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S3 IDIS CP > Pulmonary infections > Flashcards

Pulmonary infections Flashcards

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1
Q

common cold bugs

A

***rhino virus

corona, adeno, echo, coxa/b, flu, paraflu, rsv, mycoplas pneu, human metapneu

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2
Q

common cold keys

A

usually no fever, present in winter months

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3
Q

summer gripe bugs

A

coxA/B, echo, enteroviruses

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4
Q

summer gripe keys

A

cold-like febrile illness in summer

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5
Q

summer gripe presentation

A

non-specific febrile illness w malaise and headache. Sx 3-4 days

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6
Q

viral acute rhinosinu bugs

A

rhino, parainflu, RSV adeno

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7
Q

viral acute rhinosinu keys

A

Sx resolve in 5-7 days

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8
Q

viral acute rhinosinu presentation

A

do i really need to describe this??

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9
Q

bacterial acute rhinosinu bugs

A

**S pneumoniae, non typable H flu

also
anaerobes
g-
s aureus, moraxella, pyogenes

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10
Q

bacterial acute rhinosinu keys

A

adult w mod symptoms >7d, or severe sx develop (facial swelling/tooth pain)

child w mod sx >10-14d or severe (>102, facial swelling, AMS)

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11
Q

bacterial acute rhinosinu presentation

A

mucosal inflammation

sneezing, rhinorrhea, pressue and headache etc

usually follows viral

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12
Q

rhinocerebral mucormycosis bugs

A

***rhizopus, rhizomucor

also mucor, mycocladus, cunninghamella

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13
Q

rhinocerebral mucormycosis keys

A

black eschar of palate

very rare

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14
Q

rhinocerebral mucormycosis presentation

A

rhinosinusitis w bloody nasal discharge, dusky turbinates, AMS

black eschar, abscesses, decreased ocular motion

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15
Q

viral pharyngitis bugs

A

adeno, HSV, EBV, CoxAB

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16
Q

viral pharyngitis keys

A

conjunctivitis, cough, coryza, discrete ulcerative lesions, anterior stomatitis

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17
Q

viral pharyngitis presentation

A

fever, sore throat, edema, hyperemia of the tonsils

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18
Q

bacterial pharyngitis bugs

A

strep pyogenes

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19
Q

bacterial pharyngitis keys

A

complications if untreated– abscess, mastoiditis, cervical lympadenitis

acute glomerulonephritis, rheumatic fever

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20
Q

bacterial pharyngitis presentation

A

fever, sore throat, hyperemia of the tonsils

pyogenes: fever and severe pain, tonsilopharyngeal erthema w or w/o exudate, lymphadenitis. petechiae, scarlet rash, swollen uvula

kids- N/V, abd pain

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21
Q

lemierre’s (post-anginal septicemia) bugs

A

fusobacterium nerophorum

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22
Q

lemierre’s (post-anginal septicemia) presentation

A

sore throat progressing to thrombophlebitis of IJV w pain, dysphagia, neck swelling, stiffness. sepsis in 3-10d after sore throat. can spread to lungs

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23
Q

diphtheria bugs

A

corynebacterium diphtheriae

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24
Q

diphtheria keys

A

pseudomembrane, bleeding upon removal, cervical lymphadenopathy, difficulty swallowing

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25
diphtheria presentation
pharyngeal pain, pseudomembrane, bull neck, fetid breath. airway obstruction and toxemia can occur
26
viral acute pharyngitis bugs
so many bugs: parainflu, flu AB, adeno, RSV, HSV, rhino, coxAB, echo
27
viral acute pharyngitis keys
clinical s/s
28
viral acute pharyngitis presentation
begins as URTI, followed by hoarseness and reduced vocal pitch odynophagia, odynophonia, congestion, fatigue, malaise, laryngeal edema and vascular engorgement of vocal folds
29
bacterial acute pharyngitis bugs
pyogenes
30
bacterial acute pharyngitis keys
+ bacterial culture
31
bacterial acute pharyngitis
same as viral, less common begins as URTI, followed by hoarseness and reduced vocal pitch odynophagia, odynophonia, congestion, fatigue, malaise, laryngeal edema and vascular engorgement of vocal folds
32
viral croup/ laryngotracheobonchitis bugs
parainfluenza type 1 also parainflu2, fluAB, adeno, RSV, HSV, rhino, CoxAB, echo
33
viral croup/ laryngotracheobonchitis key
barking cough, inspiratory stridor and retractions less air hunger after racemic epi or humid air (no effect on bact epiglotitis) steeple sign normal swallow
34
viral croup/ laryngotracheobonchitis presentation
higher fever than laryngitis, restlessness, air hunger starts with mild URTI 2-3 d followed by barking cough, stridor at night normal lungs, maybe mild expiratory wheeze nasal flaring, lethargy, if severe, tachypnea, tachycardia, hypoxemia, hypotonia, cyanosis s/s peak 3-5d, resolve 4-7d
35
bacterial epiglottitis and supraglottitis bugs
H flu B
36
bacterial epiglottitis and supraglottitis keys
difficult swallow distressed, toxic looking thumb sign no response to racemic epi or humid air epiglottitis triad= sore throat with dysphagia, hoarse voice, generally unwell/dehydrated
37
bacterial epiglottitis and supraglottitis presentation
``` acute onset fever, sore throat, cough suprasternal notch retraction and stridor inflamed throat beefy red epiglottis ``` progresses rapidly= severe dyspnea, cyanosis, toxicity four Ds= dysphagia, dysphonia, drooling, distress
38
acute bronchitis bugs
flu AB, paraflu, adeno, RSV, HSV, rhino, CoxAB, echo mycoplas pneumoniae chlamydophilia pneumoniae
39
acute bronchitis keys
clinical s/s | CXR
40
acute bronchitis presentation
non productive cough, substernal pain, fever. rhonchi, moist crackles several hours bf cough= malaise, headache, coryza, sore throat
41
bronchiolitis bugs
RSV
42
bronchiolitis keys
observe s/s, Ag testing in nasal washings CXR= hyperinflation, patchy infiltrate, air trapping, flat diaphragm, peribronchial cuffing
43
bronchiolitis presentation
rhinorrhea, cough, low fever can lead to paroxysmal cough and dyspnea tachypnea, tachycardia, fever, wheezing, grunting, vomiting, cyanosis
44
influenza bugs
flu AB
45
influenza keys
high fever, acute onset, lab confirmation
46
influenza presentation
abrupt onset of fever, chills, rigor, headache, prostration, nonproductive cough, V/D in kids fever abates in 3-4d, cough and malaise persist for 2w can lead to pneumonia w secondary bacteria ie aureus, hflu, strep pneumo, pyogenes
47
pertussis bugs
bordetella pertussis
48
pertussis key
whoop is pathognomonic NP aspirates on bordet gengou medium ELISA, IFS Elevate WBC, lymphocytosis in kids
49
pertussis presentation
catarrhal phase 1-2w: coryza, sneezing, low fever, mild cough paroxysmal phase 2-4 weeks: inspiratory whoop with posttussis vom
50
typical pneumonia bugs
***strep pneumoniae klebsiella, pseudomonas, g-rods
51
typical pneumonia keys
sudden, rigors, toxic looking, productive cough, bloody/purulent sputum, high fever, neutrophils, WBC>15K w L shift
52
purulent vs mucoid sputum
purulent=typical, mucoid=atypical
53
rust vs green sputum
rust = strep pneumo | green =pseudomonas or H flu
54
klebsiella pneumonia
currant jelly bowing fissure w UL consolidation can cause necrosis
55
pseudomonas pneumonia
microabscesses which can coalesce
56
staph aureus pneumonia
bilateral nodular infiltrates w cavitation in kids = pneumatoceles, bronchopleural fistulas, empyema
57
typical pneumonia presentation
``` develop within 24-48 hours high fever shaking chills dyspnea tachycardia flu like symptoms ``` EXCEPTION: neonate afebrile chlamydia trachomatis pneumonia
58
typical pneumonia in CF
pseudomonas or s aureus
59
typical pneumonia in alcohol
klebsiella or oral anaerobe from aspiration
60
typical pneumonia in nursing home
enteric gram neg (enterobacter, klebsiella, e coli)
61
typical pneumonia in copd
H flu, klebsiella
62
typical pneumonia in IV drug user
staph aureus
63
typical pneumonia in elderly or w recent flu
staph aureus
64
typical pneumonia in military, dorm, young people
neisseria meningitidis
65
atypical pneumonia bugs
mycoplasma pneumoniae
66
atypical pneumonia keys
gradual onset, well looking, nonproductive cough, mucoid sputum, low fever, rare pleurisy, rare consolidation sputum: rare mononuclear cells, WBC>15K interstitial infiltrate
67
atypical pneumonia presentation
subacute onset, 1 week to develop symptoms, paroxysmal cough w mucoid/no sputum
68
afebrile pneumonia
neonates, chlamydia trachomatis
69
atypical pneumonia IC
pneumocystis jiroveci
70
aspiration pneumonia presentation
like typical pneumonia, except with recurrent chills consolidations in dependent lung segments 50% have foul sputum increased minute ventilation
71
TB
mycobact tb insidious onset, night sweats, low fever, wt loss, productive purulent cough, dyspnea, coin lesions
72
chronic pneumonia- histoplasmosis bugs
histoplasma capsulatum
73
chronic pneumonia- histoplasmosis presentation
erythema nodosum and hilar adenopathy, fungal pneumonia
74
chronic pneumonia- histoplasmosis keys
yeast cells in PMNs or monocytes when grown in vitro at RT= hyphae and tuberculate macroconidia captains wheel
75
chronic pneumonia coccidioidmycosis bugs
coccidiodes immitis
76
chronic pneumonia coccidioidmycosis presentation
erythema nodosum and hilar adenopathy, fungal pneumonia
77
chronic pneumonia coccidioidmycosis keys
spherule seen in lung material (round with many speckles inside)
78
chronic pneumonia blastomycosis bug
blastomyes dermatitidis
79
chronic pneumonia blastomycosis presentation
fungal pneumonia which may also show verrucous skin lesions
80
chronic pneumonia blastomycosis keys
broad based budding yeast
81
psittacosis bug
chlamydophilia psittaci
82
psittacosis presentation
pneumonia with bradycardia, epistaxis, horder spots (rose spots), low leukocyte count caretakers of birds
83
Q fever bug
coxiella burnetii
84
q fever presentation
pneumonia w bradycardia, hepatomegaly, endocarditis, abnl LFT. farmers with recently birthed livestock
85
legionnaire's disease bug
legionella pneumophilia
86
legionnaire's disease presentation
pneumonia with bradycardia, abd pain, V/D, hematuria, confusion, abl LFT/renal fxn tests, increase CPK

S3 IDIS CP (4 decks)

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