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Respiratory Exam 2 > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

what is the most common lethal nosocomial infection

A
  • hospital acquired pneumonia
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2
Q

the most common route of bacterial infection in the lung is

A
  • aspiration of pathogen
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3
Q

what is aspiration

A
  • inhaling of pathogens that colonize the oropharynx
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4
Q

what organism is well spread by hematogenous route of infection

A
  • staph aureus
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5
Q

onset of typical pneumonia

A
  • rapid onset
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6
Q

appearance of patient with typical pneumonia

A
  • ill appearing
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7
Q

lung exam of patient with typical pneumonia

A
  • consolidation

- crackles on exam

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8
Q

white count of patient with typical pneumonia

A
  • high white count
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9
Q

CXR of patient with typical pneumonia

A
  • airspace filling

- lobar infiltrate

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10
Q

typical pneumonia organisms

A
  • Strep pneumo
  • Staph aureus
  • gram negative bacilli
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11
Q

onset of atypical pneumonia

A
  • later onset
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12
Q

appearance of patient with atypical pneumonia

A
  • less ill appearing
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13
Q

lung exam of patient with atypical pneumonia

A
  • crackles without consolidation
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14
Q

white count of patient with atypical pneumonia

A
  • mild/no elevated white count
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15
Q

CXR of patient with atypical pneumonia

A
  • patchy/interstital infiltrates
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16
Q

atypical pneumonia organisms

A
  • mycoplasma
  • chlamydia
  • viruses
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17
Q

what pneumonia causing organisms are associated with alcoholism, nursing home, cardiopulmonary disease

A
  • aerobic gram negative bacilli
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18
Q

what pneumonia causing organisms are associated with loss of consciousness, swallowing dysfunction, poor dental hygiene, airway obstruction, neuromuscular weakness/stroke

A
  • anaerobes
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19
Q

what pneumonia causing organisms are associated with COPD and smoking

A
  • H. influenzae
20
Q

what pneumonia causing organisms are associated with nursing homes, post influenza, IVDA, bronchiectasis

A
  • S. aureus
21
Q

what pneumonia causing organisms are associated with structural lung disease, recent broad spectrum antibiotics, malnutrition, chronic steroids

A
  • P. aeruginosa
22
Q

what pneumonia causing organisms are associated with age > 65, beta lactate therapy within 3 months, exposure to child in daycare, underlying medical co-morbidities

A
  • drug resistant strep pneumonia
23
Q

we use urine antigens for which organisms

A
  • legionella
  • strep pneumo
  • histoplasma
24
Q

what stain do you use for fungus on a culture?

A
  • KOH
25
Q

upper lobe cavitary infiltrate is indicative of which infection

A
  • TB
26
Q

exposure to outdoorsmen is indicative of which infection

A
  • blastomycosis
27
Q

exposure to the desert Southwest is indicative of which infection

A
  • coccidioidomycosis
28
Q

respiratory rate for severe vital sign

A

> 30

29
Q

Systolic BP for severe vital sign

A

< 90

30
Q

Temperature for severe vital sign

A

> 40 or <35

31
Q

HR for severe vital sign

A

> 125

32
Q

WBC numbers for severe vital signs

A

> 30 K or < 4K

33
Q

initial treatment for pneumonia is always

A
  • empiric
34
Q

pathogenesis of hospital acquired pneumonia

A
  • colonization of pharynx with pathogenic bacteria

- micro-aspiration of lower respiratory tract

35
Q

is hospital acquired pneumonia based solely on a new culture result

A
  • no
36
Q

treatment of hospital acquired pneumonia based on

A
  • local hospital flora
37
Q

common pathogens in the hospital

A
  • P. aeruginosa
  • Enterobacter
  • E. Coli
  • Klebsiella
  • Acetinobacter
  • MRSA
  • Anaerobes

KEEP AMA

38
Q

neutropenic patients susceptible to infections by these organisms

A
  • bacteria
  • aspergillus
  • candida
39
Q

splenectomy patients susceptible to infections by these organisms

A
  • encapsulated organisms
40
Q

HIV or immunosuppressant patients susceptible to infections by these organisms

A
  • fungi
  • mycobacteria
  • viruses (CMV, EBV)
  • bacteria
41
Q

important infection with a CD4 below 200

A
  • PJP
42
Q

what is the most likely diagnosis of a symptomatic HIV+ patient with an abnormal CXR

A
  • bacterial pneumonia
43
Q

treatment of PJP in patients with AIDS

A
  • SMX/TMP
  • IV pentamide
  • Corticosteroids
44
Q

most common causes of pnuemonia

A
  • strep pneumo
  • H. flu
  • M. catarrhalis
45
Q

what type of TB presentation do you see in patients with a higher CD4 count

A
  • typical presentations
46
Q

what type of TB presentation do you see in patients with a lower CD4 count

examples

A
  • atypical
  • lower zone infiltrates
  • mediastinal adenopathy
  • disseminated disease

Respiratory Exam 2 (18 decks)

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