Respiratory Flashcards
what is the Guidelines for treatment of community acquired pneumonia
Amoxicillin 1 gm three times a day - best evidence
If pt can not take amoxicillin for CAP what should they take
Doxy or a macrolide (azithromycin, clarithromycin)
is an acute infection of the lung in a patient who acquired the infection in the community, not an inpatient or residential facility.
CAP
most common cause of CAP pneumonia is
Mycoplasma Pneumonia
Second most common cause of penumonia is
Strep pneumonia
The most common etiologic agent in pneumonia worldwide is
Steptococcus Pneumoniiae
Clinical evaluation of a patient with suspected pneumonia always begins with
clinical examination and chest X-ray.
what is the gold standard of diagnosis of Pneumonia
presence of an infiltrate
device that measures the amount of air you breathe in and out.
spirometry
what age needs to be hospitalized for CAP
under 3 months
measures maximum speed of expiration.
peak expiratory flow rate
Most commonly viral infection that causes inflammation of the bronchial tubes= mucous production inside causing narrowing of airways.
acute bronchitis
Presentation of acute bronchitis
Sudden onset of dry or productive (light colored sputum) paroxysm cough that keeps person up at night, may have low grade fever, mild wheezing, may have chest pain. Can last 4-6 weeks. Objective findings: lungs clear to severe wheezing, percussion is resonant, CXR benign.
acute bronchtitis tx is
Symptomatic management: ↑fluids, ↑rest, stop smoking, antitussives, expectorant, albuterol for wheezing.
Reversible airway obstruction caused by chronic inflammation of the bronchial tree.
asthma
w/inspiration, systolic BP drops due to ↑ pressure.
pulsus paradoxus
Loss of elastic recoil of the lungs and alveolar damage that takes decades, results in hyperinflation of the lungs.
Emphysema
Presentation of emphysema
Weight loss, barrel chested, pursed-lip breathing, hx heavy smoker, SOB on exertion, chronic productive cough, large amounts of light-yellow sputum.
* Percussion with hyperresonance, decreased tactile fremitus and egophony.
CXR: flattened diaphragms with hyperinflation.
An acute infection in which bacteria attach to the cilia of respiratory epithelial cells, causing inflammation that inhibits clearance of secretions. In an effort to clear secretions, affected patients exhibit violent bursts of coughing with a characteristic “whooping” sound.
pertusis
Pertussis has three stages:
tage 1: Catarrhal (1-2 weeks)
Insidious onset of nonspecific upper respiratory symptoms: nasal congestion, rhinorrhea, sneezing, and mild cough
Malaise, conjunctival suffusion, lacrimation, low-grade or no fever
Stage 2: Paroxysmal (2-8 weeks, up to 10 weeks)
Coughing spells increase in severity in the first 2 weeks and become violent, frequent, and spasmodic. The coughing spells can remain intense for up to a month before gradually lessening. Episodes of coughing may last several minutes
Cough may be more prominent at night
Posttussive vomiting is common and a sensitive and specific finding for pertussis
Stage 3: Convalescent (8-12 weeks)
Cough subsides and disappears over weeks to months
The characteristic cough can return up to several months later if another upper respiratory infection is acquired
leukocytosis (15,000-50,000/mL) with absolute lymphocytosis occurs during what in pertussis
late stage of one and two
