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Flashcards in Pulm 1 Deck (32):
1

A-a gradient is normally what? When is it higher?

Normally 5-15

Increased in PE, pulmonary edema, R-L shunt

Oxygen not getting into arteries

2

Pharyngitis criteria?

CENTOR criteria

Cough absence
Exudate
node
temp
OR age (15)

0-1 no antibiotic
2-3 throat culture
4-5 means treat

3

Sinusitis caused by what? What is mucor?

Strep pneumo H influ, moraxella

Mucor is fungal diabetes

Same as ear infection, so give Amox or doxy or levo

4

Murmurs and squatting?

What is the physiology to it?

5

Bronchotis most common cause?

tx?

Virus MOST COMMON

Mycoplasma or strep pneuma if smoker

Tx antibiotics if chronic other lung disease. (otherwise supprotive is first line)

Fluoroquinolones or macrolides

6

Atypical pneumonia CXR and types?

Mycoplasma, LEGIONELLA, chlamydophila.

XR shows diffuse and patchy

7

Most common cause of pneumo in youngster?

RSV

8

Strep pneumo pneumonia?

Tx?

RUST COLORED SPUTUM

Amox is first line, but lots of tuff works

9

Who gets H influx pnuemo? presentation?

COPD, sickle cell

Slow onset
Beta lactams and everything again

10

Most common pneumonia after influenza?

Strep, but staph can happen again

11

Staph pneumo CXR?

Abscess forming. It is post influx often

12

Klebsiellan pneumo in who? Symptoms?

CURRANT JELLY sputum in people who aspirate

Cephs and aminoglycosides

13

Psuedomonas pneuma in who?

Tx?

Ventilators, chronic ill, cystic fibrosis

Empiric antibiotics?
Pip tazo, cefepime, Cipro, levo

If sepsis, do pip taco with levo

14

GBS pneumo in who?

infants.

B lactams, amp and gent

15

Enterobacter pneumo?

Tx third gen cep or carbopanem

16

Cold agglutinin test is what?

Mycoplasma pneumo

tx macrolides

most common pneuma in young adults

17

Legionella pneumo symptoms? Tx?

Can have confusion, needs macrolide or fluoroquinolone

18

Atypical pneumonia tx?

Macrolide or fluoroquine

Mycoplasma
Legionella
Chlamydophila

19

Empiric antibiotics for pneumonia?

Levo or moxi for primary

Or beta lactam with macrolide

20

Old people are gross, so you see moe anaerobes and G- rods for pneumonia

But strep pneuma still most comon

21

Strep pneumo vaccination indication?

65 years

Long term health issue including alcohol, DM, Sickle cell

Resistance to infection lower from something like treatment OR NO SPLEEn

Smokers 19 or older

22

IF YOU SMOKE YOU NEED PNEUMO VACCINATION

OH

23

Pneumonia with caves?

Histoplasmosis

Also HISTORIC mississippi

24

Eastern north america fungal pneumonia?

Blasto

25

Fungal pneumo tx?

Severe?

Histo or blasto?

Coccidio?

If severe, ampho B

Itraconazole

Fluconoazole

26

Tx for PCP? CD4 count for PCP?

200!

You see rising LDH

21 days of antibiotics: BACTRIM

27

What is ghon complex?

Ghon focus (calcified granuloma) with hilar lymph on CXR in PRIMARY TB

28

PPD is positive at 5 mm when?

Immunodeficient or TB findings on CXR or working very close with the disease

29

secondary tb lung findings?

Symptoms?

Caseous cheesy

Fever, hemoptysis, weight loss, night sweats

Can have extra pulmonary TB just about anywhere! GREAT IMITATOR

30

Dx of tb?

weakly gram positive acid fast, Slow growing so hard to culture

Culture takes weeks

ACID FAST EVERY morning on sputum 3 days in a row

31

Latent Tb tx?

PRimary or secondary TB?

INH for 6 months

RIPE: Rifampin, INH, Pyran, Etham 2 months

Give B6 (pyrdoxine) for INH

32

Vaccination for Tb only affects ppd for about 10 years

Oh ok