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Resp II Exam II > Pneumonia and TB CIS Kinder > Flashcards

Pneumonia and TB CIS Kinder Flashcards

1
Q

dry cough
hemorrhage bullous myringitis (inside ear)

cold agglutinins

A

mycoplasma pneumonia

no cell wall so can’t be treated with penicillin

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2
Q

when you have had a splenectomy what are you most at risk for …

A

encapsulated organisms

these patients need to have a pneumococcal vaccination

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3
Q

rust colored sputum

A

strep pneumoniae

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4
Q

current jelly sputum

A

klebsiella

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5
Q

air conditioning systems

low pulse

grows on charcoal yeast extract (requires cysteine and iron)

gram negative

A

legionella

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6
Q

homeless shelter worker

A

TB

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7
Q

cave explorer

A

histoplasma capsulatum

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8
Q

foamy alveolar exudates
small hat shaped lesions on BAL
predisposing condition –> AIDS

fever, non productive cough, hypotension

A

pneumocystis jirovecii

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9
Q

with sickle cell disease –> these patients are most at risk for what organisms

A

strep pneumoniae

encapsulated

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10
Q

what is clindamycin good for

A

anaerobes

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11
Q

lancet shaped

A

strep pneumoniae

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12
Q

methenamine silver stain of lung tissue

A

pneumocystis jirovecii

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13
Q

at what CD4 level do you start prophylaxis for fungal infection

A

Less than 200

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14
Q

croup

A

parainfluenza

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15
Q

which antibiotic is most appropriate for legionella

A

erythromycin (Azithromycin) - macrolide

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16
Q

bactrim DS used against what organism

A

pneumocystis jirovecii

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17
Q

clindaymcin is used to treat what?

A

anaerobes - aspiration pneumonia

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18
Q

methicillin or nafcillin is used to treat what

A

staph

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19
Q

small, painful rash and red bumps on his lower legs

A

erythema nodosum

seen in coccidiodes immitis

also seen in sarcoidosis

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20
Q

green sputum

HAP

A

pseudomonas aeruginosa

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21
Q

pyocyanin

A

pseudomonas aeruginosa

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22
Q

transmitted by flea bites

A

yersinia pestis

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23
Q

fungus ball

A

aspergillus flavus

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24
Q

AFB culture and stain

A

tuburculosis diagnosis

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25
Q

gram stain of sputum

A

diagnosis for typical pneumonia

26
Q

if a patient just has a positive ppd test but no active disease… what would you do next…

A

INH for 6 months

27
Q

bilateral rales, wheezing and intercostal retractions with grunting

child at daycare

A

RSV

28
Q

kidney shaped diplococci capsule

seen in elderly usually

A

moraxella catarrhalis

29
Q

TB medication that causes vertigo sensation/visual impairment

A

ethambutol

30
Q

orange discolored urine body fluids

A

rifampin

31
Q

weight loss, fatigue, cough, sputum production, hemoptysis, dyspnea, fever, night sweats

A

TB

32
Q

broad based buds

Louisiana

A

blastomycosis

33
Q

5 mm or more positive PPD skin test is positive in what patients

A

HIV positive
recent close contacts with TB
persons with nodular or fibrotic changes on CXR

more…

34
Q

10 mm or positive PPD skin test is positive in what patients

A

patient traveling from TB endemic country

prisons, nursing homes, hospitals

injection drug users

35
Q

peripheral neuropathy adverse effect of this TB drug

A

isoniazid

can also be caused by streptomycin and ethambutol

36
Q

rabbits

skin manifestations ***

A

tularemia

37
Q

MAC

A

CD4 count < 50

abdominal pain and diarrhea

38
Q

most common cause of post-influenzal bacterial pneumonia

A

staph aureus

39
Q

thumb sign on lateral neck X-ray

A

h. influenzae

causing epiglottitis

40
Q

deer mouse is the primary reservoir

rodents shed the virus through urine, droppings and saliva

A

hanta virus

febrile phase:Symptoms include fever, chills, sweaty palms, explosive diarrhea, malaise, headaches, nausea, abdominal pain, back pain, and SOB. Lasts 3-7 days

hypotensive phase
oliguric phase
diuretic phase
convalescent phase

41
Q

when you look at a PPD what do you look at ? Induration or erythema?

A

induration! it has to be 5 mm of induration

42
Q

roth spots, osler’s nodes
janeway lesions
splinter hemorrhages

seen in what condition

A

endocarditis

so a patient who has used IV drugs/prostitute with staph endocarditis leading to staph pneumonia

43
Q

35 year old sheep* rancher, who for the last 10 days has had a high fever of 104.5F*, headache, chills, myalgias, malaise, and dry, non-productive cough. This came on suddenly, and persisted. There are decreased breath sounds bilaterally. The chest x-ray reveals a patchy infiltrate with multiple round, segmental opacities. There is a large area of left lower lobe consolidation. Hepatomegaly is noted, along with elevated AST and ALT levels.

Is this caused by?
A. An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences.
B. An aerobic gram positive bacteria that forms spores.
C. An alpha-hemolytic gram positive organism
D. An organism that stains acid fast
E. An organism without a cell wall

A

A. An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences.

gram negative

this is coxiella burnetii

sheep and goats!!

Q fever has splenomegaly and hepatomegaly

44
Q

5% of endocarditis cases
Normal flora
Common Cause of endocarditis in non-IV drug users
Difficult to diagnose- often takes 3 months

A

HACEK organisms

Haemophilus spp
Actinobacillus actinomycetemcomitans
Cardiobacterium hominis
Eikenella corrodens
Kingella spp
45
Q

most common cause of bronchiolitis and pneumonia in children under 1 year of age in the US

A

RSV

46
Q 
Which organism listed below is among the most common causing an exacerbation of COPD and patients who have smoked for a very long time?
A.  Myocoplasma pneumoniae
B.  Moraxella catarrhalis
C.  Chlamyida pneumoniae
D.  TWAR
E.  Pseudomonas aeruginosa
A

moraxella catarrhalis

common cause of pneumonia in elderly and patients with COPD

47
Q

brain abscess causing in HIV patients -ring enhancing brain lesion on CT/MRI

cats

tachyzoites that stain with H and E

A

toxoplasma gondii

48
Q

a disorder that begins with a flu symptoms stage that resolves and comes back affecting the liver, lungs, kidneys going to renal failure

associated with animal urine

A

leptospirosis - spirochete

49
Q

strep pneumonia has what type of response by the immune system?

A

humoral immunity with encapsulated organism

antibody mediated

50
Q

CD4 count < 200

A

PCP

51
Q

CD4 count < 100

A

toxoplasmosis

52
Q

CD4 count < 50

A

MAC
CMV
cryptococcus meningitis

53
Q

in a patient who gets classic pneumonia who has no spleen, how do they acquire the infection?

A

no longer has the full ability to produce opsonzing IgG antibody to the encapsulated organism

54
Q

dapsone

A

for patients who are allergic to sulfa

55
Q

bird and bat guano

A

histoplasma capsulatum

56
Q

Gram stain demonstrates the presence of a gram negative coccus that has a prominent polysaccharide capsule and grows on “ chocolate” agar.

can cause petechiae, purpura

A

n. meningitides

57
Q

what drug do you use as prophylaxis if you have been exposed to n. meningitides

A

rifampin

58
Q

orange urine

A

rifampin

59
Q

treat aspiration pneumonia with what

A

clindamycin

60
Q

Spore forming gram-positive
non motile rod that is aerobic or facultatively anaerobic, catalase positive, hemolysis negative

Grows on sheep agar

Zoonotic infection from goats, sheep, cattle, antelope, kudu, pigs, horses, zebu, and other animals.

Animal related products include meat, wool, hides, bones, and hair
Soil contaminated with spores

A

bacillus anthracis

61
Q

what are the signs on EKG of PE?

A

Most common finding–> sinus tachycardia

other finding:
S1 Q3 T3

S wave in lead I

Q in lead III

inverted T wave in lead III

Resp II Exam II (11 decks)

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