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Pulm Flashcards

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1
Q

Pt has fever + pleuritc pain + productive cough and no hospitalization within 48hrs? most common bug?

A

community acquired pneumonia

most common: strep pneumoniae, C pneumonaie, H flu, legionella, viruses

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2
Q

Pt has sore throat + HA + non productive cough + dyspnea? Bug?

A

atypical pneumonia
mycoplasma
chlamydia

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3
Q

Pt has fever + productive cough after being hospitalized how many hrs? Bug?

A

hospital acquired pneumonia
w/in 48hrs
bug: gram neg - e coli, pseudomonas, staph aureus

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4
Q

What are the 2 types of vaccine? When to vaccinate?

A

influenza -

pneumococcal- 65yo+

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5
Q

What PE to expect from community acquired pneumonia?

A

dullness to percussion

egophony

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6
Q

When to order culture for pneumonia?

A

if CXR shows cavitations

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7
Q

What lab to order for pneumonia? What to expect?

A

CXR - consolidations

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8
Q

What type of crackles will be heard with pneumonia?

A

late inspiratory crackles

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9
Q

What type of pulse - temperature indicates atypical pneumonia?

A

normal pulse but high fever

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10
Q

Alcoholic with pneumonia - bug?

A

klebsiella

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11
Q

Immigrant w/ pneumonia -bug?

A

TB

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12
Q

Pt lives in nursing home w/ pneumonia - bug?

A

pseudomonas

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13
Q

Pt has HIV retrosternal chest pain that is worse with inspriation, been going on for weeks? What to expect on CT?

A

pneumocystitis jiroveci

CT- ground glass appearance

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14
Q

How to tx pneumocystitis jiroveci?

A

bactrim

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15
Q

Pt who had organ transplant or renal failure, smokers are at risk for what bug w/ pneumonia?

A

legionella

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16
Q

How to tx community acquired pneumonia? How long?

A

1) macrolide - azithromycin
2) doxycyline
3) fluorquinolones - levofloxacin or macrolide w/ beta
5 days or until afebrile for 48hrs

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17
Q

How to tx hospital acquired pneumonia?

A

fluroquinolone
OR
macrolide + beta lactam

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18
Q

What are complications of pneumonia?

A

pleural effusion

pleural empyema

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19
Q

Where to look for aspirated pneumonia, FB, lung abscess?

A

RIGHT LUNG

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20
Q

What are the bugs for neonatal 0-1mo? -Pneumonia

A

group b strep

e coli

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21
Q

What are the bugs for infants 1-6mo? -Pneumonia

A

chlamydia trachomatis

RSV

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22
Q

What are the bugs for children 6mo-5yo? -Pneumonia

A

RSV

parainfluenza

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23
Q

What are the bugs for children 5-15yo? -Pneumonia

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A

mycolasma pneumonia

influenza virus A

24
Q

What are the bugs for young adults 16-30yo? -Pneumonia

Study These Flashcards
A

mycoplasma pneumoniae

25
What are the bugs for older adults 30yo+? -Pneumonia
strep penum | haemophilus influenzae
26
Common bug if pt is in ICU w/pneumonia?
``` s. pneumoniae legionella H fl Enterobacateriae S aureus pseudomonas ```
27
How to tx ICU pt w/pneumonia?
azithormycin | fluorquinolone + anti pneumoococcal beta lactam
28
How to determine if pt needs to be hospitalized w/pneumonia?
CURB 65 - Confusion - Urea nitrogen, blood >19 - RR >30/min - BP systolic
29
What are the different phases of TB?
early latent progressive
30
What is the most common bug for TB?
mycobacterium tuberculosis
31
What are the different phases of TB?
primary progressive latent
32
What is primary TB?
when TB first enters the lungs and manifests/walls off to make their home --> also spreads via lymphatics and blood --> after the first infxn it is not detectable
33
What is secondary TB?
happens when the body is suppressed/weak --> REACTIVATION (b/c the body had it's first infxn with primary TB) --> actually shows SIGNS and SX of TB --> manifests where the lungs have the MOST O2 (apical parts of the lungs)
34
What are sx of TB?
``` fever night sweats wt loss malaise dry cough --> productive apical rales: post tussive ```
35
What is latent TB?
same as primary - cannot tell if latent or primary b/c it is asymptomatic
36
What are RF for TB?
close contact immigrants HIV
37
What imaging for TB and what to expect?
CXR - upper lob infiltrates w/ cavitations; milary pattern
38
What labs to order for TB?
sputum cultures x3mornings - acid fast
39
What pt may have false positive for mantoux TST?
immigrants that may have BCG vaccination
40
What are the types to screen for TB?
mantoux TST | interferon gamma release assay
41
How to read the mantoux TST? Who does this apply to?
5mm- HIV , close contact with TB 10 mm - foreign born, IV drug users, children, homeless, prisoners, health care workers 15mm - never been exposed to health settings, NO RF
42
How to tx TB?
4 drug therapy- RIPE 1) Rifampin 2) Isoniazid 3) Rifampin 4) Ethambutol
43
Pt has sudden onset of fever+ chills + HA + nonproductive cough + sore throat + photophobia? Tx?
influenza supprotive zanamivir (do not use in asthma) /oseltamivir - antiviral very ineffecctive
44
Sx for mononucleosis? Bug?
flu like sx + splenomegaly + maculopapular rash + petechaie | EBV
45
How to dx mononucleosis?
monospot
46
How to tx mononucleosis?
supportive
47
When does a cough need further investigation?
3mo
48
Pt has rhinorrhea, myalgias, HA, fever, cough - yellow sputum? Is this viral or bacterial?
viral NO yellow pustum
49
What sx for bacterial URI?
fever, cough, yellow sputum
50
Pt has cough after URI? Tx?
acute bronchitis | supportive, +/- bronchodilators, codeine
51
What URI bug for acute bronchitis?
influenza A, B
52
What is common cold called?
acute rhinosinusitis
53
What bugs for acute rhinosinusitis?
rhinoviruses | coronavirus
54
What are sx of influenza?
fast on fast off systemic sx dec and resp incr fever, HA, chills, mayalgia, photophobia
55
Tx of influenza? Complication?
zanamivir - NOT for asthmatics

WHOLE PT (19 decks)

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