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SP: Pulmonary Pearls (12%) > Infectious Pulmonary Disorders > Flashcards

Infectious Pulmonary Disorders Flashcards

1
Q

Most common ventilator associated bacterial infection?

A

pseudomonas

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2
Q

Caused by RSV, diagnosed by nasal washing

A

Bronchiolitis

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3
Q

Caused by Hib, unvaccinated child, Thumbprint sign on X-Ray

A

acute epiglottitis

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4
Q

Caused by Parainfluenza virus, barking cough and stridor, Steeple’s sign, racemic epinephrine

A

croup

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5
Q

Inspiratory whoop, treat with macrolide, diagnose by nasopharyngeal swab, booster vaccine at 11-12 y/o

A

Pertussis (Whooping Cough)

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6
Q

Rust-colored sputum - common in patients with splenectomy

A

S. pneumoniae

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7
Q

Salmon colored sputum - MRSA treat with vancomycin

A

S. aureus

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8
Q

Ventilators, patients become sick fast - treat with 2 antibiotics

A

Pseudomonas

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9
Q

low NA+ (hyponatremia), GI symptoms (diarrhea) and high fever

A

legionella

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10
Q

Young people living in dorms, (+) cold agglutinins, bullous myringitis

A

mycoplasma

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11
Q

Currant jelly sputum, drinkers, aspiration

A

klebsiella

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12
Q

Patient with non-remitting cough/bronchitis non-responsive to conventional treatments. Caused by fungal inhalation in western states

A

Coccidioides (valley fever)

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13
Q

bird or bat droppings (caves, zoo, bird)

A

Histoplasma capsulatum

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14
Q

found in soil can disseminate and can cause meningitis.

A

Cryptococcus

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15
Q

Apical infiltration

A

Tuberculosis

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16
Q

What should be considered with a diffuse ground glass appearance and no pulmonary nodules on chest X-ray?

A

infiltrative lung disease

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17
Q

What should be considered with a localized ground glass appearance and a pulmonary nodule on chest X-ray?

A

lung cancer

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18
Q

What should be considered in a patient with pneumonia who was exposed to bird or bat droppings in the Mississippi to the Ohio river area?

A

Histoplasma capsulatum

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19
Q

List three classes of antibiotics which may be used for Klebsiella pneumoniae.

A

Cephalosporins
Aminoglycosides
Fluoroquinolones

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20
Q

What two antibiotic classes may be considered to treat legionella pneumonia?

A

Macrolides and fluoroquinolones

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21
Q

What other bacterial pneumonia are patients who have pseudomonas pneumonia prone to get?

A

S. aureus pneumonia shares similar risk factors specifically nosocomial

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22
Q

What are the combinations of antibiotics which may be used for pseudomonas pneumonia?

A
  • Anti pseudomonal beta-lactam PLUS an antipseudomonal quinolone or aminoglycoside
  • Antipseudomonal quinolone PLUS an aminoglycoside
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23
Q

At least how many antibiotics should be used at the same time for pseudomonas pneumonia?

A

Always treat w/ at least 2 antibiotics

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24
Q

What are the antibiotics which may be used for MRSA pneumonia?

A

Vancomycin or linezolid + Levofloxacin or ciprofloxacin

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25
Q

List the antibiotics classes for inpatient ICU treatment in a patient with a pneumonia caused by Strep pneumoniae or non MRSA staph.

A

Beta-lactam + macrolide or fluoroquinolone

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26
Q

List the antibiotics classes for inpatient non ICU treatment in a patient with a pneumonia caused by Strep pneumoniae or non MRSA staph.

A

Beta-lactam PLUS a macrolide

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27
Q

List the antibiotics classes for outpatient treatment in a patient with comorbidities and a pneumonia caused by Strep pneumoniae or non MRSA staph

A

Fluoroquinolone doxycycline or macrolide PLUS a beta lactam

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28
Q

List the antibiotics classes for outpatient treatment in a healthy patient with pneumonia caused by S. pneumoniae or non MRSA staph.

A

Fluoroquinolone, doxycycline or macrolide

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29
Q

How many millimeters of induration is considered positive when reading a PPD result in an HIV positive patient?

A

> 5 mm

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30
Q

A “cinnamon breath smell” is associated with what pulmonary infection?”

A

Tuberculosis

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31
Q

Red orange urine occurs with which tuberculosis medication?

A

Rifampin

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32
Q

Ethambutol side effect?

A

optic neuritis

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33
Q

What is given to prevent neuropathy in a patient receiving isoniazid (INH) therapy?

A

B6 (pyridoxine)

34
Q

Where will older pulmonary lesions from tuberculosis be found?

A

lower lobes

35
Q

Where will newer pulmonary lesions from tuberculosis be found?

A

Upper lobe cavitary lesions

36
Q

What lab is elevated in PJP pneumonia?

A

LDH

37
Q

What pneumonia is associated with air conditioning vents and spas?

A

legionella

38
Q

What is the most likely Dx? Young IV drug user with fever severe hypoxia and diffuse infiltrates on X-ray?

A

PJC pneumonia

39
Q

Bacterial pneumonia which occurs in a young patient after flu is most likely caused by what organism?

A

staph aureus

40
Q

Rusty sputum?

A

Strep pneumoniae pneumonia

41
Q

What pneumonia associated with diarrhea and low sodium levels?

A

Legionella

42
Q

Flu can be treated with oseltamivir within how many hours of onset of symptoms?

A

48 hrs

43
Q

Most common cause of acute bronchitis?

A

viral

44
Q

Name the commonly used meds to treat active tuberculosis infection.

A 
RIPE: 
Rifampin
Isoniazid (INH)
Pyrazinamide
Ethambutol
45
Q

Which vitamin should be given along with isoniazid (INH) therapy?

A

Vit B6 (pyridoxine)

46
Q

Which vitamin should be given along with isoniazid (INH) therapy?

Vitamin B6 (pyridoxine)

What is the recommended treatment for a healthcare worker with a first time positive PPD?

A

Isoniazid (INH) for 6 months

47
Q

What is the sputum test for tuberculosis?

A

AFB smear and cultures

48
Q

What is the Dx? Recent international travel now with fever night sweats cough hemoptysis SOB and weight loss.

A

tuberculosis

49
Q

Treatment for PJC pneumonia?

A

Trimethoprim-sulfamethoxazole or pentamidine

50
Q

Pneumonia seen in HIV patients with low CD4 counts?

A

PJC= Pneumocystis jiroveci (formerly called PCP)

51
Q

Treatment for Histoplasma pneumonia?

A

amphotericin B

52
Q

Pneumonia associated with inhalation of bat or bird droppings?

A

histoplasma

53
Q

Treatment for immunocompromised patient with fungal pneumonia?

A

Itraconazole or fluconazole

54
Q

Chest X-ray shows RUL abscess. Most likely organism?

A

Klebsiella (often associated with aspiration)

55
Q

Pt with suspected pneumonia has “currant jelly colored” sputum. Most likely organism?

A

klebsiella

56
Q

What organism is associated with positive cold agglutinins?

A

mycoplasma

57
Q

Name 2 antibiotics you can use to treat Legionella.

A

Macrolide or Fluoroquinolone

58
Q

Chest X-ray shows lobar pneumonia. Most likely organism?

A

strep pneumoniae

59
Q

What medications are recommended for MRSA pneumonia?

A

Vancomycin or linezolid + levofloxacin or ciprofloxacin

60
Q

Organism causing pneumonia spread by contaminated water?

A

legionella pneumonia

61
Q

Pneumonia often related to post intubation, ventilator or hospital?

A

pseudomonas pneumonia

62
Q

Pt with suspected pneumonia/URI has salmon/pink colored sputum. Most likely organism?

A

staph aureus

63
Q

Pt with suspected pneumonia/URI has rusty colored sputum. Most likely organism?

A

strep pneumoniae

64
Q

Which virus can lead to pneumonia after URI and also often causes diarrheal illness/GI symptoms?

A

adenovirus

65
Q

Virus causing pneumonia after exposure to rodent feces (Western states)?

A

hantavirus

66
Q

Most common cause of viral pneumonia in adults?

A

influenza

67
Q

Name the organisms that cause typical pneumonia.

A

Strep pneumoniae
Staph aureus
Group A Strep

68
Q

Organisms responsible for atypical pneumonia?

A

Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella

69
Q

Organism usually causing pneumonia after aspiration?

A

klebsiella

70
Q

Should normal percussion over the lung fields sound dull or resonant?

A

resonant

71
Q

What does positive egophony on auscultation in a patient with pneumonia mean?

A

When listening over the area of consolidation, patient will say “eee” and it sounds like “aaa”

72
Q

What is the Dx? Previously healthy patient with abrupt onset of fever headache malaise occurring in the winter months.

A

Influenza

73
Q

What childhood vaccine protects children from pertussis?

A

DTaP

74
Q

Preferred treatment for pertussis?

A

Clarithromycin or azithromycin

75
Q

Organism that causes whooping cough?

A

Bordetella pertusis

76
Q

Steeple sign on a frontal chest X-ray showing tracheal narrowing?

A

croup

77
Q

Virus that causes croup?

A

Parainfluenza virus type 1

78
Q

Child has barking cough and stridor?

A

croup

79
Q

What is the Dx? Child presents with dysphagia, drooling and respiratory distress. Lateral neck X-ray shows “thumbprint sign”.

A

acute epiglottitis

80
Q

How is RSV diagnosed?

A

Analysis/culture of Respiratory secretions

81
Q

Most common cause of acute bronchiolitis in an infant?

A

Respiratory syncytial virus (RSV)

SP: Pulmonary Pearls (12%) (8 decks)

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