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Pulmonology > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What are the different infectious diseases?

A
  • acute bronchitis
  • influenza
  • community acquired pneumonia
  • hospital acquired pneumonia
  • pnuemoncystis jiroveci
  • mycobaterium TB
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2
Q

What is acute bronchitis?

A
  • inflammation of the medium bronchi

- HYPERACTIVE AIRWAY W/MUCUS

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3
Q

What cx acute bronchitis?

A
  • INFLUENZA A&B (supportive)
  • parainfluenza
  • cornoavirus (types1-3)
  • rhinovirus
  • RSV (respiratory snyactal virus)
  • human metapneeumovirus
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4
Q

PE of acute bronchitis?

A

-NO FEVER
-viral URi
-mucus
-cough for more than 5 days
+/- wheezing, clearing rhonchi, chest wall tenderness (d/t coughing)

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5
Q

Labs for acute bronchitis?

A

CBC to check if there is a significant WBC increase/left shift b/c that means it is bacterial pneumonia!

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6
Q

How to tx acute bronchitis?

A

supportive for 2-3 wks and in the mean time you can give them:

  • NSAID/aceteminophen
  • bronchodilator
  • cough suppressant
  • Mucinolytic to break down the mucus
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7
Q

What is influenza?

A
  • spreads 4-6hrs
  • sx shows in 24 hrs
  • viral shedding stops in 2-5 days
  • NECROSIS OF THE EPITHELIAL TISSUE
  • the systemic sx goes down as respiratory sx goes up
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8
Q

Who are at higher risk for influenza?

A
  • chronic dz
  • facilities that have close proximities with other patients/sick people
  • older or younger people
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9
Q

PE of influenza?

A

ABRUPT SYSTEMIC onset:

  • fever
  • headache
  • chills
  • myalgia
  • malaise
  • cough
  • sore throat
  • ocular pain/burning/photophobia
  • cervical lymphadenopathy
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10
Q

Elderly PE of influenza?

A

MOTTLE

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11
Q

Labs for influenza?

A
  • Rapid flu test
  • Rapid strep to RULE OUT
  • throat swabs
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12
Q

Tx influenza?

A
  • resolves in 2-5 days
  • immunocompromised, age, cormordities:
  • -ZanamIVIR (NOT for asthma)
  • -OsteltamIVIR
  • -peramIVIR
  • ONLY W/IN 48 hrs
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13
Q

Prognosis for influenza?

A
  • good but may have persistent cough

- may have postinfluenza asthenia (weakness)

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14
Q

Complications for influenza?

A
  • primary viral pneumonia
  • -not that often but SEVERE
  • secondary bacterial pneumonia
  • -fever goes away but comes back
    • d/t S. pneumonia, H. influenza
  • muscle inflammation can cx:
  • -rhabdo
  • -myositis
  • -myoglobinuria
  • Reye’s syndrome (if child is given aspirin)
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15
Q

What is NOT a normal sign of influenza?

A
  • not getting better after 5 days

- DIFFUSE RALES, INTERSTITIAL INFILTRATE

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16
Q

What is community acquired pneumonia?

A

-OUT of the hospital for 48 hrs

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17
Q

How does CAP spread?

A

air droplets

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18
Q

What bugs for 0-1 mo?

CAP

A
  • E coli

- S. agalactae

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19
Q

What bugs for 2-5 mo?

CAP

A
  • chlamydia trachomatis

- RSV

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20
Q

What bugs for 5mo-5 yrs?

CAP

A
  • RSV

- parainfluenza

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21
Q

What bugs for 5-15yo?

CAP

A
  • influenza A

- mycoplasma

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22
Q

What bugs for 15-30yo?

CAP

A

-mycoplasma

23
Q

What bugs for older adults?

A
  • s. pneumonia

- h. influenza

24
Q

RF for CAP?

A
  • elderly
  • smoking
  • drinking
  • comorbitities
25
Q

PE for CAP?

A
  • ill appearing: fever, coughing, dyspenea, tachypnea, tachycardia, O2 down
  • lungs: inspiratory crackles(rales), dullness
26
Q

Labs for CAP?

A
  • DIAGNOSTIC: CXR
  • -pulmonary opacity
  • sputum culture –> to find out what the bugs are
  • HIV testing –> POSITIVE: P. jirovecci
27
Q

Tx for CAP?

General

A
  • might not respond to abx if had previous abx (must get from hx
  • if pt has pleural effusion labs should come back as transudate
  • empiric tx for 5 days or until afebrile for 48-72 hrs
28
Q

Tx for CAP?

Healthy

A
  • macrolide

- doxycycline

29
Q

Tx for CAP?

Abx resistant

A
  • fluorquinolone

- macroline AND Beta lactam

30
Q

Tx for CAP?

Hospitalization

A
  • fluorquinolone

- macroline AND Beta lactam

31
Q

Tx for CAP?

ICU

A
  • azithromycin
  • fluorquinolone
  • macroline AND Beta lactam
32
Q

Prevent CAP?

A 
-polyvalent pneumococcal vaccine:
for those who are 65 yo older
asplenic
nephritic syndrome
immunocompromised
cancer
HIV
transplant
sickle cell
33
Q

What is hospital acquired pneumonia?

A

pneumonia after 48 hrs of being admitted to the hospital but MUST BE NOT SICK upon admission

34
Q

Pathophysio of HAP?

A

pneumonia gets in via nasal or gastric b/c of nasogatric tube, dirty hands of care providers

35
Q

Labs for HAP?

A

sepsis panal - procalcitonin (untxd pneumonia can lead to sepsis b/c of the mucus that is leaking into the capillaries)

36
Q

Tx for HAP?

A

broad spectrum (more than 1 is used)

37
Q

What is pneumocystis jiroveci?

A

HIV/AIDs

38
Q

What is the PE of pneumocystis jiroveci?

A
  • fever
  • cough w/ white sputum
  • RETROSTERNAL chest pain
  • unexplained weight loss
  • wks of fatigue
39
Q

Labs for pneumocystis jiroveci?

A
  • if CXR is early: normal +/- interstitial infiltrates
  • if CXR w/aids: DENSE PERIHILAR INFILTRATES
  • CT: ground glass appearance
40
Q

Tx for pneumocystis jirovci?

A

TMP-SMX for 14-21 days

41
Q

What is mycobacterium tuberculosis?

A

infxn of the lungs of m. tuberculosis

42
Q

What are RF of TB?

A
  • HIV
  • corticosteroid use
  • immunosuppresive therapy
  • silicosis
  • diabets
  • gastrectomy
43
Q

What are HIGH RF of TB?

A
  • living in close contacts
  • children
  • foreign born
  • unhygenic
44
Q

What is primary TB?

A

when you are first infected with TB and the macrophages in the lungs are at war with the TB virus

45
Q

What is latent TB?

A

the war is over in the lungs but the virus didn’t die and is DORMANT and triggers (stress or reinfxn) can cx the dormant virus to come back to life

46
Q

What is Progressive Secondary TB?

A

the dormant virus is reinfxnd OR triggered that cx virus to wake up

47
Q

What is Progressive Primary TB?

A

the first infxn and the macrophages were not able to overcome them so they multiplied

48
Q

PE for TB?

A
  • chronic cough +/- blood
  • slow progressive maliase
  • anorexia
  • weight loss
  • POST-TUSSIVE APICAL RALES
49
Q

Labs for TB?

A
  • 3 sputums cultures

- CXR: primary: unilateral infiltrates; secondary: cavitations

50
Q

Mantouc TST?

A

-injection under the skin for 48-72 hrs
5mm: HIV positive, close contacts (jail)
10mm: health care workers, foreign born, children, IV drug users
15mm; low incidence of exposure, low risk of active TB

51
Q

Mantouc TST FALSE positive?

A
  • BCG vaccination
  • NONTB mycobateria related:
    • MAC
  • -may be in elders +/-underlying lung dz
  • -+/-cystic fibrosis
52
Q

Negative w/ overcrowded areas?

TB

A

repeat again on other arm

53
Q

Negative w/ occupation risk?

TB

A
  • baseline is needed
  • Boosted phenomenon (and those who have been affected once): the first TB test will be negative but they need to get another to confirm that they are negative b/c if they have another TB testing comes around they will awaken the TB virus and will test as POSITIVE when they’re not really waking up the TB virus (can be interpreted as a NEW infxn when it’s not)
  • must wait 8 wks or else you will get skin conversion which may also give out a false positive
54
Q

Tx for TB?

A
  • isoniazid
  • rifampin
  • pyarzinamide (DO NOT IN PREGGOS)
  • ehtambutol

Pulmonology (7 decks)

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