Pulm 1 Flashcards
A-a gradient is normally what? When is it higher?
Normally 5-15
Increased in PE, pulmonary edema, R-L shunt
Oxygen not getting into arteries
Pharyngitis criteria?
CENTOR criteria
Cough absence Exudate node temp OR age (15)
0-1 no antibiotic
2-3 throat culture
4-5 means treat
Sinusitis caused by what? What is mucor?
Strep pneumo H influ, moraxella
Mucor is fungal diabetes
Same as ear infection, so give Amox or doxy or levo
Murmurs and squatting?
What is the physiology to it?
Bronchotis most common cause?
tx?
Virus MOST COMMON
Mycoplasma or strep pneuma if smoker
Tx antibiotics if chronic other lung disease. (otherwise supprotive is first line)
Fluoroquinolones or macrolides
Atypical pneumonia CXR and types?
Mycoplasma, LEGIONELLA, chlamydophila.
XR shows diffuse and patchy
Most common cause of pneumo in youngster?
RSV
Strep pneumo pneumonia?
Tx?
RUST COLORED SPUTUM
Amox is first line, but lots of tuff works
Who gets H influx pnuemo? presentation?
COPD, sickle cell
Slow onset
Beta lactams and everything again
Most common pneumonia after influenza?
Strep, but staph can happen again
Staph pneumo CXR?
Abscess forming. It is post influx often
Klebsiellan pneumo in who? Symptoms?
CURRANT JELLY sputum in people who aspirate
Cephs and aminoglycosides
Psuedomonas pneuma in who?
Tx?
Ventilators, chronic ill, cystic fibrosis
Empiric antibiotics?
Pip tazo, cefepime, Cipro, levo
If sepsis, do pip taco with levo
GBS pneumo in who?
infants.
B lactams, amp and gent
Enterobacter pneumo?
Tx third gen cep or carbopanem
Cold agglutinin test is what?
Mycoplasma pneumo
tx macrolides
most common pneuma in young adults
Legionella pneumo symptoms? Tx?
Can have confusion, needs macrolide or fluoroquinolone
Atypical pneumonia tx?
Macrolide or fluoroquine
Mycoplasma
Legionella
Chlamydophila
Empiric antibiotics for pneumonia?
Levo or moxi for primary
Or beta lactam with macrolide
Old people are gross, so you see moe anaerobes and G- rods for pneumonia
But strep pneuma still most comon
Strep pneumo vaccination indication?
65 years
Long term health issue including alcohol, DM, Sickle cell
Resistance to infection lower from something like treatment OR NO SPLEEn
Smokers 19 or older
IF YOU SMOKE YOU NEED PNEUMO VACCINATION
OH
Pneumonia with caves?
Histoplasmosis
Also HISTORIC mississippi
Eastern north america fungal pneumonia?
Blasto
Fungal pneumo tx?
Severe?
Histo or blasto?
Coccidio?
If severe, ampho B
Itraconazole
Fluconoazole
Tx for PCP? CD4 count for PCP?
200!
You see rising LDH
21 days of antibiotics: BACTRIM
What is ghon complex?
Ghon focus (calcified granuloma) with hilar lymph on CXR in PRIMARY TB
PPD is positive at 5 mm when?
Immunodeficient or TB findings on CXR or working very close with the disease
secondary tb lung findings?
Symptoms?
Caseous cheesy
Fever, hemoptysis, weight loss, night sweats
Can have extra pulmonary TB just about anywhere! GREAT IMITATOR
Dx of tb?
weakly gram positive acid fast, Slow growing so hard to culture
Culture takes weeks
ACID FAST EVERY morning on sputum 3 days in a row
Latent Tb tx?
PRimary or secondary TB?
INH for 6 months
RIPE: Rifampin, INH, Pyran, Etham 2 months
Give B6 (pyrdoxine) for INH
Vaccination for Tb only affects ppd for about 10 years
Oh ok
