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Pulmonary Infectious Diseases Flashcards

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1
Q

Self limiting clinical condition caused by acute inflammation of trachea and bronchi usually secondary to infectious process

Very common

A

Acute Bronchitis

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2
Q

Acute bronchitis cough typically lasts how long?

A

10-20 days

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3
Q

Indications for CXR in patients with an acute cough syndrome to exclude pneumonia are:

A

Abnormal vital signs: P>100/min, RR >24, T >38 degrees C

Pulmonary exam findings

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4
Q

Nonspecific inflammation of terminal bronchioles (small, 2mm
airways)

Viral inflammation of bronchioles in infants and young children causing airway obstruction

A

Acute Bronchiolitis

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5
Q

What virus is most commonly responsible for acute bronchiolitis?

A

RSV

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6
Q

When to hospitalize in acute bronchiolitis?

A

<2 months old
Hypoxemic on room air (<95%)
Significant feeding difficulty due to tachypnea
Marked respiratory distress
dehydration

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7
Q

an inflammation/infection of the pulmonary parenchyma (the structure of the lung)

May involve only interstitial tissue or alveoli, alveoli and adjacent bronchi, or even entire lobe

A

Pneumonia

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8
Q

What is the #1 most deadly infectious disease in the United States?

A

Pneumonia

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9
Q

What are the most common agents in infants who develop pneumonia?

A

Viruses

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10
Q

What are the most common agents in children who develop pneumonia?

A

Mycoplasma pneumoniae

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11
Q

What are the two classifications of pneumonia?

A

Community Acquired Pneumonia (CAP)

Hospital Acquired Pneumonia

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12
Q

What are the two types of community acquired pneumonia?

A

Classic CAP
Atypical CAP

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13
Q

What is the most common pathogen in classic CAP?

A

Streptococcus pneumonia

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14
Q

What is the most common pathogen in atypical CAP?

A

Mycoplasma pneumonia

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15
Q

Mnemonic to remember CAP pneumonia organisms – SHAM

A

S – Streptococcal pneumonia
H – Haemophilus influenzae
A – Atypicals
M – Moraxella catarrhalis

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16
Q

Which organism is common in patients with underlying obstructive lung disease (ex: COPD)?

A

H. influenzae

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17
Q

Which type of CAP is more commonly seen in young
healthy adults?

A

Atypical CAP

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18
Q

What symptom is a common complaint with children who have pneumonia?

A

Abdominal pain

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19
Q

Which pathogen should you suspect with single rigor and rust colored sputum?

A

Streptococcus pneumoniae

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20
Q

Which pathogen should you suspect with currant jelly sputum and is seen more often in alcoholics?

A

Klebsiella pneumoniae

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21
Q

What pathogen do you see more often in alcoholics?

A

Klebsiella pneumoniae

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22
Q

Bullous myringitis is associated with which CAP pathogen?

A

Mycoplasma Pneumoniae

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23
Q

Which medication is a good selection in smokers with community acquired pneumonia?

A

Clarithromycin

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24
Q

Atypical CAP do not respond to which classes of medication?

A

PCNs and Cephalosporins

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25
What is the first line medication class for atypical CAP?
Macrolides
26
Treatment of Pneumonia - Children < 5 years old first line medication class?
Amoxicillin or Augmentin
27
Treatment of Pneumonia - Children > 5 years old first line medication class?
Macrolides
28
Most common cause of death from nosocomial infection
Hospital Acquired Pneumonia
29
Second most common type of nosocomial infection
Hospital Acquired Pneumonia
30
What are the most common agents in hospital acquired pneumonia?
Staph aureus (MRSA) Pseudomonas
31
Which pathogen in hospital acquired pneumonia has the worst prognosis?
Pseudomonas
32
What is the most common pathogen in HIV-related pneumonia?
Pneumocystic jiroveci
33
What is the treatment for aspiration pneumonia?
Clarithromycin
34
Method to assess severity of pneumonia and need for hospitalization
Pneumonia Severity Index 🡪 PORT Score
35
Empyema with thick purulent fluid is hallmark of which pathogen?
Staph pneumonia
36
Number one cause of adolescent pneumonia is what pathogen?
Mycoplasma pneumonia
37
Slow growing, obligate intracellular pathogen Acid-fast bacillus
Tuberculosis
38
What pathogen is responsible for Tuberculosis?
Mycobacterium tuberculosis
39
How is TB transmitted?
Transmitted by airborne droplets
40
What are some common risk factors for TB infection?
Impaired immunity (host factors) Increased exposure
41
Occurs when an individual becomes infected but does not become acutely ill These macrophages contain the mycobacterium but doesn’t necessarily eradicate it and this is known as
latent TB infection
42
This is another manifestation of primary TB infection that is very aggressive
Miliary Tuberculosis
43
Now used to denote all forms of progressive, widely disseminated hematogenous TB (even if classical pathologic or radiologic findings are absent)
Miliary Tuberculosis
44
What is the most common extrapulmonary TB manifestation?
TB Lymphadenitis
45
Spinal TB is also called what?
Pott’s disease
46
Which is a good TB screening test good for diagnosis on individual as long as their immune system is intact?
Mantoux (purified protein derivative- PPD)
47
What does the Mantoux (purified protein derivative- PPD) test evaluate for?
Evaluates both latent and active TB, but can’t distinguish between them
48
PPD Test injects how much intradermally?
5 tuberculin units or 0.1mL intradermally in forearm raising a wheal 6-10mm in diameter
49
When do you read a PPD test? What are you looking for?
Read within 48-72 hours, looking for induration diameter (measure)
50
Does a negative reaction rule out TB? If not, why?
a negative reaction does NOT rule out TB Some patients immunocompromised and won’t mount a response
51
the inability to react to skin test because of immunosuppression
Anergy
52
Skin testing is no longer recommended for whom?
those who develop anergy - false negatives BCG vaccine - false positives
53
Two step testing is used for initial TB testing of individuals who will be tested annually such as?
healthcare workers
54
What vaccine has variable effect on TB skin test?
BCG vaccine
55
≥5mm is a positive PPD test in which individuals?
HIV positive Contacts of individuals with active TB Persons with CXR consistent with old healed TB Organ transplants Immunocompromised patients High dose long term steroids
56
>10mm is a positive PPD test in which individuals?
Military Recent immigrants (<5years) from high risk countries (Asia, Africa, Latin America) IV drug users Mycobacteriology lab personnel Residents/employees of high risk congregate settings (nursing homes, prison, homeless shelters) High risk medical patients (DM, silicosis, renal failure, leukemia, lymphoma, etc) Infants/children (<4 years old) Infants, children, adolescents exposed to adults at high risk
57
>15mm is a positive PPD test in which individuals?
Everyone else – patients with no TB risk factors
58
Acid-fast bacilli on stain of sputum should make you think of what disease?
tuberculosis
59
If a patient is positive for TB, what other disease do you need to work up the patient for?
HIV
60
If you are infected with TB and it is active – something will show up on what?
Chest Xray
61
CXR Findings in TB: The primary area of TB infection associated with a lymph node As it calcifies, it becomes visible on a CXR
Ghon Complex
62
CXR Findings in TB: What the Ghon complex turns into after it and the associated lymph node has further calcified – this indicates healing
Ranke complex
63
What is the major cause of treatment failure and drug resistance in TB?
Non-compliance
64
ALL possible or proved cases of TB should be reported to what agency(s)?
local and state public health departments
65
Name the five drugs used to treat TB
Isoniazid Rifampin Pyrazinamide Ethambutol Streptomycin
66
Consider which disease in all HIV-infected patients with undiagnosed pulmonary disease?
TB
67
Properly treated TB patients are usually cured with less than what percentage rate of recurrence?
5%
68
Mycobacterium Avium Complex consists of what?
M. avium M. intracellulare
69
Mycobacterium Avium Complex's common patient populations include
AIDs patients Patients with chronic underlying lung disease (ex. COPD)

Pulmonology (8 decks)

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