Pulm quick associations Flashcards
increased lung volumes, FEV1/FVC less than 80
obstructive lung disease
Decrease lung volumes, FEV1/FVC 80 or higher
Restrictive lung disease
2 or less daytime episodes/wk or 2 or less nighttime episodes per month
FEV1 80% or more
mild intermittent asthma
3-6 daytime episodes/wk or 3-4 nighttime episodes per month
FEV1 80% or more
mild persistent asthma
daily daytime episodes/wk or more than 1 nighttime episodes per month
FEV1 60-80
moderate persistent asthma
continual daytime episodes/wk or frequent nighttime episodes per month
FEV1 less than 60
severe persistent asthma
Pulmonary disease that includes airflow limitation and is associated with chronic inflammation in the airways and lungs
COPD
Chronic productive cough for three months, may proceed or follow the development of airflow limitation
Chronic bronchitis
Permanent enlargement of the airspaces distal to the terminal bronchioles due to destruction of airspace walls
Emphysema
Chronic inflammation of the airways resulting in airway hyper responsiveness, wheezing, and shortness of breath that are reversible
Asthma
Noncaseating granulomas and associated with aerospace manufacturing
Berylliosis
Noncaseating granulomas and erythema nodosum
sarcoidosis
Associated with sandblasting
silicosis
Causes chronic bronchitis but not an increased risk of lung cancer
coal workers disease
Disease of the lungs and kidneys caused by anti-glomerular basement membrane Ab
Goodpasture
Caseating granulomas and positive c-ANCA
Granulomatosis with polyangiitis
Gram-positive diplococci MC cause of pneumonia in adults Rust colored sputum Lobar consolidation on CXR Common cause of post-influenza bacteria PNA
S. pneumo
Tx: b-lactams, macrolides, fluoroquinolones
Gram positive cocci in clusters
typical pneumonia
common cause of post influenza bacterial PNA
S. aureus
MSSA - oxacillin
MRSA - vancomycin, linezolid
Neonatal PNA, bacteremia, meningitis
Diffuse infiltrates on CXR
Group B strep
PCN or ampicillin
Vancomycin
Cephalosporins
gram-negative bacillus
PNA in older adults and chronic lung disease
Some b-lactamase producing, some are not
Haemophilus influenzae
Amoxicillin, Amox-clav, cephalosporins
Gram negative bacillus
PNA in patients with alcoholism, COPD, DM
Typical PNA with “currant jelly” sputum
Klebsiella pneumoniae
sensitivities direct therapy, high multidrug resistance
Gram negative bacillus PNA in patients with underlying lung abnormalities Hospitalized or ventilated patients often multidrug resistant biofilm
Pseudomonas aeruginosa
Antipseudomonal b-lactam - cefepime, pip-tazo, meropenem
PLUS
Ciprofloxacin or aminoglycoside
Gram negative diplococcus
PNA in patients with COPD
Moraxella catarrhalis
atypical pneumonia “walking pneumonia”
B/L interstitial infiltates on CXR
May be positive for cold agglutinins
Mycoplasma pneumoniae
Macrolide
Tetracycline
Fluoroquinolone
atypical PNA
Bilateral interstitial infitrates on CXR
Young adults in close quarters - dorms, barracks
Chlamydophila pneumoniae
Doxycycline
macrolide
atypical PNA in someone with a pet bird, or bird keeper
Chlamyophila psittaci
Doxycycline
Macrolide
Atypical pneumonia
transmitted by inhaling/aspirating contaminated water
PNA + GI symptoms - nausea, diarrhea
+/- neurological symptoms - confusion
Legionella pneumophila
Fluoroquinolone
Macrolide
Common cause of fungal PNA in immunocompromised patients
Pneumocystis jirovecii (PCP)
Pneumonia in patient with influenza and gram positive cocci in clusters in sputum
S. aureas
Pneumonia in spelunker
Histoplasmosis
Pneumonia in patient who has gram-positive diplococci in sputum
S. pneumo
MC cause of viral pneumonia in young children
RSV
Pneumonia in neonate with gram-negative rods in sputum
E. coli
Pneumonia in patient who has recently traveled to Arizona
Coccidioides immitis
MC cause of viral pneumonia in adults
influenza
predisposes to secondary PNA with S. pneumo, S. aureus
Pneumonia associated with travel through the desert in Southwest US or dust storm
Coccidioides immitis
Itraconazole
Fluconazole
Pneumonia associated with caves, soil contaminated with bird/bat droppings in Mississippi and Ohio river valleys
Histoplasma capsulatum
Itraconazole
Pneumonia associated with soil contaminated by pigeon or chicken droppings, immunocompromised patients
Cryptococcus neoformans
Fluconazole
Pneumonia associated with skin lesions and soil exposure in Southeastern, South Central and Midwestern US and Canada
Blastomyces dermatitis
Amphotericin B
Itraconazole
Pneumonia associated with pulmonary symptoms in chronic infection, Central/South America
Paracoccidioides brasiliensis
Itraconazole