Cough and SOB lecture Flashcards
Tests to be thinking about
CXR PFT Bronchodilator Methacholine Sputum test Rapid strep Flu test Covid
Smoking hx?
COPD
Emphysema
Chronic Bronchitis
Cough
COPD Asthma Bronchitis PNA Allergic rhinitis HF exacerbation Pulm Embolism Lung CA Cocci TB Flu
Whenever you have edema and sx that are seemingly heart related, remember it can be a primary respiratory problem
bc when lungs aren’t functioning properly, causes R side of heart to back up and be under more pressure
any WBC over 10 (or 11) is
HIGH
Orthopnea
SOB when lying down
Paroxysmal nocturnal dyspnea
SOB that awakes the patient
Tx for PNA:
Azithro “Z pack” or
Doxy
5 days
for uncomplicated CAP
Everyone used to get Levaquin (Levofloxacin) for PNA,
BUT now we caution with FluoroQ bc
life threatening Hypoglycemia/coma
Delirium, agitation, memory impairment
Tendons, retinal detachment
Influenza season for PNA
September - May
Clinical pearls for PNA
Wet cough Fever SOB Pleuritic CP Chills
If you see PNA in the upper lobes
consider Aspiration PNA
Right upper lobe PNA
Aspiration
CAP important tests
CXR
Blood or sputum culture (sometimes)
Acute bronchitis
Cough
NO FEVER
normal lung exam
Tests for Acute bronchitis
CXR (if abnormal exam, SOB, or high fever)
Influenza sx
Sudden onset
High fever
severe Myalgia
September-May season
Influenza test
Typically Clinical dx
Can test
Aspiration PNA
Impaired mentation (dementia, prior stroke, substance abuse)
Test for Aspiration PNA
CXR: showing R upper lobe
TB sx
Long duration of sx
Risk factors for TB
TB testing
CXR w upper lobe cavitary lesions
Sputum for AFB (acid fast bacilli)
What is tx for COPD exacerbation?
ABX!!
Macrolide: Z pack
and
______
SOB when lying down
Orthopnea