Influenza, Bronchitis, Pneumonia Flashcards
Symptoms for Flu
Fever Aches Chills Tiredness Sudden onset
Diagnostic test for Influenza?
Rapid influenza Diagnostic test (RAT)
Physical exam findings for Influenza
Pretty benign
- Flushing
- Hot, dry skin
- MM injection
What is another diagnostic test you can use for Influenza
CxR for lungs
What indicates Treatment for Influenza
- Illness that requires hospitalization
- Severe or complicated illness
- High risk for complications
Who is considered High risk groups for influenza
- Higher aged groups
- Pregnancy (2 weeks post partum)
- Children less than 19 or chronic ASA therapy
- American Indians and Alaska Natives
- Morbidly Obese (more immunosuppressed)
- Resident nursing homes
Antirivral Medications
Neurinidase Inhibitors -Influenza A/B:
Time frame for antivirals for influenza
24-48 hrs
Complications for Influenza
Pneumonia
Guidelines for first time Pediatric flu vaccines
2 vaccines, 4 weeks apart
After then just need vaccine annually
What are the guidelines for egg allergies and flu vaccine?
Who is contraindicated from the flu vaccine
Unless they’ve had a severe reaction go
Which of the of the following is considered the gold standard for laboratory diagnosis of influenza?
Viral culture
Etiology for Bronchitis
VIRAL
Influenza A and B
Parainfluenza
Coronavirus
Rhonavirus
Bacterial causes for Bronchitis
Bordetella pertussis- only one that needs treatment
Mycoplasm
Pneumonias
Clinical presentation for acute Bronchitis
Deeper Cough for 1-3 weeks
Febrile
Chest wall tenderness
Wheezing
Mild dyspnea
How would bronchitis present on a physical exam
- Wheezing
- Negative for rales and consolidation
- Rhonchi clears with coughing
Management of Bronchitis
Symptomatic treatments depending on symptoms
- Antitussives (codeine)
- B2 agonists
Which of the following causes of acute bronchitis necessitate treatment with antibiotics?
Bordetella pertussis
Etiology behind Pertussis
Bordetella pertussis - releases toxins that damages cilia and swelling of airways
3 stages of Pertussis
slide 35
What diagnostic lab results would you expect to find with pertussis
CBC: Elevated White count
Treatments for Pertussis
Azithromycin 500 mg day, 250 mg day 2-5 days.
Easier compliance
Vaccination recommendations for Pertussis
- All infants= DTap
- Adolescents 11-18 = Tdap booster
- All adults = single Tdap dose
- Pregnancy between 27-36 weeks or post partum
Risk factors for Pneumonia
Advanced age
Alcoholism
Tobacco use
Immunosuppression/HIV
Most common cause for Pneumonia?
Strept pneumonia - 2/3 causes
Atypical causes/organisms for pneumonia
- Mycoplasma pneumonia
- Chlamydophila pneumonias
- Legionella spp.
Atypical causes/organisms for pneumonia
- Mycoplasma pneumonia (interstitial x-ray)
- Chlamydophila pneumonias
- Legionella spp.
What diagnostic tests are need to diagnose Pneumonia?
CBC = Leukocytosis
CXR - Lobar, Interstitial, Cavitation
What diagnostic tests are need to diagnose Pneumonia?
CBC = Leukocytosis
CXR (Gold Standard) - Lobar, Interstitial, Cavitation
In a previously healthy patient being treated outpatient, which of the following antibiotics is recommended for initial treatment of community acquired pneumonia?
Azithromycin
Which of the following medications is recommended in a patient with community acquired pneumonia associated with MRSA?
Vancomycin
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?
Not enough information need a x-ray due to 5 day long history
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?
Inpatient
The patient from the prior slide is admitted to the hospital, general medical unit. Which of the following is the most appropriate treatment?
Levofloxacin alone
