Pulmonary Flashcards
Patient presents with low-grade fever, cough, bullous myringitis (vesicles on the TM), cold symtoms, crackles on pulm exam and cxr shows focal infiltrate. What is the organism?
Mycoplasma pneumonia
patient with pneumonia and interstitial infiltrates is more hypoxic on pulse ox than appears on chest radiography and has an increased LDH. What is the organism?
PJP
Patient with CHF or COPD presents with pneumonia, hyponatremic with an episode of diarrhea, what is the organism?
Legionella
Patient with pneumonia presents with rigors and rust colored sputum. What is the organism?
Strep pneumo
Alcoholic or chronic illness pt with pneumonia presents with currant jelly sputum, what is the organism?
Klebsiella pneumo
What organism is associated with alcohol abuse and pneumonia?
Klebsiella pneumo
What organism is associated with COPD and pneumonia?
Haemophilus pneumo
What organism is associated with cystic fibrosis and pneumonia?
Pseudomonas
What organism is associated with young adult in college and pneumonia?
Mycoplasma or chlamydia pneumo
What organism is associated with air conditioning/aerosolized water and pneumonia?
Legionella
What organism is associated with post splenectomy patients and pneumonia?
encapsulated organisms, strep and haemophilus pneumo
What organism is associated with leukemia/lymphoma and pneumonia?
Fungus
What organism is associated with children <1 year and pneumonia?
RSV
What organism is associated with children <2 and pneumonia?
Parainfluenza virus
What is the most common bacterial pathogen in all groups for pneumona
strep pneumo
What type of pathogen is suspected with elevated procalcintonin levels in a patient with pneumonia?
Bacterial
What is the initial management for outpatient pneumonia?
simple uncomplicated patient: macrolide or doxy, patient with chronic disease fq or macrolide + beta lactam
What are the indications for hospitalization of a patient with community acquired pneumonia?
neutropenia, multilobar or poor host resistance, patients > 50 yo with comorbidities, altered mental status or hemodynamic instability
What patients are recommended to receive the pneumococcal vaccine?
Children 2-5 yo, > 65 or people with chronic illness which predisposes an increased risk of pneumonia (COPD, sickle cell, Tobacco, splenectomy, liver disease)
Young patient presents with low-grade fever for a week, non-productive cough, myalgias and fatigue. WBCs are normal. CXR shows segmental RLL infiltrate. What is the likely organism?
Mycoplasma
What is the initial treatment for atypical pneumonia?
emycin or doxy
A patient has confirmed influenza A induced pneumonia. What is the treatment?
Combination treatment with oseltamivir and rimantadine
At what point in a hospital admission is a pneumonia considered hospital acquired?
48 hours after admission
What is the typical isolation period for a person with active TB?
2 weeks after combination therapy has begun
How many medications are used and what is the duration of therapy for active TB?
4 medications for 2 months then 4-7 additional months of organism specific therapy
Which TB medication has side effects of hepatitis, peripheral neuropathy and requires B6 administration?
Isoniazid
Which TB medication has side effects of hepatitis, flu syndrome, and orang body fluid?
Rifampin
Which TB medication has the side effect of optic neuritis (may cause red-green vision loss)?
Ethambutol
What is the typical cause of acute bronchitis?
viruses
How do you differentiate between acute bronchitis and pneumonia?
CXR
what is the first line treatment for acute bronchitis in a COPD patient or patient with > 7 days of symptoms?
2nd gen cephalosporin then macrolide or bactrim
What is the treatment for a child with confirmed RSV bronchiolitis?
Admission and treatment with ribavirin, nebulized albuterol, IV fluids, antipyretics, humidified oxygen
What is the initial antibiotic management for epiglottitis?
3rd gen cef for 7-10 days
Child presents with harsh barking, seal-like cough and inspiratory stridor , low-grade fever. What is the diagnosis? Treatment?
Croup - usually viral, usually treatment is supportive but may require steroids, humidified oxygen and epinephrine nebs in severe cases
A patient diagnosed with lung CA via sputum cytology likely has which type of CA?
SCC
What is the most common type of lung CA?
AdenoCA
A patient with a primary lung CA and paraneoplastic syndrome likely has which type of CA?
Small (oat) cell
Which lung cancer is chemo/rad before surgery?
Small (oat) cell
What is the standard monitoring procedure for solitary pulmonary nodule?
CT q3 months for 1 year then q6 months for 2 years
What are the treatment options for pulmonary carcinoid tumors?
Octreotide may help with symptoms but excision is definitive
What are the results of a spirometry study for an asthmatic?
FEV1/FVC < 75% with greater than 10% increase in FEV1 after bronchodilator administration
What are the indicators for starting oxygen on a COPD patient?
Resting hypoxemia PaO2 < 55, or SaO2 < 88%
What types of malignancies are more common in cystic fibrosis patients?
GI tract CAs
What is the definitive diagnostic test for cystic fibrosis?
Sweat chloride test/DNA testing
What is the duration of anticoagulation for PE?
3 months at minimum
Patient with chronic dyspnea, bilateral hilar adenopathy, splenomegaly and erythema nodosum has noncaseating granulomatous inflammation on lung biopsy. Diagnosis?
Sarcoidosis
