Respiratory part II

Question 1

Croup Prodrome sx (5)

Answer 1

1. mild uri
2. nasal congestion
3. sore throat
4. cough
5. low-grade fever

Question 2

Croup later sx (3)

Answer 2

1 stridor
2 hoarse voice
3 seal bark-like cough

Question 3

Croup course

Answer 3

3-5d, resolves 4-7 days

Question 4

Croup PE

Answer 4

distress from airway obstruction

mild expiratory wheezing

Question 5

Croup sever PE

Answer 5

tachypnea
tachycardia
inspiratory stridor

Question 6

DDx Croup (SOB and stridor)

Answer 6

Epiglottitis
Forgein Body
Diptheria
Retropharyngeal abscess

Question 7

Acute Bronchitis sx

Answer 7

Cough > 5 days with sputum production

Question 8

Acute Bronchitis PE (5)

Answer 8

low fever
wheezing suggests bronchospasms
Rhonchi
Normal percussion 
no changes in transmitted voice tests

Question 9

Acute bronchitis ddx (5)

Answer 9

1 chronic bronchitis (if chronic)
2 pneumonia (usually sicker)
3 post-nasal drip
4 GERD
5 asthma

Question 10

Pneumonia org?

which is most concerning

Answer 10

Viral, bacterial, fungal

Bacterial is most concerning

Question 11

4 classifications of pneumonia

Answer 11

1. community-acquired
2. Nosocomial pneumonia
3. Ventilator-associated pneumonia
4. Healthcare-associated pneumonia

Question 12

Bacterial pneumonia PE (5)

Answer 12

1 looks sick
2 high fever
3 + egophony
4 dullness to percussion
5 pallor
6. tachycardia
7 bradycardia
8 rhonchi
9 increased tactile fremitis

Question 13

Bacterial pneumonia general sx

Answer 13

1. rapid breathing
2. SOB
3. abdominal pain
4. severe fatigue

Question 14

Bacterial organisms pneumonia

Answer 14

Pneumococcus- bloody rust sputum, shaking and chills
Pseudomonas- green sputum
Haemophilus- green sputum
Klebsiella- current jelly
Legionella- HA, malaise, n/v, anorexia,

Question 15

Work up pneumonia

Answer 15

CXR-dense shadow with demarcated borders

CBC

Question 16

Prognosis of bacterial pneumonia

Answer 16

3-5 days of tx if uncomplicated

Question 17

Bacterial pneumonia complications

Answer 17

1. lung abscess
2. pleural effusion
3. empyema

Question 18

Pneumonia: Age

1. Bacterial
2. Viral
3. Mycoplasma

Answer 18

1. any
2. any, but typically older kids and young adults
3. any

Question 19

Pneumonia Sputum

1. Bacterial
2. Viral
3. Mycoplasma

Answer 19

1. copious, rusty, purulent, blood-streaked–many PMNs on gram stain
2. Scant, Thin, Microscopic exam; no bacteria
3. Scant, thin, sparse organism, PMNs and macrophages, clumps of resp epithel. cells

Question 20

Pneumonia URI

1. Bacterial
2. Viral
3. Mycoplasma

Answer 20

1. Precedes
2. Concorrent
3. Precedes

Question 21

Pneumonia Fever

1. Bacterial
2. Viral
3. Mycoplasma

Answer 21

1. High
2. Low/absent
3. Varies

Question 22

Pneumonia Onset

1. Bacterial
2. Viral
3. Mycoplasma

Answer 22

1. Rapid
2. Gradual/mild
3. Gradual

Question 23

Pneumonia Myalgia

1. Bacterial
2. Viral
3. Mycoplasma

Answer 23

1. Absent
2. Present
3. Varies

Question 24

Pneumonia Toxic Appearance

1. Bacterial
2. Viral
3. Mycoplasma

Answer 24

1. Present
2. Absent
3. Absent

Question 25

Pneumonia CXR 1. Bacterial 2. Viral 3. Mycoplasma

Answer 25

1. Pulmonary infiltrate, consolidation, unilateral 2. Varies interstitial pneumonia 3. WNL, may be diffuse lower lobe infiltrate, may be consolidation

Question 26

Pneumonia WBC 1. Bacterial 2. Viral 3. Mycoplasma

Answer 26

1. 15,000+ count 2. Low, WNL or slight inc 3. WNL or slight inc

Question 27

Mycoplasma Pneumonia dx (4)

Answer 27

PCR EIA serology NO bacteria found on gram-stained sputum sample CXR may have no findings or some diffuse infiltrate

Question 28

Pneumocystis jirovecii pneumonia | bacterial, viral, fungal?

Answer 28

fungal

Question 29

Pneumocystis jirovecii is often deadly in what population?

Answer 29

AIDS infected

Question 30

Complications of pneumocystis jirovecii? (2)

Answer 30

Spontaneous pneumothorax | hypoxemia

Question 31

Coccidioidomycosis is also known as?

Answer 31

San Joaquin Valley fever and desert rheumatism

Question 32

Etiology of coccidioidomycosis?

Answer 32

soil fungus in arid conditions

Question 33

Sxs coccidioidomycosis?

Answer 33

1. self-limited respiratory tract infection, occurs 1-3 weeks after exposure--MOST subclinical 2. non-specific complaints--fever, cough,chest pain 3. Disseminates in immunocompromised and when it does to CNS---meningitis; headaches

Question 34

Coccidiodomycosis work-up

Answer 34

CBC- eosinophilia, lymphocytosis, monocytosis CXR: Infiltrates can range from segmental or lobar to diffuse reticulonodular Skin testing, delayed-type hypersensitivity rxn may become pos in 1-3 wks

Question 35

Diagnosis of Coccidioidomycosis

Answer 35

Clinical suspicion and hx of possible exposure or travel to an endemic area

Question 36

Allergic Bronchopulmonary Aspergillosis sputum

Answer 36

brown flecks in it

Question 37

Allergic Bronchopulmonary Aspergillosis picture

Answer 37

pt already has asthma and then develops cough, wheezing, dyspnea worse, low fever

Question 38

Histoplasmosis also known as

Answer 38

spelunkers lung

Question 39

Histoplasmosis sx Acute Chronic Disseminated

Answer 39

A-fatigue, fever, chills, chest pain, dry cough ~10 d post exp) Ch- persistent or relapsing Dis-