the minor criteria for severe CAP

A

Resp rate greater than 30
multilobar infiltrates
confusion/disorientation
uremia BUN > 30
leukopenia WBC <4000
thrombocytopenia
hypothermia
hypotension requiring aggressive fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how many major criteria are needed to classify as severe CAP and what are they

A

at least 1
septic shock requiring vasopressors
respiratory failure requiring mechanical ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is supportive care for CAP

A

humidified air
bronchodilators
fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CAP empiric therapy for:
outpatient
healthy w/o comorbidities

A

Amox 1gm PO Q8H
Doxy 100mg PO BID
Azith zpack (high resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CAP empiric therapy for:
outpatient
w/ comorbidities

A
  • Levo 750mg PO QD
  • Moxi 400mg PO QD
  • b-lactam + macrolide or doxy (preferred option)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CAP what b-lactams should be used when treating outpatient CAP w/ comorbidities

A
  • Augmentin
  • Cefpodoxime
  • Cefuroxime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CAP empiric therapy for:
inpatient
non severe
no MRSA/pseudomonas

A
  • Levo 750 or Moxi 400
  • B-lactam + macrolide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CAP empiric therapy for:
inpatient
severe
no MRSA/pseudomonas

A
  • Levo or Moxi + B-lactam
  • B-lactam + macrolide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what b-lactams should be used inpatient w/ CAP

A
  • Amp/sulbactam
  • ceftriaxone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what can be used in place of a macrolide in inpatient CAP

A

doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are risks for MRSA in CAP

A

2-14 days post influenza
previous MRSA
previous hospitalization and use of IV antibiotics within 90 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are risks for pseudomonas in CAP

A

previous pseudomonas
previous hospitalization and IV antibiotics in 90 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CAP empiric therapy for:
inpatient
MRSA risks

A

Vanc or Linezolid

25
CAP empiric therapy for: inpatient pseudomonas risk
-Pip/tazo -cefopime -meropenem
26
when to use corticosteroids in CAP
only when there is septic shock
27
duration of therapy for CAP
minimum of 5 days
28
CAP pen-susc streptococcus pneumoniae 1st line treatment
pen G or amox
29
CAP pen-resist strep pneumo 1st line treatment
ceftriaxone or respiratory FQ
30
CAP h. influenzae first line treatment
2nd/3rd gen cephalosporin unasyn augmentin
31
CAP mycoplasma pneumoniae 1st line treatment
macrolide or doxy
32
CAP chlamydia pneumoniae first line treatment
macrolide or doxy
33
CAP legionella first line treatment
FQ or azithromycin
34
CAP MSSA first line treatment
cefazolin or nafcillin
35
CAP MRSA first line treatment
vanc or linezolid
36
CAP anaerobes first line treatment
b-lactam/bL inhibitor and add metronidazole if utilizing cephalosporin
37
CAP enterbacterales first line treatment
3rd/4th gen cephalosporin carbapenem
38
what is hospital acquired pneumonia
greater than 48 hours after hospital admission
39
what is VAP
greater than 48 hours after endotracheal intubation
40
how to diagnose HAP/VAP
no standard diagnosis mostly based on timing and presentation
41
what are the risks for HAP/VAP
advanced age severe comorbidities duration of hospitalization multidrug resistance (prior ABX use)
42
HAP common pathogens
Pseudomonas aeruginosa Enterobacterales Acinetobacter Staph Aureus *greatest concern!*
43
what is the duration of therapy for HAP
7 days if clinically stable
44
what are MRSA risks in HAP
previous MRSA or ABX in 90 days >10-20 MRSA rates unknown MRSA prevalence
45
what are pseudomonas risks in HAP
>10% incidence resistance rates unknown
46
HAP empiric therapy for: MRSA coverage
vanc or linezolid
47
HAP empiric therapy for pseudomonas
pip/tazo cefepime imipenem meropenem levofloxacin
48
HAP empiric therapy for: not high risk
Pip/tazo cefepime imipenem meropenem levo
49
what are you trying to cover in HAP w/ no high risk
goal is to cover MSSA and pseudomonas
50
HAP empiric therapy for: not high risk w/ MRSA
pip/tazo, cefepime, imipenem, meropenem, levo PLUS vanc or linezolid
51
what is the goal when treating HAP w/ no high risk but MRSA
goal is to cover MRSA and pseudomonas
52
HAP empiric therapy for: high risk w/ MRSA
pick 2 different classes from pip/tazo, cefepime, imipenem, meropenem, levo, tobra/amikacin PLUS vanc or linezolid
53
what is the goal when treating HAP w/ high risk and MRSA
goal is to cover MRSA and multidrug resistant pseudomonas
54
VAP empiric therapy
pick two from pip/tazo, cefepime, imipenem, meropenem, levo, tobra/amikacin PLUS vanc or linezolid
55
what is the goal when treating VAP
goal is to cover MRSA and pseudomonas
56
when should daptomycin be used in LRTI
NEVER! inactivated by pulmonary surfactant
57
when should aminoglycosides be used in LRTI
never as monotherapy and avoid empiric unless necessary (lots of AEs)
58
when to use polymyxins in LRTI
avoid empiric, reserve for high MDR patients
59
when to use tigecycline
good if also intra-abdominal infections.

Infectious Diseases (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions