what is the MCC of young person pneumonia that lives in close quarters?
mycoplasma
what does a fatty embolus cause in the lungs?
diffuse pulmonary infiltrates
what can prevent pneumonia post op?
incentive spirometry
what is MCC of pneumonia in HIV pts?
PCP
which obstructive lung dz has predominantly neutrophil driven inflammation?
COPD
80% of chronic cough is caused by what three etiologies
GERD
what is the MCC of CAP?
strep pneumo
what two blood tests are helpful in treating asthma?
RAST panal
IgE
where are tb bugs kept in remission?
alveolar macrophages
when will TB become an active infection?
bug escapes from alveolar macrophage
when does TB dissemination occur?
before an active immune response
where are common areas that TB can affect?
brain, larynx, lymph node, lung, spine, bone, kidney
what helps evaluate likelihood of infection of TB?
infectiousness of person with TB
environmental factors that increase infectivity
proximity, frequency, duration of exposure
how long after infection will LTBI be detected on TST or interferon gamma assay (IGRA)?
2-8 weeks
do ppl with LTBI spread infection?
no
in how many ppl with LTBI become active TB?
10%
half occur within 2 years of initial infection
what confirms TB infection?
positive TB culture (most often obtained by bronchoscopy)
what percentage of HIV ppl will get active TB after being exposed to it?
50%
who else is at risk for getting TB?
silicosis (interstitial lung dz) DM steroid use gastrectomy children <5yrs
what are clinical features of TB
fever, chills, nightsweats, anorexia, wt loss, fatigue, chronic productive cough, CP, +/- hemoptysis, blood-streaking MC (frank blood is rare)
what are extrapulmonary features of TB if it has gone to other organ systems?
blood in urine
h/a, confusion
back pain
hoarseness
what is PE of TB lungs?
post tussive apical rales, but often is normal
in which pt would a 5mm PPD be a positive?
HIV
recent TB contacts
Fibrotic changes on CXR (indicating prior TB)
PING
in which pt would a 10 mm PPD be a positive?
recent immigration
injection drug user
medical workers/mycobateria lab workers
children <5yo
in which pt would a 15 mm PPD be a positive?
no known TB risk (general population)
what are the 3 most common non TB infections?
M avium, M chelonae, M absessus
difficult to treat
3-5 drug regimen for 18 months
