DX and TX Flashcards
Chronic Bronchitis
- chronic productive cough for at least 3 months a year for 2 consecutive years
- non-reversible
- smoking
- ages 50-60
- blue bloater: big belly, cyanotic, obese
Dx: spirometry
Tx: GOLD Criteria
emphysema
- loss of elastic recoil and airway collapse
- smoking
- AAT deficiency
- dyspnea, cough
-pink puffer: barrel chest, skinny
Dx: spirometry
Tx: GOLD criteria
bronchiectasis
- widening and scarring of airways
- cystic fibrosis
- thick/dark brown mucopurulent sputum
- hemoptysis
Dx: CT
Tx: mucus clearance
acute bronchitis (viral and bacteria)
- cough preceded by URI that moves to lower respiratory tract infection
- at least 5 days
- winter/fall
Dx:clinical
Tx:
viral: supportive, OTC cough med
bacterial: azithro
acute bronchiolitis
- infection and inflammation of the small airways: bronchioles
- starts from viral URI
- RSV
- infants 2 months to 2 years
- winter/fall
Dx: clinical
Tx: supportive
acute epiglottitis
- inflammation and swelling of epiglottis that causes serious rapid infection and airway obstruction
- GAS
- dysphagia, drooling, distress
- tripod position
- hot potato voice
Dx: clinical/laryngoscopy (cherry red)
Tx: airway management, ENT referral, and IV Abx (ceftriaxone)
croup
- inflammation of larynx, trachea, and subglottilc airway
- 6 months to 3 years age
- fall/early winter
- “seal like barking” cough
- virus: parainfluenza type 1
- bacteria: S. aureus
Dx: clinical
Tx: glucocorticoids (dexamethasone PO), add nebulized epi if severe
empyema
- pus in the pleural space cavity between lung and chest wall
- from PNA, lung abscess, Tb
- chest pain, fever, cough, night sweats
Dx: CXR, CT, pleural fluid analysis
Tx: tube thoracostomy + Abx
influenza
- orthomyxovirus
- spread through respiratory droplets
- fall/winter
- fever, chills, malaise, HA, URI (sore throat, swollen lymph nodes, runny nose), dry cough
Dx: PCR
Tx: supportive/oseltamivir
Covid-19
- spread through respiratory droplets
- dysregulates renin-angiotensin-aldosterone system
- most asymptomatic
- loss of smell/taste
Dx: nasopharyngeal swab SARS Cov 2 NAAT
Tx: supportive, paxlovid if severe
pertussis
- B. Pertussis
- transmitted via respiratory droplets
- rapid consecutive coughs followed by high pitched inspiration (whoop)
Dx: nasopharyngeal culture
Tx: azithromycin
RSV
- Jan/Feb
- most significant LRI cause young kids
- major risk factor: prematurity
- associated with airway reactivity later in life (asthma)
- bronchiolitis
- grunting in infant
- crackles/ prolonged inspiration
Dx:
clinical based on history: bronchiolitis, URI prodrome, tachypnea, chest retractions, wheeze, crackles
Tx: Time/supportive
tuberculosis
- M. tuberculosis (slow growing bacteria)
- airborne droplets
- common in malnourished, overcrowded populations
- malaise, fever, wight loss, productive cough with hemoptysis, crackles heard only after short cough
Dx: skin test or interferon gamma assay
Tx:
DOT therapy
6 month regimen: RIPE x2 months, then only I and R x4 months
9 month regimen: RIE x4-8 weeks, then only I and R for remaining 9 months
aspergillosis
- fungi: aspergillus fumigatus
- disease of immunocompromised or critically ill
- lungs, sinuses, brain –> MC affected
- allergic, chronic, invasive
Dx:
chest CT: nodules, wedge shaped infarcts, halo sign
definitive: tissue/culture
Tx: IV voriconazole
CAP (outpatient)
- outside hospital or within 48 hours after admission to hospital
- defect in: cough reflex, mucociliary clearance system, immune response
- fever, hypothermia, cough, inspiratory crackles, dullness to percussion
- hospital admission based on CRB-65
- ICU admission based on Major/minor criteria
Dx: CXR
Tx: azithro, doxy
