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Pulmonary > Infectious Diseases PREmidterm edit > Flashcards

Infectious Diseases PREmidterm edit Flashcards

1
Q

acute bronchitis definition + common causes

A

-Self-limited inflammation of large airways -> cough without pneumonia

-VIRUS MC:
-Influenza A and B
-Parainfluenza
-Coronavirus (types 1-3)
-Rhinovirus
-RSV

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2
Q

pathophysiology acute bronchitis

A

Inflammatory response to infections of bronchial epithelium
-inflamed areas of bronchi and tracheal mucosa thicken
- purulent sptum: from sloughed off tracheobronchial epithelium and inflammatory cells

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3
Q

acute bronchitis symptoms

A

Sx:
Cough for over 5 days
+/- purulentputum (50%)**
- >5 days = acute bronchitis NOT URI
- NO FEVER, tachycardia, tachypnea -> r/o pneumonia

Signs:
- rhonchi**
- normal vitals
+/- wheezing

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4
Q

PFTs: acute bronchitis

A

-generally not indicated
-may become abnormal
-significant reductions in FEV1 -> obstructive pattern
-bronchial hyperreactivity

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5
Q

acute bronchitis dx

A

PHYSICAL EXAM!

-cough WITHOUT fever, tachycardia and tachypnea suggests bronchitis, rather than pneumonia
-normal vital signs
- no rales and egophony

Chest x-ray:
- only if cant distinguish by physical exam

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6
Q

Acute bronchitis rapid tests

A

-Rapid dx tests for several pathogens linked to acute bronchitis -> COVID-19, Influenza, RSV

Rapid tests should be used if:
-Suspected organism is treatable
-Infection circulating in the community
-pt has suggestive symptoms or signs

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7
Q

treatment of acute bronchitis

A

Antimicrobial agents are NOT recommended in most acute bronchitis **
Supportive Care*
- If cough is 20+ days, may give inhaled or oral corticosteroids

Antimicrobial therapy only if:
- Influenza agents
- Pertussis
- COVID-19

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8
Q

influenza symptoms

A

ABRUPT onset of fever, headache, myalgia*
arthralgias, malaise
- watching tv and all of sudden feel awful

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9
Q

influenza PE

A

Physical Exam: not that bad
- Feeling of hot and flushed
- Oropharyngeal hyperemia
- Mild cervical lymphadenopathy
- Respiratory exam unremarkable

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10
Q

influenza labs, xray and dx

A

Labs = not helpful
-leukopenia

Xray = normal

Diagnostic Test: RT-PCR
- Rapid tests for influenza antigens are widely available
- RT-PCR is most sensitive and specific*

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11
Q

influenza maincomplication and risk group

A

Pneumonia (MC)
-High risk groups:
-Cardiovascular or pulmonary ds
-Diabetes mellitus, renal disease, hemoglobinopathy, or immunosuppression
-Nursing homes or chronic care facilities
-Over age 50, pregnant, young kids

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12
Q

primary viral pneumonia description + sx

A

Occurs when symptoms persist and worsen **
- INTERSTITIAL tissue

Sx:
-High fever, dyspnea, and progression to cyanosis can be seen

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13
Q

primary viral pneumonia vs secondary pneumonia xray

A

Primary: INTERSTITIAL, diffuse everywhere inflitrates

Secondary:
- Lobar/ALVEOLAR Infiltrates
- consolidations

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14
Q

secondary bacterial pneumonia

A

Relapse, get a bacterial infection while recovering from virus**
- purulent sputum
- MC: Strep pneumoniae
- Most severe: Staph aureus

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15
Q

influenza complications

A

Reye syndrome**- assoc with kids and aspirin use -> dont give aspirin to kids -> encephalopathy
-flu + aspirin = assoc with reye syndrome

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16
Q

prevention of influenza + prophylax

A

Influenza vaccine provides 85% efficacy immunity for few months - 1 year
- Vaccine is HIGHLY RECOMMENDED for > 6 months
- Takes 2 weeks after shot for immunity

Chemoprophylaxis
- Oseltamivir, Zanamivir, Baloxavir
- Reduces attack rate if taken within 48 hours after exposure

17
Q

influenza treatment

A

Supportive Care with Hydration!
- Analgesics (ASA is not recommended, risk of Reye Syndrome)

Neuraminidase inhibitors: within 48h of sx
-Baloxavir (QD*)
-Oseltamivir (BID x 5 days) -> tamaflu
-Zanamivir (two 5mg inhalations twice daily for 5 days) - cant give to pts with asthma

18
Q

who to treat: influenza

A

-Illness requiring hospitalization
-Progressive, severe, or complicated illness, regardless of previous health or vaccination status
-High risk pts: children under 2, over 65, comorbid ds, immunosurpressed, ASA users

19
Q

bordetella pertussis infection description and is pertussis lifelong immunity after vaccination

A

Transmission: respiratory droplets
-Incubation period: 7–21 days
Most cases (50%) are those < 2 yo

vaccine or past disease does not give lasting immunity to pertussis**
-Adults are important reservoir (waning immunization)

20
Q

bordetella pertussis stages

A

Sx last about 6 weeks

-1. Catarrhal stage- feels like a respiratory infection
-2. Paroxysmal stage- whooping cough
-3. Convalescent stage- recovery

21
Q

bordetella pertussis: Catarrhal stage

A

-7-10 days
-insidious/gradual onset
-Lacrimation, sneezing, coryza, anorexia, malaise, and hacking NIGHT cough that becomes DIURNAL (during day) -> like URI

22
Q

bordetella pertussis: paroxysmal stage

A

-1-6 wks but up to 10
-posttussive emesis & fatigue
-“whoop”: cough

23
Q

bordetella pertussis: convalescent stage: 1-3 weeks

A

-Decrease in frequency and severity of paroxysms of cough

24
Q

bordetella pertussis labs and CXR

A

WBC: 15,000–20,000/mcL

CXR: nonspecific
-Peribronchial cuffing (walls of bronchi are edematous -> donut sign), perihilar infiltrates, interstitial edema, or atelectasis
-Pulmonary consolidation (20 %)
-primary or Secondary bacterial pneumonia

25
Q

bordetella pertussis complications

A

-Pneumonia (primary and secondary)

26
Q

pertussis diagnosis

A

-Diagnosis: combinations of diagnostic tests to identify persons with pertussis, based upon the duration of cough
- Wk 0-2: culture + PCR
- Wk 2-4: PCR + serology
- Wk 4+: serology

27
Q

pertussis prevention

A

DTaP vaccine!!
-Booster vaccination: for adolescents/adults

Post exposure prophylaxis: azithromycin

28
Q

tx and post exposure tx for pertussis

A

-adults - ZPAC- azithromycin

Pulmonary (23 decks)

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