Pulmonary #4 (Influenza, Bronchitis, Pertussis) Flashcards

1
Q

Risk factors for influenza

A

-Children
-Elderly
-Pregnancy
-Immunocompromised

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2
Q

Symptoms of influenza

A

Abrupt onset of symptoms including headache, fever, chills, malaise, URI symptoms, pharyngitis, PNA
-Myalgias involving legs

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3
Q

How do you diagnose influenza

A

-Rapid influenza nasal swab or viral culture

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4
Q

Although supportive is the mainstay treatment in healthy patients for influenza, when should antivirals be given?

A

In patients that are hospitalized or at high risk of complications: 65 or older, immunosuppression, CVD (not HTN), DM, HIV, Sickle-Cell, etc.

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5
Q

If antivirals are recommended, what one is the DOC?

A

Oseltamivir within 48 hours of onset of symptoms

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6
Q

Adverse reactions to Oseltamivir

A

Skin reactions
Nausea
Vomiting
Transient neuropsychiatric events

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7
Q

True or False: During influenza outbreaks in long-term facilities, all residents should get prophylaxis regardless of vaccination status.

A

True

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8
Q

Who can get the inactivated influenza vaccine?

A

Annually, for all individuals 6 months or older, including pregnant.

High dose if > 65 years old

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9
Q

Who can get the live attenuated, intranasal influenza vaccine?

A

2-49 years old

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10
Q

When should you get the influenza vaccine?

A

End of October

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11
Q

What are some contraindications to the flu vaccine?

A

-Guillan-Barre Syndrome within 6 weeks after previous flu shot
-high fever
-infants < 6 months

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12
Q

Which shot should patients with an egg allergy get (flu)?

A

Inactivated

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13
Q

What are the contraindications to the live attenuated vaccine?

A

-Immunocompromised
-Pregnancy
-50 years or older
-If taken antivirals within the last 48 hours
-Close contacts of severely immunocompromised people

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14
Q

Acute bronchitis is MC caused by

A

viruses (Adenovirus, Influenza, Coxsackie, RSV, Rhinovirus)

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15
Q

Symptoms of acute bronchitis

A

-Cough is hallmark (at least 5 days, 1-3 weeks)
-Hemoptysis
-Malaise, dyspnea, URI symptoms

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16
Q

Treatment for acute bronchitis

A

Symptomatic: fluids, antitussives, antipyretics, analgesics

17
Q

Pertussis (whooping cough), is due to Bordatella pertussis. What type of bacteria is this?

A

Gram-negative coccobacillus

18
Q

What are the three phases of pertussis?

A

-Catarrhal phase: URI symptoms last 1-2 weeks. Most contagious.

-Paroxysmal Phase: severe coughing fits with inspiratory whooping sound after cough fits. Post tussive emesis.

-Convalescent Phase: resolution of the cough

19
Q

What diagnostics should you order if you suspect pertussis?

A

-Throat culture and PCR

20
Q

Although supportive is the mainstay of treatment for pertussis, what ABX can be given to reduce contagiousness of Pertussis?

A

Macrolides (Azithromycin is first-line, Bactrim is the second line)

21
Q

What are some complications of pertussis?

A

PNA
Otitis Media
Increased mortality in infants

22
Q

What is the vaccine schedule for Pertussis?

A

2 months
4 months
6 months
15-18 months
4-6 years of age

Booster at 11-18 years of age