Legionnaires Disease and Additional Adult Respiratory Conditions Flashcards
Who is MOST at risk of contracting Legionnaires disease? A: 42 yr old with COPD B: 30 yr old with hx of TB C: 56 yr old, former smoker D: 72 yr old with CKD
C: 56 yr old, former smoker
Answer: C
What transmission sources are responsible for legionnaires disease?
Answer: contaminated water sources (Showerheads / faucets), air conditioning cooling towers
What KEY lab finding is present in Legionnaires Disease versus other pneumonia? A: elevated CK B: decreased WBC C: decreased sodium D: elevated LFTs
C: decreased sodium
C: hyponatremia (<130 – low Na+ levels are a common feature of patients with community-acquired pneumonia when caused by Legionella
pneumophila. Legionella produces an interstitial disease that can destroy the JG apparatus, so you can’t secrete renin. Without renin, you
can’t make aldosterone, so you get a type IV renal tubular acidosis and can’t reabsorb Na+)
What treatment is appropriate for a patient with Legionnaires disease?
Answer: (macrolides) azithromycin PO, clarithromycin, or a fluoroquinolone “acins” (cipro, levo, moxi, gemi) for 10-14 days
(ERYTHROMYCIN IS NOT USED BECAUSE IT IS NO LONGER EFFECTIVE AGAINST THIS GRAM-NEGATIVE BACTERIA)
A 65-yr. old patient presents for persistent, productive cough. You note that he is a smoker. The upper airways are clear after you have him . He has a fever and also complains of copious sputum with symptoms lasting 10 days. What is his likely diagnosis?
Answer: Bacterial Bronchitis
A patient presents with a 6-day productive cough that clears with coughing. He is afebrile. What is his likely diagnosis?
Answer: Viral Bronchitis
How do you diagnose bronchitis?
Answer: Clinical exam
When would you do a CXR on a bronchitis patient?
Answer: Suspected pneumonia
