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Flashcards in Respiratory 2 Deck (58):
1

what is the average incubation period for URIs?

1-5 days

2

how long does viral shedding occur w/ URI

3 weeks

3

what eye condition is often seen with URIs?

Conjunctivitis

4

is it common for a URI to become pneumonia

no

5

does mucus color or lymph nodes matter for URI bacterial or viral diagnosis

No

6

how do you treat pharyngitis?

Amoxicillin, PCN, Erythromycin, Clindamycin (if positive rapid strep)

7

how much of laryngitis is viral?

90%

8

how much is otitis media is viral?

48%

9

what bacteria cause otitis media?

strepto pneumo
Moraxella
H. influenze

10

what are some symptomatic relief meds for URIs

Pseudoephedrine
Phenylephrine
Ipratropium bromide: effective but expensive
NaCl Nasal drops
Afrin, Neosynephrine
Antihistamines

11

what are 2 very powerful vasoconstrictors that can lead to necrosis in the nose

afrin, neosynephrine

12

contraindications for symptomatic relief meds?

HTN
hx of arrhythmia
BPH
urinary retention
glaucoma

13

what are some expectorants?

Guaifenesin
SSKi (potassium iodine)

14

what are some cough suppressants

dextromethorphan (OTC meds)
codeine
hydrocodone
tessalon perles (benzonatate)- anesthetic

15

where is bronchitis found

south of the larynx

16

for kids 2-5 years old what are the most common causes of bronchitis

RSV
adenovirus

17

when should you give abx to a 2-5 year old?

culture + for heavy growth strep, H. flu, associated sinusitius or not improving in a week

18

are abx needed in adolescents and adults with acute bronchitis?

No, usually self limited

19

common causes of adolescents with bronchitis

viral
mycoplasma
chlamydia
pertussis

20

what can a persistent cough of >14 days be?

pertussis

21

how do you tx pertussis

erythromycin
azithromycin
bactrim

22

what is the tx for COPD exacerbations?

antibiotic and steroid

23

what is the typical pneumonia?

lobar

24

In HIV or non-HIV what is the number one cause of pneumonia?

stret. pneumo

25

Rigors (chills), fever, purulent sputum and “lobar infiltrates”

Typical pneumonia

26

what etiology of pneumonia is a lobar consolidating infiltrate

strept pneumo
legionella

27

what is the etiology of lobar enlargement for penumo?

klbsiella

28

who do you see anaerobe pneumonia with?

poor teeth
foul smelling

29

bronchopneumonia can have what etiologies

mycoplasm
strep pneumo
h. flu

30

if you see a cavitation on x-ray waht should you suspect

anaerobic bacteria, TB

31

what 4 organisms cause atypical pneumonias?

mycoplasm
chlamydia
legionella
viral- influenza

32

what do you do for atypical pneumonias?

serologic studies: convalescent titers

33

outpatient tx of pneumonia of someone who is previously healthy
no use of macrolide <3 months

macrolide or doxycycline

34

pneumonia tx
patient with comorbidities or used macrolides <3 month ago or in a high macrolide resistant area

respiratory flurorquinolone or
macrolide + beta-lactam

35

For inpatient, non-ICU tx for pneumonia

Resp Fluoroquinolones or anti pneumoccocal beta-lactam + Macrolide

36

ICU pneumo tx
3 options

1. Anti pneumococcal Beta-lactam and azithromycin
2. Anti pneumococcal Beta-lactam and resp fluoroquinolo.
3. (PCN allergies) resp fluoroquinolone +Aztreonam

37

if someone has CAP with CA-MRSA what should you add?

Vanco
Linezolid

38

Buboes in groin, exposure to animals

Bubonic plagues

39

Begins as flu-like illness, respiratory symptoms, hemoconcentration and thrombocytopenia, typical blood smear

Hantavirus

40

if a person has bilateral, fever, and hypoxemia what should you get?

blood and sputum gram stains and cultures

41

what empiric therapy do you start on someone with bilatreal infiltrates, fever, hypoxemia

ceph de jour plus macrolides/ doxy or flouroquinolones

42

Severe hypoxemia
V/Q mismatching PaO2/FiO2 ratio <150)
bilateral diffuse infiltrates on CXR

ARDS

43

Is ARDS caused by a heart problem?

No

44

what are some causes ARDS?

sepsis
pneumonia
severe trauma

45

in the developing world what is there a high correlation with TB?

HIV/ AIDS

46

what lobe of the lung usually has TB?

RUL

47

where can TB go?

anywhere
lymph nodes

48

if someone has no risk of TB exposure what is considered positive?

>15 mm

49

what populations is a positive TB test >5 mm

HIV infection
contact to active TB case
abnormal CXR
immunosupression

50

what populations do you use >10 mm as positive TB test?

Recent immigrants
IV drug users
children
high risk medical
residents of jails/ hospitals/ nursing homes

51

what test is an alternative to tuberculin skin test?

whote blood interferon (IFN)-gamma assay

52

if a patient is an alcoholic and you can't treat TB b/c INH would ruin the liver would you do the test?

No

53

if there is a positive TST test what should you get?

sputum for AFB smear and culture x 3 mornings

54

what med should you also give with INH?

B6 (pyridoxine)

55

if a pregnant lady has any risk factors for TB what do you do?

give INH

56

what should a patient report while on INH

any abdominal pain

57

if a person has active TB how long should they be in isolation?

minimum of 2 weeks

58

how long should you treat for TB?

6 months