Influenza, Bronchitis, Pneumonia

Question 1

Symptoms for Flu

Answer 1

Fever
Aches
Chills 
Tiredness
Sudden onset

Question 2

Diagnostic test for Influenza?

Answer 2

Rapid influenza Diagnostic test (RAT)

Question 3

Physical exam findings for Influenza

Answer 3

Pretty benign

• Flushing
• Hot, dry skin
• MM injection

Question 4

What is another diagnostic test you can use for Influenza

Answer 4

CxR for lungs

Question 5

What indicates Treatment for Influenza

Answer 5

1. Illness that requires hospitalization
2. Severe or complicated illness
3. High risk for complications

Question 6

Who is considered High risk groups for influenza

Answer 6

1. Higher aged groups
2. Pregnancy (2 weeks post partum)
3. Children less than 19 or chronic ASA therapy
4. American Indians and Alaska Natives
5. Morbidly Obese (more immunosuppressed)
6. Resident nursing homes

Question 7

Antirivral Medications

Answer 7

Neurinidase Inhibitors -Influenza A/B:

Question 8

Time frame for antivirals for influenza

Answer 8

24-48 hrs

Question 9

Complications for Influenza

Answer 9

Pneumonia

Question 10

Guidelines for first time Pediatric flu vaccines

Answer 10

2 vaccines, 4 weeks apart

After then just need vaccine annually

Question 11

What are the guidelines for egg allergies and flu vaccine?

Who is contraindicated from the flu vaccine

Answer 11

Unless they’ve had a severe reaction go

Question 12

Which of the of the following is considered the gold standard for laboratory diagnosis of influenza?

Answer 12

Viral culture

Question 13

Etiology for Bronchitis

Answer 13

VIRAL

Influenza A and B
Parainfluenza
Coronavirus
Rhonavirus

Question 14

Bacterial causes for Bronchitis

Answer 14

Bordetella pertussis- only one that needs treatment

Mycoplasm

Pneumonias

Question 15

Clinical presentation for acute Bronchitis

Answer 15

Deeper Cough for 1-3 weeks

Febrile

Chest wall tenderness

Wheezing

Mild dyspnea

Question 16

How would bronchitis present on a physical exam

Answer 16

1. Wheezing
2. Negative for rales and consolidation
3. Rhonchi clears with coughing

Question 17

Management of Bronchitis

Answer 17

Symptomatic treatments depending on symptoms

1. Antitussives (codeine)
2. B2 agonists

Question 18

Which of the following causes of acute bronchitis necessitate treatment with antibiotics?

Answer 18

Bordetella pertussis

Question 19

Etiology behind Pertussis

Answer 19

Bordetella pertussis - releases toxins that damages cilia and swelling of airways

Question 20

3 stages of Pertussis

Answer 20

slide 35

Question 21

What diagnostic lab results would you expect to find with pertussis

Answer 21

CBC: Elevated White count

Question 22

Treatments for Pertussis

Answer 22

Azithromycin 500 mg day, 250 mg day 2-5 days.

Easier compliance

Question 23

Vaccination recommendations for Pertussis

Answer 23

1. All infants= DTap
2. Adolescents 11-18 = Tdap booster
3. All adults = single Tdap dose
4. Pregnancy between 27-36 weeks or post partum

Question 24

Risk factors for Pneumonia

Answer 24

Advanced age
Alcoholism
Tobacco use
Immunosuppression/HIV

Question 25

Most common cause for Pneumonia?

Answer 25

Strept pneumonia - 2/3 causes

Question 26

Atypical causes/organisms for pneumonia

Answer 26

1. Mycoplasma pneumonia 2. Chlamydophila pneumonias 3. Legionella spp.

Question 27

Atypical causes/organisms for pneumonia

Answer 27

1. Mycoplasma pneumonia (interstitial x-ray) 2. Chlamydophila pneumonias 3. Legionella spp.

Question 28

What diagnostic tests are need to diagnose Pneumonia?

Answer 28

CBC = Leukocytosis CXR - Lobar, Interstitial, Cavitation

Question 29

What diagnostic tests are need to diagnose Pneumonia?

Answer 29

CBC = Leukocytosis CXR (Gold Standard) - Lobar, Interstitial, Cavitation

Question 30

In a previously healthy patient being treated outpatient, which of the following antibiotics is recommended for initial treatment of community acquired pneumonia?

Answer 30

Azithromycin

Question 31

Which of the following medications is recommended in a patient with community acquired pneumonia associated with MRSA?

Answer 31

Vancomycin

Question 32

A 45 y/o woman is evaluated for a 5-day history of a productive cough. She had a low grade fever, up to 100.8 F. She has had occasional wheezing. Which of the following is the most likely diagnosis?

Answer 32

Not enough information need a x-ray due to 5 day long history

Question 33

A 67 y/o male is evaluated for new onset of confusion, and diagnosed with CAP. Medical history is positive for active prostate cancer, but he is otherwise healthy. Vital signs are stable. Should he be treated inpatient or outpatient?

Answer 33

Inpatient

Question 34

The patient from the prior slide is admitted to the hospital, general medical unit. Which of the following is the most appropriate treatment?

Answer 34

Levofloxacin alone