Pnuemonias and TB Part I, D KInder, CIS Flashcards Preview

Year 2 Resp Exam 2 > Pnuemonias and TB Part I, D KInder, CIS > Flashcards

Flashcards in Pnuemonias and TB Part I, D KInder, CIS Deck (52):
1

22 y.o bullous myringitis, right middle lobe infiltrate, non-productive cough, fever

mycoplasma pnuemonia

2

bullous myringitis

blood filled TM

3

how to test for mycoplasma pneumonia

cold agglutinins test. autoAb to RBC

4

obligate intracell organism to cause pneumonia

chlamydia spp

5

pneumonia from infected excrement from pigeons

histoplasmosis

6

bradycardia in relation to patient's fever
pneumonia
what causes this

legionella

7

why does penicillin not work on mycoplasma

has no cell wall

8

fever, chills, yellow sputum
previous splenectomy
optochin sensitive
+ quelling reaction
microbe?

streptococcus pneumonia

9

splenectomy patients are unable to protect against what organisms

encapsulated because B cell immunity is down

10

19 y.o college student
fever, dry cough, malaise, aches all over
mildly dec breath sounds b/l
cold agglutinins

mycoplasma pneumonia

11

40 y.o female
nonproductive cough, low grade fever
atypical pneumonia based on CXR
complement Ab to Chlamydia psittaci
most likely occupation?
- cat breeder
-homeless shelter worker
-poultry farmer
-cave explorer
-wool sorter

poultry farmer

12

wool sorter disease pathogen

Bacillus anthracis

13

poultry farmer in central US, microbe?

histoplasmosis or psittaci

14

25 y.o M
fever nonproductive cough
hypotension
CXR b/l infiltrates
silver stain with foamy alveolar exudates
predisposing condition?

AIDS
pneumocystis jirovecii
CD4<200

15

what organism causing pneumonia do you expect in sickle cell patient?

asplenic
encapsulated pathogens like strep pneuomnia

16

southwest US organisms

coccidiodes

17

drug used for chronic aspiration

clindamycin

18

45y.o F
chills rigors, fever
onset 2 days
gram + encapsulated lancet shaped diplococci
microbe?

strep pneumoniae

19

type microbe H influenza

gram - rod

20

vital signs legionella

high fever and bradycardia

21

alcoholism is assoc with what pneumonia-causing organism

klebsiella

22

56 y.o DM M with chronic sinusitis
Tx 8 weeks antibiotics does not get better
2 wks later dies from posterior erosion of organism into his brain
strongly suspect infection with what?

mucormycosis
fungus
common in DM

23

25 y.o M prostitute, IV drug abuse
fever marked SOB
hacking and non-productive, present for weeks
PaO2 55 PaCO2 50
b/l infiltrates lower lobes
wheeze and dec breath sounds. oral thrush
what is most consistent with Dx?
Acid fast organisms in sputum
elevated cold agglutinins
+ methamine silver stain lung tissue
decreased serium IgA
+ convalescent precipitans for histpolasmosis

pneumocystis jiroveci
+ silver stain of lung tissue

24

6 mo from kenya
runny nose, dry non-productive cough
hacking and progressively more frequent and severe
severe paroxysms assoc with cyanosis, plethoric facies, bulging eyes, protrusion of the tongue, and distention of the neck veins

bordetella pertussis

25

decreased IgA means what in patients

more prone to respiratory infections

26

croup microbe

parainfluenza

27

50 y.o M
ER with severe pneumonia
just returned from Howell MI air conditioning and heat engineer
40 pack yr and drinks 8-10 beers/night
culture on charcoal yeast extract has small gram - bacteria
best antibiotic?

legionella
erythromycin-- macrolide

28

clindamycin is used to Tx what

anaerobic

29

Staph non resistant is Tx with what

methicillin or nafcillin

30

19 y.o african american M
San Diego
5 week fever, nonproductive cough and SOB
Tx for levofloxacin little response
- HIV and PPD
CXR R upper lobe infiltrate
small painful rash and red bumps on lower extremities
Dx test?

fungal serologic tests- coccidiodes mycosis

31

65 y.o M with acute respiratory failure
marked CO2 retention and hypoxemia
ventialor
became ill with signs sepsis, kussmaul breathing and signs of septic shock
CXR show diffuse b/l infiltrates that turned to marked in one day
greenish colored sputum noticed on suction
most likely organism?

Pseudomonas aeruginosa

32

gram negative faculative intracell bacterium transmitted by flea bites

yersinia pestis

33

36 y.o M with stage IV sarcoidosis with hemoptysis
CXR L upper lobe pleural thickening
CT shows free floating density- fungus ball
most likely fungus to cause fungus ball?

aspergillus flavus

34

45 y.o M
fever malaise, fatigue
sputum streaked with blood
nonproductive
pulse 60
b/l rales
L lower lobe infiltrate
concerned about legionnaires and order what test?

Urinary antigens

35

21 y/o F
+ PPD
asymptomatic
Tx?

INH 6 mo

36

4 mo infant, winter
runny nose, fever, cough, wheezing
daycare with children same Sx
b/l rales wheezing and intercostal retractions with grunting
most likley infecting oganism

RSV

37

70 t.o M
lobar pneumoniae
kidney shaped gram - diplococci
most likely organism?

Moraxella catarrhalis

38

Influenza B on cruis liner
no influenza A so far
medications for unvaccinated patients on ship?

oseltamivir

39

76 y.o american indian F
admitted for Tx CAP
in hospital Dx mycobacterium tb confirmed by AFB
began on 4 drug regimen then changed to different regimen 4 wks later from sensitivity data
eye complaint now from meds
most likely due to what medication?

ethambutol

40

44 y.o M with chronic pneumonia
night sweats, fever, weight loss, fatigue, cough, sputum hemoptysis and dyspnea
CXR left sub segmental lower lobe pneumonia
poorly responsive antibiotics
small nodular lesions on surface of arms and legs
travels and makes canoes from polyurethane foam
single broad based buds off yeast cells
most likely region where obtained this disease

louisiana

41

large yeast cells with single broad based buds

blastomyces dermatitidis

42

39 y.o Hx HIV
fever, cough, night sweats, 7 lb weight loss
hemoptysis CD4

Tx
INH, pyranizamide, rifampin, ethambutol

43

+PPD in healthy med student

10mm or larger

44

10mm + PPD fits what criteria

recent arrivals from endemic countries
injection drug users
residents at high risk settings
mycobacterial lab personnel
persons with clinical conditions that place them at high risk

45

15 mm +PPD test used for what

live in an area no knonw risk factors TB

46

21 y.o HIV+ M cough and weight loss
given provisional Dx PCP pnuemonia given low CD4 count
worsens
partner previously died from pulm TB
he has active pulm TB and put on 4 drug regimen
2 weeks later but on HAART and now complaining of unusual sensations

isoniazid but also streptomycin and ethambutol

47

21 y.o F
SOB previously admitted for "flu"
getting worse
put on 15 lb, nonproductive cough
rabbit hutches
normal heart
dec DLCO
CXR normal
CT diffuse hazy opacities without focal infiltrates
Dx?

interstitial pulmonary fibrosis

48

cause of Q fever?

coxiella burnetti

49

42 y.o M archeologist, ancient ruin Western US
HA, productive cough, dyspnea, fatigue, achy joints night sweats
red painful lumps on legs
dec breath sounds and diffuse crackles
b/l hilar adenopathy with spherical coin lesion
- AFB and -PPD
Dx?

coccidiomycosis

50

16 y.o homeless for 6 mo, prostitution
cough low grade fever, malaise, diffuse abdominal pain and diarrhea
occasional hemoptysis
b/l cervical supraclavicular and inguinal lymphadenopathy
liver and spleen enlarged to palpation
diastolic rumble and Left lower sternal borader (increases intensity with inspiration)
R atrial P waves
needle tracks, CD4 50, blood and sputum cultures negative
Dx is associated with?
-abundant AFB with macrophages characteristic MAC
-abundant AFB characteristic mycobacterium TB
- + silver stains for cyst or trophozoite
- + Ab legionella
- + cold agglutinin test

abundant AFB within macrophages characteristic of MAC

51

71 y.o F acute dyspnea, cough, fever flu season, consolidation left lower lung field
most common cause post influenza pneumonia?

staph aureus

52

3 y.o from haiti
high fever, sore throat and dsypnea with respiratory stridor
drool from mouth, neck extended
cannot swallow
thumb sign on lateral neck view
causative organism?

epiglottitis
H influenzae