Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANRE PULM > Pulm Infxs > Flashcards

Pulm Infxs Flashcards

1
Q

MC serious viral airway infxn of adults
Respiratory secretions
Freq in winter

A

Influenza (A & B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs/Sxs (Flu)

A

Acute/SUDDEN onset
HA, FEVER, chills, sore throat, myalgias, arthralgias
Progressive dyspnea -> resp. failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dx / Tx / Prevention (Flu)

A

Rapid tests (nasopharyngeal) A & B
Supportive (rest, hydration, Tylenol)
Oseltamivir - within 3-4 days
Annual vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Self-limited inflamm of trachea, bronchi, bronchioles 2/2 infxn
Mucus formation
90% viral

A

Acute Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Etiology (Acute Bronchitis)

A

Rhinovirus, coronavirus
Mycoplasma pneum
Chlamydophila pneum
Bordetella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs/Sxs (Acute Bronchitis)

A

Cough +/- sputum
Concurrent URI
Fever rare (unless flu or PNA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dx / Tx (Acute Bronchitis)

A

CXR (for abnml VS / pulm findings) - NML!!!
NO ABX; no cough supp or expectorants
Reassurance, NSAIDS/APAP, decongest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Etiology of acute exacerbation of COPD

A

Infxn (70-80%): H. flu, S. pneum, flu, paraflu, coronavirus, rhinovirus
Non-infxn: smoking, meds, non-compliance, HF, allergens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Signs/Sxs (AE COPD)

A 
Chng sputum (volume, character)
Chng cough (freq, severity)
Inc dyspnea, RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dx (AE COPD)

A

Sputum gram stain / cx
Viral studies (NP swab)
CXR (r/o PNA if fever, hypoxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx (AE COPD)

A

O2
Bronchodilators (albut + ipratropium)
Systemic steroids
Abx (Uncomplicated: Doxy, Bactrim, Zpack; Complicated: Augmentin, Levoflox)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

1 ID cause of death

A

CAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Etiology (CAP)

A

Typicals: S.pneum (fever, rigors, multi-lobar consolidation), H.flu, M.cat
Atypicals: Legionella, Mycoplasma, Chlamydophila (interstitial; not consolidated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Signs/Sxs (CAP)
Typicals -
Atypicals -

A
  • High Fever, Rigors, Sweats, Productive Cough, Lobar consolidation
  • Fever, Fatigue, Non-productive Cough, Patchy infiltrates

+/-
Dyspnea, Myalgia, HA, Anorexia, Abd cramp, Tachypnea, Tachycardia, Adventitious BS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
PNA - MC
High fever
Single rigor
Productive cough - rust colored / purulent
Pleurisy
Lobar consolidation - white out on CXR
Gram + diplococci
Lancet shaped
A

S.pneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PNA
Unimmunized
Underlying obstructive lung dz (COPD)
Gram - coccobacillus

A

H.flu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

High fever
Hyponatremia
DIARRHEA
Appearance worse than CXR

A

Legionella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bullous myringitis
COLD AGGLUTININS
Young, healthy pop. (“walking PNA”)

A

Mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Laryngitis
Older pts
Interstitial

A

Chlamydophila

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dx (CAP)

A

CXR +/- :
Sputum analysis
Blood cx
Antigen detection (urinary, NP swab)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gram - diplococci

A

only seen in M.cat and Gonorrhea mening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx (CAP)

A 
OUT.PT: Doxy, Zpack (macrolide), Levoflox (FQ)
IN.PT: cover for S.PNEUM and LEGIONELLA
Ceftriaxone (gold stnd for S.pneum) 
\+ Zpack (gold stnd for Legionella); 
FQ for B-lactam allergy (? elderly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mycobacterium
Slow growing, obligate, intracellular
Acid fast bacilli
Transmitted by resp droplets

A

TB

24
Q

Etiology (TB Infxn)

A

Exposure
Lymphatic uptake of infected macrophages
CAP-like presentation

25
Q

Etiology (Latent TB Infxn)

A

Infected but not acutely ill
Asx
Cannot spread TB
Have + skin test / blood test

26
Q

Etiology (Active TB Dz)

A

= Reactivation Dz.
Sxs - FEVER, NIGHT SWEATS, anorexia, WT LOSS, COUGH, pleuritic chest pain, SOB, hemoptysis
Lymphadenitis of neck (scrofula)
Skeletal/spinal TB (Pott’s dz)

27
Q

Dx 1 (TB)

A

Mantoux TST = PPD (evaluates latent & active TB); look at induration, not errythema
>5mm immunocompromised or recent TB contact
>10mm recent immigrant, IVDU, healthcare/ prison/ homeless setting, very young, co-morbid condtion
>15mm no RF

28
Q

Dx 2 (TB)

A

Interferon-gamma release assay (IGRA)
(evaluates both latent & active TB)
blood test
can distinguish b/n prior BCG and TB infxn

29
Q

Dx 3+ (TB)

A

Sputum for AFB & cx - for active TB only
Tissue bx - CASEATING GRANULOMAS
CXR - UPPER lobe infiltrates, CAVITATION

30
Q

Tx (TB)

A

LTBI (latent TB infxn): Isoniazid (INH) x 9 mo
Active TB: 4 drug regimen
Isoniazid (INH), Rifampin (RIF), Pyrazinamide (PZA), Ethambutol (EMB) x 6-8 wks
Followed by…2 drugs (INH & RIF) x 16 wks

31
Q

M. avium + M. intracellulare
Commonly seen in AIDS pts (CD4<50), COPD
TB-like sxs

A

MAC (Mycobacterium avium complex)

32
Q

Whooping cough

Very contagious

A

Bordetella pertussis

33
Q

3 stages of Bordetella pertussis

A

1) Catarrhal: URI (1-2 wks)
2) Paroxysmal: “Whooping” cough, post-tussive vomiting
3) Convalescent: lasts months

34
Q

Dx & Tx (Bord pertussis)

A

NP swab
1st line: macrolides (erythromycin, azithro)
2nd line: sulfa

35
Q

PNA

ETOH

A

Moraxella catarrhalis

36
Q

Causes of CAP in newborns

A

S. agalactiae (GBS)
Listeria
TB

37
Q

Causes of CAP in children < 5

A

Similar to adults but less atypicals

38
Q

Causes of CAP in children > 5 - teens

A

More likely to have Mycoplasma or Chlamydophila

39
Q

Causes of CAP in adults

A 
MC - Atypicals (Mycoplasma, Chlamydophila;
Legionella - less common)
S. pneum - common (? %)
Viruses - 20% (Flu, paraflu, RSV)
H. flu
E. coli, Klebsiella - more common in NH
40
Q

Post influenza PNA
“Bronchitis”
Difficult to differ from bact

A

Viral PNA

Influenza A/B, RSV, Coronavirus (SARS)

41
Q

PNA that is very dependent on geographic location and immune status

A

Fungal PNA

42
Q

Mississippi and Ohio River Valleys
Fever, Cough, CP, HA
Pulm infiltrates +/- hilar lymph nodes

A

Histoplasma capsulatum

43
Q

Midwest US
Fever, Cough, Night sweats, Wt loss
Lobar PNA

A

Blastomyces dermatitides

44
Q

Desert areas Southwest (AZ)
Flu-like sxs, Fatigue, Sore throat, Cough
Residual pulm nodule

A

Coccidioides immitis

45
Q

Opportunistic, unicellular fungi

AIDS defining dz; CD4

A

Pneumocystis jiroveci / carinii PNA (PCP)

46
Q

Tx (PCP)

A

O2, intubate/ventilate
IV abx
Prophylaxis: TMP/SMX if CD4 < 200

47
Q

Extrapulmonary TB

A

1) Miliary - disseminated (lungs, GI, CNS); CXR (buckshot pattern)
2) Vertebral (Pott’s Dz.)

48
Q

INH… 2 major side effects…

Tx one with…

A 
peripheral neuropathy & liver problems
Vit B6 (pyridoxine)
49
Q

Peds
URI c wheezing
RSV, Flu, Paraflu

A

Acute bronchiolitis

50
Q

W/U & Tx (Acute bronchiolitis)

A

CXR, CBC, RSV nasal swab

Supportive, ? hospitalize, Ribavirin

51
Q

Peds
Acute inflamm upper airway
MC etiology: H. flu
Rapid onset fever, stridor, drooling, tripod, toxic-appearing

A

Acute epiglottitis

52
Q

W/U & Tx (Epiglottitis)

A

DO NOT EXAMINE AIRWAY
Secure airway
Soft tissue neck x-ray (THUMB SIGN)
IVF, Abx, steroids, neb epi

53
Q

Peds
Viral subglottic inflamm (Paraflu)
Stridor, “BARKING” cough, worse at NIGHT

A

Laryngotracheobronchitis (CROUP)

54
Q

Dx & Tx (Croup)

A

Soft tissue neck x-ray (STEEPLE SIGN)

neb epi, steroid, IVF

55
Q

Common winter virus in peds < 2 (PNA or bronchiolitis)

Rhinorrhea, fever, intercostal retractions, tachypnea

A

Resp Syncytial Virus (RSV)

Supportive care

PANRE PULM (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions