Pulmonary Flashcards
(210 cards)
1
Q
what is atopy
A
wheezing, eczema, and seasonal rhinitis
2
Q
what is the pathophysiology of ASTHMA
A
it is an overproduction of IGE which results in there beta 2 receptors.
This leads to inflammation and mucus production and bronchial smooth muscle contraction
3
Q
Clinical features of asthma
A
FEV1/FVC
4
Q
what is bronchitis
A
infection and inflammation of the bronchial tree
there is also mucous formation
5
Q
what is the most common cause of bronchitis
A
80% viral
6
Q
who is at risk of acute bronchitis
A
smokers, COPD, DM and immunocompromised
7
Q
what test should you order for acute bronchitis and why
A
cxr to rule out pneumonia
8
Q
how do you treat acute bronchitis
A
albuterol and an antitussive and hydration
9
Q
what is the most common infection with cystic fibrosis
A
pseudomonas
10
Q
what is the etiology of COPD
A
smoking
it can also be due to alpha 1 antitrypsin
11
Q
what pattern is seen on PFT in a patient with COPD
A
FEV1
12
Q
what is the pattern for PFT in a patient with restrictive pattern
A
FEV1 is normal or slight decreased
FVC decreased more than FEV1
FEV1/FVC ratio is increased
TLC is decreased
13
Q
people with emphysema are know as
A
pink puffers
they are thin due to increased energy expenditure during breathing
patient tend to lean forward
Patients have a barrel chest increased AP diameter
accessory muscle use
14
Q
people with chronic bronchitis are know as
A
blue bloaters
they are over weight and cyanotic due to hypercapnia and hypoxemia
chronic cough and sputum production
15
Q
what is bronchiectasis
A
irreversible dilation of the airways due to inflammatory destruction of the airway walls
Secondary infection with Pseudomonas aeruginosa
16
Q
etiology of bronchiectasis
A
Cystic fibrosis most common Mechanical obstruction, tumor, mucus Infectious, TB, Pneumonia, MAC hypogammaglobulinemia Chronic aspiration
17
Q
signs and symptoms of bronchiectasis
A
chronic cough mucopurulent sputum (foul smelling)
hemoptysis due to rupture of blood vessels near bronchial walls
wheezing
digital clubbing
recurrent or persistent pneumonia
18
Q
how is bronchiectasis diagnosed?
A
High rest CT
PFT shows obstructive pattern
CXR is normal in most cases
19
Q
what is the treatment for bronchiectasis?
A
Abx for acute exacerbations Bronchial hygiene hydration chest PT Bronchodilators
20
Q
what is Cystic Fibrosis
A
defect in chloride channel protein causes impaired chloride and water transport which leads to thick viscous secretions in the respiratory tract, exocrine pancreas, sweat glands, intestines and GU
21
Q
who is affected by CF
A
autosomal recessive condition predominantly affecting caucasians
22
Q
what happens with patients who have CF
A
typically get obstructive lung disease with chronic pulmonart infections (pseudomnonas), pancreatic insufficiency and other GI problems
23
Q
what is the treatment for CF
A
pancreatic enzyme replacement, fat soluble vitamins, chest PT, vaccinations for influenza and pneumococcal and ABX for infections
24
Q
what is emphysema
A
permanent enlargement of air spaces distal to terminal terminal bronchioles due to destruction of alveolar walls from protease.
Elastase is released from PMN and macrophages and digest human lung. This is inhibited by alpha1-antitrypsin
25
what is the pathogenesis of chronic bronchitis
excess mucus production narrows the airways; patients often have a productive cough
Inflammation and scarring of the airways, enlargement in mucous glands and smooth muscle hyperplasia lead to obstruction
26
signs of COPD
```
prolonged forced expiratory time
during auscultation, end expiratory wheezes on forced expiration, decreased breath sounds and inspiratory crackles
Tachypnea, Tachycardia
Cyanosis, accessory muscle use
hyperresonance on percussion
signs of cor pulmonale
```
27
How is COPD diagnosed
with PFT i s definitive diagnostic test
Decreased FEV1 and Decreased FEV1/FVC ratio
Increased total lung capacity and functional reserve capacity (indicates air trapping)
28
```
Obstructive lung disease
FEV1, FEV1/FVC
PEFR, Residual volume
TLC
Vital lung capacity
```
```
FEV1-low
FEV1/FVC-low
PEFR-Low
Resid Vol-High
TLC-High
Vital cap-low
```
29
```
Restrictive lung disease
FEV1, FEV1/FVC
PEFR, Residual volume
TLC
Vital lung capacity
```
```
FEV1-normal to slightly low
FEV1/FVC-normal to high
PEFR-Normal
Resid Vol-low,norm,high
TLC-low
Vital cap-low
```
30
CXR in COPD
low sensitivity fir diagnosing COPD
Hyperinflation, flattened diaphragm and enlarged retrosternal space
decreased vascular markings
Useful in acute exacerbation to rule out pneumonia
31
what is the most important intervention for COPD
smoking cessation
| it prolongs survival rate but does not reduce it to the level of someone who has never smoked.
32
what two interventions for COPDers has lowered mortality
smoking cessation and oxygen therapy
33
what is the treatment of COPD
```
-Inhaled Beta2-agonists (albuterol)
long active agents like salmeterol
Inhaled
-anticholinergics like ipatropium bromide
-combo of albuterol and ipatropium
-Inhaled steroids like fluticasone or budesonide
-Theophylline
-O2 therapy
-vaccination influenza and pneumococcal
```
34
what is contraindicated in COPD and asthma as far as medication goes?
beta blockers because they can mask brochospam
35
what is the criteria for continuous or intermittent long term oxygen therapy in COPD
PaO2 55mm HG
or
O2 sat
36
acute COPD excerbation definition
a persistent increase in dyspnea not relieved with bronchodilators
Increased sputum production are common
37
what is first line treatment in acute COPD excerbation
Broncodilator alone or in combo with anticholinergic
| supplemental O2 to keep
38
When do you use systemic steroid in a COPD exacerbation
for patient requiring hospitalization usually methylprednisolone
DO Not use inhaled steroid with acute exacerbation
39
asthma triad
1. air way inflammation
2. Airway hyperresponsiveness
3. reversible airflow obstruction
40
when does asthma start?
can start at any age
41
extrinsic asthma
patients are atopic produce immunoglobulin E to environmental antigens
May be associated with eczema and hay fever
42
intrinsic asthma
not related to atopy or environmental factors
| triggers include pollen, house dust, mold and cockroaches, cats, dogs, cold air, tobacco smoke
43
clinical features of asthma
intermittent SOB, wheezing, chest tightness, and cough
Symptoms are worse at night
Wheezing during inspiration and expiration
44
how is asthma diagnosed
PFT
they will show a obstructive patter
Decrease in FEV1, and FEV1/FVC
Spirometry before and after bronchodilator can confirm diagnosis by proving reversible air way obstruction
If there is an increase in FEV1 or FVC by at least 12% it is considered reversible
45
```
Peak Expiratory flow rate
Normal
mild
mod-sev
severe
```
norm:450-650
mild>300
mod-sev:100-300
sev
46
what is bronchoprovocation test
used when asthma is suspected but PFT are nondiagnostic.
| measures lung function before and after inhalation of mathacholine
47
what is the most common finding of asthma on CXR
normal
can show hyperinflation
48
ABGs in asthma
should be considered if patient is in significant respiratory distress
Hypercarbia is common
49
what id the PaCO2 is normal or increased
respiratory failure may ensue.
When respiratory rate is increased that should cause PaCO2 to decrease but Increased PaCO2 is a sign of respiratory muscle fatigue or severe air way obstruction.
Pt should be hospitalized and mechanical vent should be considered
50
what is the treatment for acute attacks
albuterol inhaler onset is 2 to 5 minutes and last 4to6 hours
51
what is the treatment of acute severe asthma excarbation?
```
Inhaled beta2 agonist via MDI or neb
assess patients response to bronchodilators with peak expiratory flow and clinically
Corticosteroids
third line agenst include iv magnesium
supplemental O2 to keep sats >90%
```
52
intermittent asthma symptoms and night time symptoms
rescue med usage
interfere with normal activity
symptoms
53
```
severe persistent asthma
sypmtoms
night symptoms
rescue med use
interfer activity
lung function
```
```
symptoms
throughout the day
night
7times/week
rescue med use
several time/day
activity inter
extereme
FEV1
```
54
```
Mild persistent asthma
symptoms
night symptoms
rescue med use
activity interfe
lung function
```
```
symptoms
>2days/week
night symptoms
3-4 times/month
rescue med use
> 2 days/week but not daily
activity interference
minor
```
55
what are typical cardiopulmonary pattern in restrictive lung disease
RVH
RAD
right heart strain pattern
56
what is the key to pnemoconosis?
exposure
57
what are the types of pneumoconiosis related to environmental exposure
Asbestosis (ships, insulation, pleural plaquing)
Silicosis (sandblasting, foundry work
Black lung coal miners lung
58
Interstitial lung disease with granulomas
Sarcoidosis
Histocytosis
Wegners's granulomatosis
churg-strauss
59
alveolar filling disease
good pasture
Idopathic hemosiderosis
alveolar proteinosis
60
what is sarcoidosis?
non infectious granulomatous disease
90% lung involvement
they are noncaseating granulomas
61
who does sarcoidosis usually affect?
young to middle age
62
what is the work up for sarcoidosis and what do the results look like
```
Leukopenia, eosinophilia
Hypercalcemia/hypercalciureia
Increased ESR/CRP
+RF
Increased serum ACE
```
63
what does a CXR look like for sarcoidosis
nodular lesions with bilateralhilar lymphadenopathy
64
how is sarcoidosis dxed
transbronchial biopsy
65
what is the treatment for sarcoidosis
steroids only for symptoms
| most cases resolve or significantly improve in 2 years
66
what is erythema nodosum
is a reddish painful tender lumps commonly located on the front of legs below the knees
found in sarcoidosis
67
what are symptoms of sarcoidosis
```
anterior and posterior uveitis
erythema nodosum
conjunctivitis
heart arrhythmias
bells palsy
```
68
what do PFT look like for sarcoidosis
decreased VC and TLC decreased diffuse lung capacity
| decreased FEV1/FVC
69
what is asbestosis?
diffuse interstitial fibrosis of the lung caused by inhalation of asbestos fibers
70
when does asbestos develop
15 to 20 years after exposure
71
what does asbestos look like on a CXR
honey combing with pleaural plaques
| hazy infiltrates with bilateral linear opacities
72
what causes silicosis
exposure to sandblasting, mining, stone cutting and glass manufacturing
73
What are people who have silicosis at risk of getting
TB
74
What does silicosis look like on CXR
egg shell calcifications
| localized and nodular peribronchial fibrosis most common in upper lobes
75
what is the treatment for silicosis
removal from exposure
76
what causes berylliosis?
exposure to beryllium from fluorescent lightbulbs and aerospace engineering
77
how is berylliosis diagnosed
beryllium lymphocyte proliferation test
78
how is berylliosis treated
steroids
79
what causes idiopathic pulmonary fibrosis
its unknown
80
what is the presentation of IPF
gradual onset of progressive dyspnea, nonproductive cough
81
what is the mean survival of ITP
3-7 years
82
what does the CXR look like with IPF
ground glass or honeycomb or normal
83
how is IPF diagnosed
open lung biopsy
84
what is the treatment of IPF
no effective treatment but supplemental oxygen, steroids and lung transplant have shown to be beneficial
85
what is acute respiratory failure?
when there is inadequate oxygenation of blood or ventilation or both
86
hypoxia is defined as
PaO250mm hg
87
hypercapnia is defined as
PCO2>50
88
how is ARDS diagnosed
hypoxemia that is refractory to oxygen therapy ratio of PaO2/FiO20.5
89
what are the causes of ARDS
Sepsis most common
trauma
overdose
near drowning
90
what does pertussis look like under a microscope
gram negative coccobacillus
91
how is pertussis diagnosed
clinical suspicion
| patients will have severe or prolonged cough or post tussive vomiting
92
how are kids treated who have pertussis
supportive therapy and hospitalization
| Positive tests are
93
how are adults treated
azithromycin or clarithromycin
Tdap booster
Vaccinate pregnant women
94
what are the two types of lung cancers
Small Cell lung cancer
| Non-small cell lung cancer
95
which lung cancer is more common?
non-small cell
96
non small cell cancer involves which cancers?
squamous cell
adenocarcinoma
large cell
bronchoalveloar cell carcinoma
97
what are risk factors for lung cancer?
```
Cigarette smoke accounts for >85%
2nd hand smoke
Asbestos
Radon
COPD
there is a linear relationship between pack years and risk of lung cancer
```
98
when cancer has the lowest association with smoking of all lung cancers
adenocarcinoma
99
how is NSCLC staged
TNM system
100
how is SCLC staged
Limited- which is confined to chest plus supraclavicular nodes but not cervical or axillary
Extensive which is outside of the chest
101
what symptoms are most common of squamous cell
cough, hemoptysis, obstruction, wheezing and dyspnea
| recurrent pneumonia
102
what are lung cancer constitutional symptoms?
anorexia, weight loss, weakness
103
What do symptoms of local invasion by lung cancer present like
1. superior vena cava syndrome which cause facial fullness, face and arm edema, dilated veins over the anterior chest and arms
2. Phrenic nerve palsy causing hemidiaphtagmatic paralysis
3. Hoarsness
4. Horners Syndrome lack of sweating, ptosis and miosis
5. Pancoast tumor causes shoulder pain upper extremity weakness and horners syndrome
104
what is the treatment for NSCLC?
Surgery is the best option
you need to make a definitive pathological diagnosis before surgery
If patient has metastatic disease they are not candidates for surgery
Radiation is important adjunctive therapy
105
what is the treatment for SCLC for limited disease
chemo and radiation are initially used
106
what is the treatment for SCLC for extensive disease
chemo alone is used as initial tretment
107
what features favor a benign vs malignant nodules
Age- the older the patient the more likely it is to be malignant 50% chance over age 50
Smoking- smokers have higher risk of malignancy
Size of nodule- larger the nodule the more likely it is to be malignant >2cm
Borders- malignant nodules have more irregular borders
Calcifications-eccentric asymmetric calcification suggest malignancy. Dense central calcification suggest benign
Change in size
108
what cancers are usually peripherally located
Adenocarincoma
| Large cell carcinoma
109
which lung cancers are centrally located
SCLC
| Squamous
110
A person presents with flushing, diarrhea and bronchospasm. What type of cancer do they have
the person has pulmonary carcinoid
they are presenting with carcinoid syndrome
111
what is a pleural effusion?
fluid in the plural space
112
what are symptoms of pleural effusion
SOB
cough
chest pain
113
what are signs of pleural effusion
decreased air entry
dullness
wheezes and crackles
114
what does a pleural effusion look like of a CXR
meniscus
blunting of costophrenic angle
Bilateral pleural effusion would be more likely CHF
115
what causes transudative effusion
due to either elevated capillary pressure in visceral or parenteral pleura or decreased plasma oncotic pressure
116
what causes a exudative effusion
causes by increased permeability of pleural spaces
117
what should you do if you suspect a exudative effusion
test pleural fluid for cell count, glucose, pH, amylase, triglycerides
118
what is found in exudative effusions?
Protein >0.5
LDH>0.6
LDH> 2/3 upper limit of normal serum LDH
119
what is the most common cause of a Pleural effusion
CHF
120
what causes exudative effusions
Malignancy
Bacterial Pneumonia
Viral infection
Pulmonary embolism
121
```
what will the results of
Protein
LDH
Glucose
look like in exudative effusions
```
Protein-high
LDH-high
glucose-low because bacteria and cells are in the fluid and are using the glucose
122
```
what will the results of
Protein
LDH
Glucose
look like in transudative effusions
```
Protein-low
LDH-low
glucose-high
123
how are exudative effusions treated
surgical drainage or removal
124
how is transudative effusions treated
drugs
125
causes of transudative effusions
CHF
Cirrhosis
Nephrotic syndrome
Peritoneal dialysis
126
what does a bilaterally effusions suggestive of
CHF
127
isolated left sided pleural effusion
pneumonia, cancer, boerhaave (esopaheal) rupture
| aortic dissection
128
lsolated right sided effusion
pneumonia, cancer, CHF, PE
129
what is a parapneumonic effusion
pleural effusion in the presence of pneumonia
| this can lead to
130
what is a pneumothorax
air in the pleura space
131
what causes a traumatic pneumothorax
iatrogenic
always get CXR after the procedure of Transthroacic needle aspiration
thoracentsis
central line placement
132
what causes a spontaneous pneumothorax
occurs with out any trauma
133
what is a primary simple pneumothorax
occurs in a healthy individual without any underlying lung disease
which is causes by bleb ruptures into pleural space
common in tall young men
134
what is secondary complicated pneumothorax
occurs as complication of underlying lung disease COPD, asthma, TB
135
what are symptoms of pneumothorax
ipsilateral chest pain with sudden onset
dyspnea
cough
136
what are physical signs of pneumothorax
decreased breath sounds over affected side
hyperresonance over chest
decreased or absent tactile fremitus on affected side
mediastinal shift towards side of pneumothorax.
137
what is the treatment for a primary pneumothorax
if small pneumothorax and patient is asymptomatic:
Observation and should resolve in 10days
If larger pneumo administer supplemental oxygen
chest tube insertion
138
what is the treatment for secondary pneumo
chest tube and drainage
139
what is a tension pneumothorax
accumulation of air within the pleural space that tissues surrounding the opening to the pleural cavity act as a valve and allow air to enter but not escape
140
what causes a tension pneumothorax
Mechanical ventilation
CPR
Trauma
141
what are clinical features of tension pneumothorax
hypotension
distended neck veins
shift of trachea away from tension pneumo
decreased breath sounds on affected side
hyperresonance to percussion on side of pneumo
142
how is tension pneumothorax treated
treated as medical emergency due to hemodynamic compromise
| large bore needle in second or third intercostal space MCL followed by chest tube placement
143
what is pulmonary hypertension
mean arterial pressure greater than 25 mmHg at rest of 30mm Hg during exercise
144
how is pulm hypertension diagnosed
ECG shows right ventricle hypertrophy
echo will show dilated pulmonary artery
dilation and hypertrophy of RA and RV
Right heart Cath
145
how is pulm HTN treated
oxygen
vasodilators (sildenafil, epoprstenol) CCB
anti coagulation
lung transplant
146
what is primary pulmonary hypertension
HTN in the absence of disease of heart and lung
147
what establishes the diagnosis of primary pulm htn
cardiac cath
148
what is Cor pulmonale
RVH with eventual RV failure from pulmonary HTN secondary to pulmonary disease
149
what is the most common cause of Cor pulmonale
COPD
150
what are signs of Cor pulmonale
decreased exercise tolerance
cyanosis and digital clubbing
JVD, hepatomegaly, edema
151
how is cor pulmonale diagnosed
CXR will show enlargement of RA,RV and pulmonary arteries
ECG will show right axis deviation, Peaked P waves, RVH
ECho RVH dilitation but normal LV size and function
152
treatment for cor pulmonale
treat pulmonary disorder
use diuretic cautiously
long term oxygen
153
what is a pulmonary embolism
occurs when a thrombus in another region of the body embolizes to the pulmonary vascular tree via RV and pulmonary artery
154
what are risk factors for DVT
```
age >60
malignancy
prior DVT/PE
cardiac disease
obesity
trauma/surgery
pregnancy/estrogen use
```
155
sypmtoms of PE
```
dyspnea
pleuritic chest pain
cough
hemoptysis
syncope
```
156
signs of PE
```
tachypnea
rales
tachycardia
S4
Increased P2
shock
low grade fever
```
157
what do ABGs look like on a patient with a PE
PaO2 low
| PaCO2 low and pH is high
158
what does the A-a gradient look like in a PE
increased A-a gradient
| Low pO2 despite high FiO2
159
how to diagnosed a PE if low suspicion
D dimer
if negative PE ruled out
if positive then do a CT-PA
160
how to diagnose a PE if high suspicion
CT PA if positive PE ruled in
| CT PA negative consider U/S VQ scan
161
causes of elevated D-dimer
```
aortic dissection
MI
Preg
surgery
trauma
infection/inflammation
```
162
treatment for PE
oxygen to fix hypoxemia
anticoagulation therapy start immediately if suspicion is high
give a bolus followed by continuous infusion for 5 to 10 days with a goal INR of 1.5-2.5
start warfarin on day 1 and continue for 3 to 6 months or more
thrombolytic therapy
Inferior vena cava filter if anticoag is Contraindicated
163
which lung is most commonly involved with pulmonary foreign body
the right lung because of the anatomy where the right bronchus is more straight
164
how does foreign body aspiration present?
some develop acute respiratory distress
most often patient appear well but later develops respiratory disfunction
SOB, fever, tachypnea, hypoxemia
165
how is a foreign body diagnosed?
CXR
166
what are symptoms of TB
cough, weight loss, fatigue, fever, night sweats, chest pain, hemoptysis
typically happens over weeks
167
how does primary TB show up on CXR
homogeneous infiltrates, hilar/paratracheal lymph nose enlargement, segmental atelectasis, cavitations with progressive disease
168
what does reactivation TB look like on CXR
fibrocavitiy apical disease, nodules, infiltrates, posterior apical segment of the right upper lobe
169
what is a gohn complex
calcified primary focus
170
what is a ranke complex
calcified primary focus and calcified hilar lymphnodes represent healed infection
171
how is TB diagnosed
identification of Mycobacterium tuberculosis from cultures or by DNA or RNA amplification techniques
172
what is the histological hallmark of TB
caseating granulomas
173
what is the treatment for active TB
```
RIPE
Rifampin, Isoniazid, Pyrazinamide, ethambutol
for 2 months
then
RI
for 4 months
watch LFTs
```
174
what are the side effects of Isoniazid
hepatitis, peripheral neuropathy
175
side effects of Rifampin
hepatitis, flu, orange body fluid
176
side effects of ethambutol
red-green vision loss
177
a PPD is considered positive at >5mm for what patients?
HIV positive person
Recent contact with active TB carrier
Person with evidence of TB on CXR
Immunocompromised on steroids
178
a PPD is considered positive at >10mm for what patients?
recent immigrants from high TB areas
HIV neg injection drug users
mycobaerioogy lab peopel
residents and employees in high risk settings
Pts with certain med conditions like DM, sillicosis
179
a PPD is considered positive at >15mm for what patients?
people with no risk factors
180
what is the Bacille Calmette guerin
vaccine administered to a Tb neg person in cases with high risk for intense prolonged exposure
181
what is the most common cause of respiratory disease in preterm infant
hyaline membrane disease
182
what causes hyaline membrane disease
deficiency in surfactant
183
how is hyaline membrane disease treated
intermitten ventilation
| exogenous surfactant
184
how does hyaline membrane disease present
rapid labored breathing, grunting, retractions, fast heart rate
185
what is community acquired pneumonia
occurs in community or within first 48-72 hours of hospitalization
186
what is the most common CAP
streptococcus pneumonia
187
what is nosocomial pneumonia
occurs during hospitalization after first 48-72 hours
188
what is the classic presentation of CAP
sudden chill followed by fever pleuritic chest pain and productive cough
crackles
increased tactile fremitus
189
what is the presentation of atypical pneumonia
sore throat, headache followed by nonproductive cough and dyspnea
low to no fever
less severe lung exam
190
which bacteria are the typical bugs
```
SHaKeM
Strep pneumo
Haemophilius infl
Klebsiella
Moraxella
```
191
which bugs cause atypical pneumona
```
MC LIRP
Mycoplasma
Chlamydophilia
Legionella
RSV
parainfluenza
```
192
what are the two recommendation to prevent pneumonia
Flu shot
| pneumococcal vaccine
193
who should receive pneumococcal vaccine
patients >65
young patients with high risk like heart disease, sickle cell, pulmonary disease, diabetes, alcoholic cirrhosis and asplenic individual
194
how is pneumonia diagnosed
PA and Lateral CXT
195
when do you admit a patient with CAP
hypotension
| hypoxic
196
how is CAP treated
patients with out comorbid conditions are treated with azithromycin or clarithromycin
If comorbid condition treat with fluroquinolone
197
what is the treatment for HAP
cephalosporins with pseudomonal coverage
ceftazidome or cefepime
carbapenems: imipenem
pipercillin/tazobactam
198
how is ventilator pneumonia treated
Ceftazidime or cefepime
Or zosyn or inapenem
aminoglcoside or fluroquinolone
vanco or linezolid
199
what antivirals are used for the flu
zanamivir or oseltamivir
200
what type of pneumonia are HIV patients at risk for
PCP
| pneumocystis jiroveci
201
what is the treatment for PCP
bactrim
202
what is the most common pneumonia in HIV patients
Strep pneumo
203
patient has rust colored sputum rigors, high WBC,
strep pneumo
gram positive encapsulated diplococci
204
elederly, alcoholic with COPD, currant jelly sputum
klebsiella
205
pneumonia seen in COPD, smokers, elderly
Haemophilus influenza
gram neg encapsulated coccobacillus
206
patients invaded with plastic like nursing home, G-tube/ET tube, CF, hot tubs
pseudomonas
gram neg coccobacillus
207
neonate with staccato cough
chlamydophilia
208
sick old men, COPD, out breaks associated with air conditioning
Legionella
209
alcoholics have high risk of aspiration with abscess formation
Anaerobic
210
flea from rodents can cause this pneumonia
yersinia pestis
