Flashcards in Pneumonnia Deck (47):
what should you do if you have a high clinical suspicion but CXR is negative?
get serial xrays, the disease may blossom
what do you do if the CXR shows what looks like pneumonia but the clinical picture doesn't fit?
think of something else
what are classic presentation of legionella pneumonia?
what is drug of choice for legionnella?
what are drugs that get good atypical coverage?
what is proper dosing of levaquin for pneumonia?
what do you do with pleural fluid with a pneumonia?
tap it if there is enough (antibiotics won't be enough)
what do you do with pts with pneumonia in flu season?
flu swab and if you still think they have it do a PCR
what are DOC in outpatient previously healthy pt with pneumonia?
what are DOC in outpatient with comorbid dz with pneumonia?
combo therapy (aug + azithromycin)
what are DOC in inpatient non ICU pneumonia?
combo (rocephin PLUS azithro)
what are DOC in inpatient, ICU pneumonia?
zosyn 4.5 PLUS cipro PLUS vanc
what type of pneumonia hits hard and very abrupt?
what is the criteria for sepsis?
10% bands on WBC count
how can you evaluate for a pleural effusion?
US or CT without contrast
how long might a pneumonia take to get better radiographically?
always, always follow pneumonia until it does what?
clears up radiographically
what is the definition of an MDR pathogen?
bug with resistance to 2 or more of the abx typically used to treat it (esp important in regards to Gram negative bacilli)
what is the leading cause of death of nosocomial infections?
hospital acquired pneumonia
what are common HAP bugs?
what are clinical signs of HAP?
decline in oxygenation
new infiltrate on CXR
what is zosyn?
pipercillin and BL inhibitor
people die because of what?
they don't get abx quickly enough or the right kind
what should you do when you go to a new job/hospital?
learn your bugs so you can tailor abx choices based on where you are
what is the trough that you want for vanc?
what are good/bads with linezolid for MRSA?
expensive, easier to dose, GI issues
what are good/bad with vancomycin for MRSA?
nephrotoxic, harder to dose, cheaper
what is the timing goal for abx therapy?
direct approach at 72hrs
what time frame determines a chronic lung absess?
what is a common cause of a lung abscess?
what defines a primary abscess?
what defines a secondary abscess?
what are most bugs that cause lung abscess?
anaerobes from the mouth
what is Lemierre's syndrome?
thrombophlebitis of the IJ
can cause lung abscess
what are classic sxs of lung abscess?
cough, fever, wt loss, purulent sputum, bad taste in mouth, poor dentition
what bug is a/w DM and lung abscess?
think about these bugs in PING and lung abscess?
where is TB usually located in the lungs?
upper lobes with associated parenchymal involvement
what type of carcinoma of the lung cavitates?
what causes multifocal lesions, recurrent sinusitis, renal failure, and hematuria?
txment of lung abscess with no MDR risks
unasyn and clinda
txment of lung abscess with no MDR risks and PCN allergy
once off IV abx continue treatment with
PCN fluor + clinda
how long do you treat with abx?
6-8 weeks with serial images to ensure resolution