PUL not COPD or Asthma Flashcards
How do you tx anthrax?
prophalxisis : doxy x 60 days with 3 subcu doses of vaccine
What are the two most contagious forms of TB
pulmonary and laryneal ( airbourne)
What is the BCG vaccine?
live vaccine against TB
what is the lab test for TB
Mantoux tb skin test TST which
intradermal .1 ml purfied protein derivate PPD at the inner surface forearm
read 48-72 hours
+ = raised pale wheal (hardened and palpable)
what is the two step testing PPD
needs a second negative test in 1-3 weeks of first
if second is positive it may indicate dx or booster phenmomen
what is the gold standard for dx pulmonary TB infection
sputum for c and S
what to do if TST is +
oder CXR if you suspect active TB start empiric therapy until you can get sputum results
What is the tx for latent TB
prophxylais in high risk group : HIV, DM, immune supression
regimen is 9 or 6 months
watch for signs of hepatitis,
what labs should you get prior to tx of TB
LFTs, EYE exam
what will you seen on an cxr with a person with TB
right upper lobe , cavitations, paratracheal lymphadenopathy and focal consolidation in the middle lobe
Highest risk groups < 5mm induration = negative result ( if no s/s of TB)
HIV + recent contact with TB person CXR with fibrotic chests consistent with previous TB any child w/ close contact < 5 immunocompromised pt
High risk groups < 10mm induration = negative result ( if no s/s of TB)
recent immigrants
IDU
staffor residents in ( prisons, hospitals_
children under 5
Pertusis
whooping cough
prolonged cold -like illness , 3-6 weeks getting worse, severe paroxysmal cough with a “ whooping” sounds
caused by bordetella pertusis
tx : macrolides : Azthromycin x 5 days
Sjogren Syndrome
autoimmune, that effect exocrine glands ( lacrimal and salivary glands) known as Sicca syndrome
presentation: dry eyes for more than 3 months, dry mouth for 3 months, wake up at night dur to dry mouth, swallen salivary glands
DX with labs, esr, tear testing, MRI paratid glands
