Clinical Correlates of Infections

Question 1

What is the course of admission for TB?

Answer 1

Negative-pressure room – Keeps airflow from spreading to the other rooms
Chest X-ray
Routine labs

Question 2

How do we test for TB?

Answer 2

Acid Fast Stain (AFB or Ziehl-neelsen)
Rhoadmine/auramine stain

Question 3

What is the therapy for TB?

Answer 3

4 drug therapy for presumed TB (INH, Rifampin, Ethambutol and Pyrazinamide)
10 days and then discharged
Direct Observed Therapy (DOT)
After 2 months of 4 drug therapy it changes to 9 month course of 3 drug therapy

Question 4

How do we check pleural effusion on radiograph?

Answer 4

Decubitus needed to check pleural effusion

Fluid pushes mediastinum over

Question 5

What do we use to test influenza?

How about to treat?

Answer 5

NAAT test is best method (highest sensitivity, speed)
Rapid flu test is useful but low sensitivity, needs to be nasal

Neuraminidase inhibitors

Question 6

What symptomology does pneumonia often present with?

Answer 6

Thick sputum, streaks of blood, pleuritic pain, green sputum (neutrophilic infiltrates)
Dullness to percussion, rales, wheezes

Question 7

How long of a hospitalization should it take for you to think HCAP?

Answer 7

48 hours

Question 8

In pneumonia what causes: fever, green sputum, pleuritic chest pain, low pulse ox?

Answer 8

Fevers chills due to cytokines
Green sputum is from PMNs
Pleuritic chest pain due to acute inflammation of the pleural surfaces
Low pulse ox due to reduced gas exchange