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Clin Med II-Pulmonary > Bronchitis and Pneumonia > Flashcards

Bronchitis and Pneumonia Flashcards

1
Q

only bacterial cause of AB (Acute Bronchitis) responds to abx

A

B. pertussis

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2
Q

AB is febrile or afebrile?

A

afebrile unless etiology is flu

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3
Q

rhonchi in AB

A

clears with coughing , no rales

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4
Q

procalcitonin

A

elevated in bacterial infection, drop of 80% =>d/c abx

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5
Q

management of AB

A

symptomatic, OTC, antitussives, beta 2 agonists

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6
Q

abx needed for AB?

A

no but 60-90% are given. educate pts

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7
Q

1 cause of transmission of pneumonia

A

aspiration from oropharynx

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8
Q

classification of Pneumonia

A

CAP, HAP, VAP, HCAP

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9
Q

most common cause of CAP

A

s. pneumo

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10
Q

clinical signs of CAP-general

A

fever, RR>24, Tachycardia, rales, consolidation

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11
Q

clinical signs of CAP-atypical

A

confusion, weakness, FTT, delirium, abd pain, tachypnea, HA, N/V/D, myalgia/arthralgia

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12
Q

Dx labs for CAP

A

leukocytosis (15-30) with left shift

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13
Q

Dx CXR for CAP

A

infiltrate /consolidation

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14
Q

types of consolidation in CAP

A

lobar, interstitial, cavitation (straight line)

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15
Q

CURB 65

A

confusion, urea>7, RR>30, BP, >65

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16
Q

ICU

A

3-5 on CURB65

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17
Q

Admit

A

2 on CURB65

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18
Q

out pt

A

0-1 on CURB65

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19
Q

CAP tx: healthy no abx use w/in past 3 months

A

macrolide/doxycycline

20
Q

CAP tx: macrolide resistant/abx use w/in 3 months

A

respiratory fluroquinolone/betalactam+macrolide

21
Q

first line beta lactam

A

high dose amoxicilin/ amoxicilin-clavulanate

22
Q

alternative to beta lactam

A

ceftriaxone, cefpodoxime, cefuroxime

23
Q

CAP-inpt-nonICU tx

A

respiratory fluoroquinolone/ anti-pneumoccocal beta lactam+macrolide

24
Q

CAP-ICU tx

A

anti-pneumococcal beta lactam + azithromycin/ anti-pneumococcal beta lactam + resp. fluoroquinolone/ resp. fluoroquinolone+ aztreonam

25
Q

CAP tx Pen allergy

A

resp. fluoroquinolone+ aztreonam

26
Q

CAP ICU w/ pseudomonas risk

A

Antipneumococcal, antipseudomonal beta lactam + either ciprofloxacin or levofloxacin/ above beta-lactam+ an aminoglycoside + azithromycin/ above beta-lactam + an aminoglycoside + a respiratory fluoroquinolone

27
Q

CAP ICU w/MRSA

A

add vancomysin or linezolid

28
Q

pathophysiology for HAP, VAP, HCAP

A

altered upper respiratory tract flora: pharyngeal colonization

29
Q

Dx for HAP, VAP, HCAP

A

new or progressive infiltrate on lung imaging + 2 of (fever, purulent sputum, leukocytosis)

30
Q

sputum gram stain and culture are indicated for ?

A

HAP, VAP, HCAP

31
Q

are considered at risk for drug resistance

A

HCAP

32
Q

what has long duration of tx? (14-21 days)

A

pseudomonas aeroginosa

33
Q

Tx of HAP, VAP, HCAP

A

Antipneumococcal, antipseudomonal beta lactam + respiratory fluoroquinolone + vancomycin/linezolid

34
Q

monotherapy can be used for HAP/VAP if

A

no resistent pathogen

35
Q

prevention of VAP

A

no acid-blocking meds, decontamination of oropharynx and gut, probiotics, positioning (not supine) , subglottic drainage

36
Q

common cause of viral CAP

A

flu=>secondary bacterial common (staph)

37
Q

fungal pneumonias

A

Histoplasmosis,
Blastomycosis,
Coccidiodomycosis

38
Q

pneumonia a/w HIV

A

Pneumocystis jirovecii pneumonia

39
Q

what is the most common symptoms of Pneumocystis jirovecii pneumonia?

A

fever, cough, progressive dyspnea

40
Q

test results for Pneumocystis jirovecii pneumonia?

A

high LDH and low CD4

41
Q

tx of Pneumocystis jirovecii pneumonia?

A

bactrim

42
Q

common cause of aspiration pneumonia

A

G- and anaerobic

43
Q

risk factors for aspiration pneumonia

A

post op, neurologic compromise, anatomical defect

44
Q

common site of aspiration pneumonia

A

RLL

45
Q

abx for aspiration pneumonia

A

Piperacillin/tazobactam or ampicillin/sulbactam; or Clindamycin; or moxifloxacin

Clin Med II-Pulmonary (7 decks)

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