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EOR Family med > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

MC cause pneumonia

A

streptococcus pneumoniae

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2
Q

Typical sx pneumonia

A

fever
productive cough
pleuritic chest pain
dyspnea
rigors (severe chills with violent shaking)

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3
Q

atypical sx pneumonia

A

low grade fever
dry nonproductive cough
extra pulmonary sx (myalgias, malaise, pharyngitis, N/V/D)

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4
Q

PE pneumonia - typical

A

tachypnea
tachycardia
signs of consolidation - bronchial breath sounds, dullness to percussion, increased tactile fremitus, ego phony, inspiratory rales (crackles)

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5
Q

PE atypical pneumonia

A

pulmonary exam often normal
may have crackles (rales)

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6
Q

MC cause of community acquired pneumonia

A

streptococcus pneumonia

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7
Q

gram stain streptococcus pneumonia

A

gram positive diplococci

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8
Q

what color is sputum for streptococcus pneumonia

A

blood-tinged (rusty) sputum

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9
Q

klebsiella pneumonia sputum

A

current jelly - thick, mucoid and blood-tinged

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10
Q

gram stain for haemophilus influenza

A

gram negative rod

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11
Q

gram stain klebsiella pneumoniae

A

gram negative rod

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12
Q

staphylococcus aureus and pneumonia is associated w

A

a superimposed infection after a viral infection
hospital acquired pneumonia (MRSA)

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13
Q

gram stain staphylococcus aureus

A

gram positive cocci in clusters

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14
Q

most common cause of atypical (walking) pneumonia

A

mycoplasma pneumonia

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15
Q

community acquired pneumonia

A

outside hospital setting
< 48 hours in hospital setting

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16
Q

hospital acquired pneumonia

A

> 48 hours in hospital setting

17
Q

Admission for pneumonia

A

CURB65 - admission if at least 2
Confusion
Uremia (> 30 mg/dL)
Respiratory rate >/= 30
BP low SBP < 90 or DBP < 60
Age > 65

18
Q

pneumococcal vaccines for >/= 65

A

PCV15
PCV20

19
Q

if PCV15 is given, what should you do ONE YEAR LATER

A

PPSV23

20
Q

what pneumococcal vaccine is used in childhood

A

PCV13

21
Q

tx community acquired pneumonia in otherwise healthy

A

Amoxicillin or Macrolide (Azithromycin) or Doxycycline

22
Q

Tx community acquired pneumonia in pts w comorbidities

A

Amoxicillin clavulanate or a cephalosporin plus a macrolide

or mono therapy fluoroquinolone (Levofloxacin, Moxifloxacin, Gemifloxacin)

23
Q

community acquired tx inpatient nonsevere

A

Beta lactam plus a macrolide
or fluoroquinolone

24
Q

cause of tuberculosis

A

Mycobacterium tuberculosis (acid-fast bacteria)

25
Q

major pathology of tuberculosis

A

granulomatous inflammation with caseation (central necrosis) - caseating granulomas

26
Q

patients with what type of TB are not infectious

A

latent

27
Q

sx tuberculosis

A

prolonged fever (often w diurnal pattern)
cough (often mild and nonproductive and then becomes productive and foul-smelling)
pleuritic chest pain
dyspnea
hemoptysis
fever
chills
night sweats

can affect any organ

28
Q

PE for tuberculosis

A

often normal - may have clubbing

29
Q

if chest image is suggestive of TB, what should you do

A

3 sputum samples collected and sent for acid fast bacilli staining and culture
one sample tested with nucleic acid amplification (NAAT)

30
Q

how is latent TB diagnosed

A

tuberculin skin test

31
Q

cxr for TB

A

hilar adenopathy MC
pleural effusions
pulmonary infiltrates

32
Q

tx latent TB

A

9 month therapy of isoniazid and pyridoxine
or 4 mos Rifampin if intolerant to Isoniazid

33
Q

if positive tuberculin skin test, what is done to confirm

A

interferon gamma release assay

34
Q

what do you do if tuberculin skin test positive and interferon gamma release assay are both positive

A

screen for active TB (CXR and sputum tests)

35
Q

tx active TB

A

RIPE
Rifampin
Isoniazid
Pyridoxine
Ethambutol

EOR Family med (25 decks)

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