Medicine Rvw - Shiv Flashcards
What lung Volumes/Capacities cannot be measured with spirometry?
TLC, FRC, RV
Total lung capacity, functional reserve capacity and residual volume
Percentage of FEV1/FVC ratio for obstructive lung disease?
< 70%
Percentage FEV1/FVC ratio for restrictive lung disease.
Normal or increased > or = 70%
Understand and be able to draw out this slide.
Draw out slide
Understand this slide very well
Understand and draw out slide.
List the type of face mask in order of least oxygen delivery to most oxygen deliver that can be used.
- nasal cannula
- simple mask
- partial rebreathing mask
- non-rebreathing mask
What is the most common pathogen associated with acute pharyngitis?
Group A β-hemolytic Streptococcus (S. pyogenes)
Besides pharyngitis what other conditions is S. pyogenes commonly associated with?
Acute Glomerulonephritis & Acute rheumatic fever.
Etiology of acute viral pharyngitis.
Respiratory viruses i.e. Rhinoviruses and Coronaviruses, Influenza virus, etc
What is the etiology of acute bacterial pharyngitis?
typically caused by S. pyogenes
What age group is prone to acquiring acute bacterial pharyngitis?
children age 5-15 years
Is acute pharyngitis due to respiratory viruses severe?
not severe
C/F of acute pharyngitis caused by influenza virus.
fever, myalgias, headache, cough, tender cervical adenopathy and pharyngeal exudates.
Pharyngoconjunctival fever is due to infection by what types of organisms?
adenovirus infection
C/F of acute pharyngitis caused by Group A strep.
presents with pharyngeal pain, fever, nausea, vomiting.
hyperemic pharyngeal membrane with tonsillar hypertrophy and exudate
Strains that generate erythrogenic toxin can also produce Scarlet Fever characterized by an erythematous rash and strawberry tongue.
What C/F is acute pharyngitis from coxsackie virus(herpangina) associated with?
small vesicles that develop on the soft palate and uvula and then rupture to form shallow white ulcers.
Distinguish what is causing what is seen in these photos.
Left: streptococcal pharyngitis
Middle: viral pharyngitis
Right: acute pharyngitis (streptococcal pharyngitis)
What is the primary goal of running diagnostic test when assessing if an individual has pharyngitis?
to separate acute streptococcal pharyngitis from other etiologies.
How would you treat pharyngitis caused by Group A B-hemolytic strep?
Either Penicillin, Amoxicillin or erythromycin
How to treat viral pharyngitis?
entirely symptom based treatment except in severe cases of influenza where we use amantadine, oseltamivir, zanamivir
What are some complications of acute streptococcal pharyngitis?
Rheumatic fever is the best-known complication,
Acute glomerulonephritis
Peritonsillar abscess (QUINSY)
What is croup?
is a syndrome that includes laryngotracheitis, laryngeotracheobronchitis (seal like bark), and laryngotracheobronchopneumonitis.
What population is croup common in?
more common in boys than in girls, usually occurs between 6-36 months of age
What is the etiology of croup?
Parainfluenza virus types 1 to 3 (type 1 is most common), Influenza A and B viruses
C/F of croup?
usually start like an URTI, with low-grade fever and coryza followed by a barking cough and various degrees of respiratory distress (e.g., nasal flaring, respiratory retractions, stridor), steeple sign (which is non specific may be seen in other conditions)
Treatment protocol for croup.
Humidification therapy
Corticosteroid therapy
Nebulized Epinephrine
What is being seen in this figure?
steeple sign characteristic of a patient with croup.
What is acute epiglottitis?
Is an acute, rapidly progressive form of cellulitis of the epiglottis and surrounding tissues that may lead to complete airway obstruction and is potential fatal.
What are causal organisms of acute epiglottitis?
Streptococcus pneumoniae,Staphylococcus aureus,H. influenza
C/F of acute epiglottitis.
High fever, severe sore throat, odynophagia, and dysphagia develop abruptly.
Fatal asphyxia may occur within a few hours of onset.
tripod position
Drooling is very common
What age group is acute epiglottitis often seen in?
young children more commonly
Upon physical examination of acute epiglottitis what is witnessed?
Moderate or severe respiratory distress, with inspiratory stridor and retractions of the chest wall.
What will one see upon oropharyngeal examination of acute epiglottitis?
infection that is much less severe than would be predicted from symptoms
What is seen upon direct fiberoptic laryngoscopy of an individual with acute epiglottitis? Where is this procedure typically performed?
frequently performed in a controlled environment (e.g. An operating room) to visualize and culture the typical edematous “cherry-red” epiglottis (beefy-red, stiff, edematous epiglottis) and facilitate placement of an endotracheal tube.
What is characteristic in a neck radiograph of individual with acute epiglottitis?
the “thumbprint sign”)
Where can cultures be taken from in an individual with acute epiglottitis?
Cultures from the supraglottic tissues and blood
What features will raise suspicions that a person may have epiglottitis?
Often, there is no visible oropharyngeal inflammation. However, severe throat pain with a normal-appearing pharynx raises suspicion of epiglottitis and also in patients with sore throat and inspiratory stridor
What is tonsillitis often caused by?
most often caused by the common cold viruses (adenovirus, rhinovirus, influenza, coronavirus, and respiratory syncytial virus), but occasionally by Epstein-Barr virus.
What bacterial pathogen is tonsillitis most commonly caused by?
Group A β-hemolytic streptococcus (GABHS) is most common
C/F tonsilitis.
Halitosis and muffled/scratchy voice
Painful swallowing is hallmark
sore throat
What are conservative treatment methods for tonsillitis?
To reduce the discomfort from tonsillitis include pain and fever by
Antipyretics and analgesics,
Drink plenty of fluids to drink,
Get lots of rest,
What are the antibiotics that should be used in the treatment of tonsillitis?
the tonsillitis is caused byGABHS, thenpenicillinoramoxicillinbeing primary choices.
Can surgery be implicated to treat tonsillitis?
Chronic, severe or recurrent cases may be treated with Tonsillectomy(surgical removal of tonsils) as a choice for treatment.
