Pulmonary Flashcards
Acute bronchitis organisms
most likely viral
adenovirus
coronavirus
RSV
Acute bronchitis treatment
symptomatic
Pertussis organism
Bortadella pertussis (G-)
Pertussis stages
catarrhal
paroxysmal
convalescent
Most infectious stage of pertussis
catarrhal
Pertussis labs
nasopharyngeal swab
Pertussis treatment
1st line: Macrolides
-Azithromycin
Tdap booster
Prophylaxis for close contacts
CAP organisms
- Streptococcus pneumoniae
- Haemophilus influenza
Gold standard for CAP diagnosis
CXR
CAP lab results
- leukocytosis
- bandemia
CAP treatment for low risk patients
- amoxicillin
- doxycycline
- macrolide
CAP treatment for high risk patients, used abx within last 3 months
-Augmentin or cefpodoxime or cefuroxime AND
Macrolide or doxycycline
-Levaquin
CAP high risk patients
- > 65
- immunocompromised
- multiple comorbidities
- recent antibiotic use
- day care attendance, LTC facilities
PPSV23 only
increased risk patients -asthma COPD smoking CVD DM liver disease
pneumococcal schedule for very high risk patients
PCV13 now
PPSV23 in 8 weeks
PPSV23 in 5 years (booster)
pneumoccoccal for >65 and healthy
PPSV23 only
> 65 and immunocompromised for pneumococcal
PCV13 now
PPSV23 in 1 year
Pneumococcal dosing for <2 years old
2 months
4 months
6 months
12-15 months
Children >2 who have not been pneumococcal vaccinated
1 dose PCV13
Atypical PNA organisms
- mycoplasma pneumoniae
- chlamydia pneumoniae
- Legionella pneumoniae
Atypical PNA treatment
-macrolide
azithromycin
clarithryomycin
erythromycin
Phlegm color in bacterial PNA
rust colored
COPD components
- emphysema
- chronic bronchitis
- possible asthma
COPD with emphysema presentation
- barrel chest
- increased AP diameter
- accessory muscle use
- pursed lip breathing
- weight loss
COPD with chronic bronchitis presentation
- chronic cough
- sputum production
- coarse crackles
Inhaled anticholinergic mechanism
prevent bronchoconstriction
Beta agonist mechanism
produce bronchodilation
What to add to first line treatment for CODP
- SAMA, LABA
- SABA
Examples of SAMA
-ipratropium (Atrovent)
Examples of LAMA
-tiotropium (Spiriva)
Example of LABA
- salmeterol
- indacaterol
- olodaterol
SAMA SABA combo
Ipratropium/albuterol (Combivent)
alpha-1-trypsin deficiency
- rare
- severe lung damage at early ages
- early onset COPD