Pulmonary infections Flashcards Preview

S3 IDIS CP > Pulmonary infections > Flashcards

Flashcards in Pulmonary infections Deck (86):
1

common cold bugs

***rhino virus

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

2

common cold keys

usually no fever, present in winter months

3

summer gripe bugs

coxA/B, echo, enteroviruses

4

summer gripe keys

cold-like febrile illness in summer

5

summer gripe presentation

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

6

viral acute rhinosinu bugs

rhino, parainflu, RSV adeno

7

viral acute rhinosinu keys

Sx resolve in 5-7 days

8

viral acute rhinosinu presentation

do i really need to describe this??

9

bacterial acute rhinosinu bugs

**S pneumoniae, non typable H flu

also
anaerobes
g-
s aureus, moraxella, pyogenes

10

bacterial acute rhinosinu keys

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)

11

bacterial acute rhinosinu presentation

mucosal inflammation

sneezing, rhinorrhea, pressue and headache etc

usually follows viral

12

rhinocerebral mucormycosis bugs

***rhizopus, rhizomucor

also mucor, mycocladus, cunninghamella

13

rhinocerebral mucormycosis keys

black eschar of palate

very rare

14

rhinocerebral mucormycosis presentation

rhinosinusitis w bloody nasal discharge, dusky turbinates, AMS

black eschar, abscesses, decreased ocular motion

15

viral pharyngitis bugs

adeno, HSV, EBV, CoxAB

16

viral pharyngitis keys

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

17

viral pharyngitis presentation

fever, sore throat, edema, hyperemia of the tonsils

18

bacterial pharyngitis bugs

strep pyogenes

19

bacterial pharyngitis keys

complications if untreated-- abscess, mastoiditis, cervical lympadenitis

acute glomerulonephritis, rheumatic fever

20

bacterial pharyngitis presentation

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

21

lemierre's (post-anginal septicemia) bugs

fusobacterium nerophorum

22

lemierre's (post-anginal septicemia) presentation

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

23

diphtheria bugs

corynebacterium diphtheriae

24

diphtheria keys

pseudomembrane, bleeding upon removal, cervical lymphadenopathy, difficulty swallowing

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