111914 clinical cases

Question 1

contact isolation

Answer 1

paper gown, gloves

don’t necessarily need mask

Question 2

droplet precuations

Answer 2

6 feet away–relatively well protected (like for common cold, influenza)

meningitis

so would wear paper mask

Question 3

airborne precautions

Answer 3

mycobacteria
measles
varicella zoster

Question 4

TB symptoms and risk factors

Answer 4

cough
hemoptysis
weight loss
homelessness
malnutrition

Question 5

TB is more commonly located in what area of lung?

Answer 5

upper lobe

Question 6

what stain is good for TB?

Answer 6

acid fast stain (not done as much anymore)

rhodamine stain

Question 7

how is m tuberculosis identified in the lab?

Answer 7

liquid culture (uses gene probe tech)
or solid culture

Question 8

anytime you see white or dense consolidation in lung on CXR

Answer 8

is lung collapsed?
is there fluid or liquid?
is there consolidation?

Question 9

anaerobic aspiration–most commonly from

Answer 9

community

Question 10

what is the only viral respiratory illness we have drugs for?

Answer 10

influenza

Question 11

high fever is pathognomonic for

Answer 11

influenza

Question 12

what test can do you for diagnosing influenza?

Answer 12

respiratory viral nucleic acid amplification test from nasopharygenal swab

Question 13

why is flu antigen test not as good as NAAT for determining whether it’s influenza?

Answer 13

b/c not very sensitive (have to do throat swab, can’t do sputum)

Question 14

pain in the chest every time you take a deep breath or cough

Answer 14

pleuritic chest pain, tells you something is rubbing against chest to give pleural irritation

Question 15

what makes sputum green?

Answer 15

myeloperoxidase granules from neutrophils

Question 16

if pseudomonas is a consideration, what should you give inpt?

Answer 16

alpha penumococcal
alpha pseudomonal beta lactam (piperaccllin-tazobactam, cefepime, ormeropenem) PLUS
alpha pseudomonal fluoroquinolone

Question 17

pathophysiology-fevers and shaking chills are due to

Answer 17

cytokines release in response to infection

Question 18

cough of yellow green sputum-pathophysio

Answer 18

PMNs that have engulfed microorganisms and release myeloperoxidase

Question 19

chest pain with cough and deep breathing-pathophysio?

Answer 19

acute inflam of the pleural surfaces resulting in pain distribution along intercostal nerve zones

Question 20

history of smoking-pathophysio?

Answer 20

impaired mucociliary clearance of organisms

Question 21

rales and dullness to percussion-pathophysio?

Answer 21

increased pulmonary secretions and fluid collecting in alveolar spaces at site of pneumonia