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WHOLE PT > Pulm > Flashcards

Pulm Flashcards

1
Q

Pt has fever + pleuritc pain + productive cough and no hospitalization within 48hrs? most common bug?

A

community acquired pneumonia

most common: strep pneumoniae, C pneumonaie, H flu, legionella, viruses

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2
Q

Pt has sore throat + HA + non productive cough + dyspnea? Bug?

A

atypical pneumonia
mycoplasma
chlamydia

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3
Q

Pt has fever + productive cough after being hospitalized how many hrs? Bug?

A

hospital acquired pneumonia
w/in 48hrs
bug: gram neg - e coli, pseudomonas, staph aureus

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4
Q

What are the 2 types of vaccine? When to vaccinate?

A

influenza -

pneumococcal- 65yo+

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5
Q

What PE to expect from community acquired pneumonia?

A

dullness to percussion

egophony

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6
Q

When to order culture for pneumonia?

A

if CXR shows cavitations

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7
Q

What lab to order for pneumonia? What to expect?

A

CXR - consolidations

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8
Q

What type of crackles will be heard with pneumonia?

A

late inspiratory crackles

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9
Q

What type of pulse - temperature indicates atypical pneumonia?

A

normal pulse but high fever

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10
Q

Alcoholic with pneumonia - bug?

A

klebsiella

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11
Q

Immigrant w/ pneumonia -bug?

A

TB

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12
Q

Pt lives in nursing home w/ pneumonia - bug?

A

pseudomonas

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13
Q

Pt has HIV retrosternal chest pain that is worse with inspriation, been going on for weeks? What to expect on CT?

A

pneumocystitis jiroveci

CT- ground glass appearance

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14
Q

How to tx pneumocystitis jiroveci?

A

bactrim

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15
Q

Pt who had organ transplant or renal failure, smokers are at risk for what bug w/ pneumonia?

A

legionella

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16
Q

How to tx community acquired pneumonia? How long?

A

1) macrolide - azithromycin
2) doxycyline
3) fluorquinolones - levofloxacin or macrolide w/ beta
5 days or until afebrile for 48hrs

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17
Q

How to tx hospital acquired pneumonia?

A

fluroquinolone
OR
macrolide + beta lactam

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18
Q

What are complications of pneumonia?

A

pleural effusion

pleural empyema

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19
Q

Where to look for aspirated pneumonia, FB, lung abscess?

A

RIGHT LUNG

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20
Q

What are the bugs for neonatal 0-1mo? -Pneumonia

A

group b strep

e coli

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21
Q

What are the bugs for infants 1-6mo? -Pneumonia

A

chlamydia trachomatis

RSV

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22
Q

What are the bugs for children 6mo-5yo? -Pneumonia

A

RSV

parainfluenza

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23
Q

What are the bugs for children 5-15yo? -Pneumonia

A

mycolasma pneumonia

influenza virus A

24
Q

What are the bugs for young adults 16-30yo? -Pneumonia

A

mycoplasma pneumoniae

25
Q

What are the bugs for older adults 30yo+? -Pneumonia

A

strep penum

haemophilus influenzae

26
Q

Common bug if pt is in ICU w/pneumonia?

A 
s. pneumoniae
legionella
H fl
Enterobacateriae
S aureus
pseudomonas
27
Q

How to tx ICU pt w/pneumonia?

A

azithormycin

fluorquinolone + anti pneumoococcal beta lactam

28
Q

How to determine if pt needs to be hospitalized w/pneumonia?

A

CURB 65

  • Confusion
  • Urea nitrogen, blood >19
  • RR >30/min
  • BP systolic
29
Q

What are the different phases of TB?

A

early
latent
progressive

30
Q

What is the most common bug for TB?

A

mycobacterium tuberculosis

31
Q

What are the different phases of TB?

A

primary
progressive
latent

32
Q

What is primary TB?

A

when TB first enters the lungs and manifests/walls off to make their home –> also spreads via lymphatics and blood –> after the first infxn it is not detectable

33
Q

What is secondary TB?

A

happens when the body is suppressed/weak –> REACTIVATION (b/c the body had it’s first infxn with primary TB) –> actually shows SIGNS and SX of TB –> manifests where the lungs have the MOST O2 (apical parts of the lungs)

34
Q

What are sx of TB?

A 
fever
night sweats
wt loss
malaise
dry cough --> productive 
apical rales: post tussive
35
Q

What is latent TB?

A

same as primary - cannot tell if latent or primary b/c it is asymptomatic

36
Q

What are RF for TB?

A

close contact
immigrants
HIV

37
Q

What imaging for TB and what to expect?

A

CXR - upper lob infiltrates w/ cavitations; milary pattern

38
Q

What labs to order for TB?

A

sputum cultures x3mornings - acid fast

39
Q

What pt may have false positive for mantoux TST?

A

immigrants that may have BCG vaccination

40
Q

What are the types to screen for TB?

A

mantoux TST

interferon gamma release assay

41
Q

How to read the mantoux TST? Who does this apply to?

A

5mm- HIV , close contact with TB
10 mm - foreign born, IV drug users, children, homeless, prisoners, health care workers
15mm - never been exposed to health settings, NO RF

42
Q

How to tx TB?

A

4 drug therapy- RIPE

1) Rifampin
2) Isoniazid
3) Rifampin
4) Ethambutol

43
Q

Pt has sudden onset of fever+ chills + HA + nonproductive cough + sore throat + photophobia? Tx?

A

influenza
supprotive
zanamivir (do not use in asthma) /oseltamivir - antiviral very ineffecctive

44
Q

Sx for mononucleosis? Bug?

A

flu like sx + splenomegaly + maculopapular rash + petechaie

EBV

45
Q

How to dx mononucleosis?

A

monospot

46
Q

How to tx mononucleosis?

A

supportive

47
Q

When does a cough need further investigation?

A

3mo

48
Q

Pt has rhinorrhea, myalgias, HA, fever, cough - yellow sputum? Is this viral or bacterial?

A

viral NO yellow pustum

49
Q

What sx for bacterial URI?

A

fever, cough, yellow sputum

50
Q

Pt has cough after URI? Tx?

A

acute bronchitis

supportive, +/- bronchodilators, codeine

51
Q

What URI bug for acute bronchitis?

A

influenza A, B

52
Q

What is common cold called?

A

acute rhinosinusitis

53
Q

What bugs for acute rhinosinusitis?

A

rhinoviruses

coronavirus

54
Q

What are sx of influenza?

A

fast on fast off
systemic sx dec and resp incr
fever, HA, chills, mayalgia, photophobia

55
Q

Tx of influenza? Complication?

A

zanamivir - NOT for asthmatics

WHOLE PT (19 decks)

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