Pulmonary #4 (Influenza, Bronchitis, Pertussis) Flashcards
Risk factors for influenza
-Children
-Elderly
-Pregnancy
-Immunocompromised
Symptoms of influenza
Abrupt onset of symptoms including headache, fever, chills, malaise, URI symptoms, pharyngitis, PNA
-Myalgias involving legs
How do you diagnose influenza
-Rapid influenza nasal swab or viral culture
Although supportive is the mainstay treatment in healthy patients for influenza, when should antivirals be given?
In patients that are hospitalized or at high risk of complications: 65 or older, immunosuppression, CVD (not HTN), DM, HIV, Sickle-Cell, etc.
If antivirals are recommended, what one is the DOC?
Oseltamivir within 48 hours of onset of symptoms
Adverse reactions to Oseltamivir
Skin reactions
Nausea
Vomiting
Transient neuropsychiatric events
True or False: During influenza outbreaks in long-term facilities, all residents should get prophylaxis regardless of vaccination status.
True
Who can get the inactivated influenza vaccine?
Annually, for all individuals 6 months or older, including pregnant.
High dose if > 65 years old
Who can get the live attenuated, intranasal influenza vaccine?
2-49 years old
When should you get the influenza vaccine?
End of October
What are some contraindications to the flu vaccine?
-Guillan-Barre Syndrome within 6 weeks after previous flu shot
-high fever
-infants < 6 months
Which shot should patients with an egg allergy get (flu)?
Inactivated
What are the contraindications to the live attenuated vaccine?
-Immunocompromised
-Pregnancy
-50 years or older
-If taken antivirals within the last 48 hours
-Close contacts of severely immunocompromised people
Acute bronchitis is MC caused by
viruses (Adenovirus, Influenza, Coxsackie, RSV, Rhinovirus)
Symptoms of acute bronchitis
-Cough is hallmark (at least 5 days, 1-3 weeks)
-Hemoptysis
-Malaise, dyspnea, URI symptoms
Treatment for acute bronchitis
Symptomatic: fluids, antitussives, antipyretics, analgesics
Pertussis (whooping cough), is due to Bordatella pertussis. What type of bacteria is this?
Gram-negative coccobacillus
What are the three phases of pertussis?
-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
What diagnostics should you order if you suspect pertussis?
-Throat culture and PCR
Although supportive is the mainstay of treatment for pertussis, what ABX can be given to reduce contagiousness of Pertussis?
Macrolides (Azithromycin is first-line, Bactrim is the second line)
What are some complications of pertussis?
PNA
Otitis Media
Increased mortality in infants
What is the vaccine schedule for Pertussis?
2 months
4 months
6 months
15-18 months
4-6 years of age
Booster at 11-18 years of age
