01 Pulmonary Flashcards
Where does acute bronchitis always start?
Upper airways
When must you consider a diagnosis of acute bronchitis? When the pt presents with ___.
Cough > 5 days
What causes 90% of cases of acute bronchitis?
Viral infection (don’t need an antibiotic)
What three patients should get an antibiotic for their acute bronchitis?
- Chronic illnesses (e.g., heart, lung, liver, renal, neuromuscular disease)
- Smokers
- Immunocompromised pts (e.g., HIV, Crohn’s disease, rheumatoid arthritis, uncontrolled diabetes)
What bug do smokers harbor?
H flu (Haemophilus influenzae)
How long does a cough from acute bronchitis last?
About 2-3 weeks
What should you do if a patient with acute bronchitis comes back three weeks later, still coughing–not any better?
He may have pneumonia or pertussis. Could be other things too.
What type of pneumonia is on the FNP exam?
CAP, not nosocomial
The CDC says the pneumococcal vaccine is given how many times in a lifetime?
Once
At what age should an immunocompetent adult get the pneumococcal vaccine?
Age 65
Should anyone get the pneumococcal vaccine earlier than 65?
Yes. Smokers; chronic disease in lungs, heart, or liver; someone without a spleen.
Should anyone be revaccinated with pneumococcal vaccine?
Yes. Anyone over the age of 65 who got it previously and five years have lapsed
What would a patient with pneumonia look like?
Cough, discolored sputum, feel bad, running fever, SOB, tachypnea
What might you see on a chest x-ray of someone with pneumonia?
Infiltrates (e.g., left lobar)
In adults, pneumonia is often caused by bacteria. What three bugs?
- Streptococcus pneumoniae (strep pneumo)
Atypical pathogens…
- Mycoplasma pneumoniae
- Chlamydophila pneumoniae
The atypical ones are actually the most common ones.
