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S3 IDIS CP > Pulmonary infections > Flashcards

Pulmonary infections Flashcards

1
Q

common cold bugs

A

***rhino virus

corona, adeno, echo, coxa/b, flu, paraflu, rsv, mycoplas pneu, human metapneu

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2
Q

common cold keys

A

usually no fever, present in winter months

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3
Q

summer gripe bugs

A

coxA/B, echo, enteroviruses

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4
Q

summer gripe keys

A

cold-like febrile illness in summer

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5
Q

summer gripe presentation

A

non-specific febrile illness w malaise and headache. Sx 3-4 days

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6
Q

viral acute rhinosinu bugs

A

rhino, parainflu, RSV adeno

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7
Q

viral acute rhinosinu keys

A

Sx resolve in 5-7 days

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8
Q

viral acute rhinosinu presentation

A

do i really need to describe this??

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9
Q

bacterial acute rhinosinu bugs

A

**S pneumoniae, non typable H flu

also
anaerobes
g-
s aureus, moraxella, pyogenes

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10
Q

bacterial acute rhinosinu keys

A

adult w mod symptoms >7d, or severe sx develop (facial swelling/tooth pain)

child w mod sx >10-14d or severe (>102, facial swelling, AMS)

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11
Q

bacterial acute rhinosinu presentation

A

mucosal inflammation

sneezing, rhinorrhea, pressue and headache etc

usually follows viral

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12
Q

rhinocerebral mucormycosis bugs

A

***rhizopus, rhizomucor

also mucor, mycocladus, cunninghamella

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13
Q

rhinocerebral mucormycosis keys

A

black eschar of palate

very rare

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14
Q

rhinocerebral mucormycosis presentation

A

rhinosinusitis w bloody nasal discharge, dusky turbinates, AMS

black eschar, abscesses, decreased ocular motion

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15
Q

viral pharyngitis bugs

A

adeno, HSV, EBV, CoxAB

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16
Q

viral pharyngitis keys

A

conjunctivitis, cough, coryza, discrete ulcerative lesions, anterior stomatitis

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17
Q

viral pharyngitis presentation

A

fever, sore throat, edema, hyperemia of the tonsils

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18
Q

bacterial pharyngitis bugs

A

strep pyogenes

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19
Q

bacterial pharyngitis keys

A

complications if untreated– abscess, mastoiditis, cervical lympadenitis

acute glomerulonephritis, rheumatic fever

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20
Q

bacterial pharyngitis presentation

A

fever, sore throat, hyperemia of the tonsils

pyogenes: fever and severe pain, tonsilopharyngeal erthema w or w/o exudate, lymphadenitis. petechiae, scarlet rash, swollen uvula

kids- N/V, abd pain

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21
Q

lemierre’s (post-anginal septicemia) bugs

A

fusobacterium nerophorum

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22
Q

lemierre’s (post-anginal septicemia) presentation

A

sore throat progressing to thrombophlebitis of IJV w pain, dysphagia, neck swelling, stiffness. sepsis in 3-10d after sore throat. can spread to lungs

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23
Q

diphtheria bugs

A

corynebacterium diphtheriae

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24
Q

diphtheria keys

A

pseudomembrane, bleeding upon removal, cervical lymphadenopathy, difficulty swallowing

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25
Q

diphtheria presentation

A

pharyngeal pain, pseudomembrane, bull neck, fetid breath.

airway obstruction and toxemia can occur

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26
Q

viral acute pharyngitis bugs

A

so many bugs: parainflu, flu AB, adeno, RSV, HSV, rhino, coxAB, echo

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27
Q

viral acute pharyngitis keys

A

clinical s/s

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28
Q

viral acute pharyngitis presentation

A

begins as URTI, followed by hoarseness and reduced vocal pitch

odynophagia, odynophonia, congestion, fatigue, malaise,

laryngeal edema and vascular engorgement of vocal folds

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29
Q

bacterial acute pharyngitis bugs

A

pyogenes

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30
Q

bacterial acute pharyngitis keys

A

+ bacterial culture

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31
Q

bacterial acute pharyngitis

A

same as viral, less common

begins as URTI, followed by hoarseness and reduced vocal pitch

odynophagia, odynophonia, congestion, fatigue, malaise,

laryngeal edema and vascular engorgement of vocal folds

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32
Q

viral croup/ laryngotracheobonchitis bugs

A

parainfluenza type 1

also parainflu2, fluAB, adeno, RSV, HSV, rhino, CoxAB, echo

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33
Q

viral croup/ laryngotracheobonchitis key

A

barking cough, inspiratory stridor and retractions

less air hunger after racemic epi or humid air (no effect on bact epiglotitis)

steeple sign

normal swallow

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34
Q

viral croup/ laryngotracheobonchitis presentation

A

higher fever than laryngitis, restlessness, air hunger

starts with mild URTI 2-3 d
followed by barking cough, stridor at night

normal lungs, maybe mild expiratory wheeze

nasal flaring, lethargy,

if severe, tachypnea, tachycardia, hypoxemia, hypotonia, cyanosis

s/s peak 3-5d, resolve 4-7d

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35
Q

bacterial epiglottitis and supraglottitis bugs

36
Q

bacterial epiglottitis and supraglottitis keys

A

difficult swallow
distressed, toxic looking
thumb sign
no response to racemic epi or humid air

epiglottitis triad= sore throat with dysphagia, hoarse voice, generally unwell/dehydrated

37
Q

bacterial epiglottitis and supraglottitis presentation

A 
acute onset
fever, sore throat, cough
suprasternal notch retraction and stridor
inflamed throat
beefy red epiglottis

progresses rapidly= severe dyspnea, cyanosis, toxicity

four Ds= dysphagia, dysphonia, drooling, distress

38
Q

acute bronchitis bugs

A

flu AB, paraflu, adeno, RSV, HSV, rhino, CoxAB, echo
mycoplas pneumoniae
chlamydophilia pneumoniae

39
Q

acute bronchitis keys

A

clinical s/s

CXR

40
Q

acute bronchitis presentation

A

non productive cough, substernal pain, fever. rhonchi, moist crackles

several hours bf cough= malaise, headache, coryza, sore throat

41
Q

bronchiolitis bugs

42
Q

bronchiolitis keys

A

observe s/s, Ag testing in nasal washings

CXR= hyperinflation, patchy infiltrate, air trapping, flat diaphragm, peribronchial cuffing

43
Q

bronchiolitis presentation

A

rhinorrhea, cough, low fever

can lead to paroxysmal cough and dyspnea

tachypnea, tachycardia, fever, wheezing, grunting, vomiting, cyanosis

44
Q

influenza bugs

45
Q

influenza keys

A

high fever, acute onset, lab confirmation

46
Q

influenza presentation

A

abrupt onset of fever, chills, rigor, headache, prostration, nonproductive cough, V/D in kids

fever abates in 3-4d, cough and malaise persist for 2w

can lead to pneumonia w secondary bacteria ie aureus, hflu, strep pneumo, pyogenes

47
Q

pertussis bugs

A

bordetella pertussis

48
Q

pertussis key

A

whoop is pathognomonic

NP aspirates on bordet gengou medium
ELISA, IFS

Elevate WBC, lymphocytosis in kids

49
Q

pertussis presentation

A

catarrhal phase 1-2w: coryza, sneezing, low fever, mild cough

paroxysmal phase 2-4 weeks: inspiratory whoop with posttussis vom

50
Q

typical pneumonia bugs

A

***strep pneumoniae

klebsiella, pseudomonas, g-rods

51
Q

typical pneumonia keys

A

sudden, rigors, toxic looking, productive cough, bloody/purulent sputum, high fever,

neutrophils, WBC>15K w L shift

52
Q

purulent vs mucoid sputum

A

purulent=typical, mucoid=atypical

53
Q

rust vs green sputum

A

rust = strep pneumo

green =pseudomonas or H flu

54
Q

klebsiella pneumonia

A

currant jelly
bowing fissure w UL consolidation

can cause necrosis

55
Q

pseudomonas pneumonia

A

microabscesses which can coalesce

56
Q

staph aureus pneumonia

A

bilateral nodular infiltrates w cavitation

in kids = pneumatoceles, bronchopleural fistulas, empyema

57
Q

typical pneumonia presentation

A 
develop within 24-48 hours
high fever
shaking chills
dyspnea
tachycardia
flu like symptoms

EXCEPTION: neonate afebrile chlamydia trachomatis pneumonia

58
Q

typical pneumonia in CF

A

pseudomonas or s aureus

59
Q

typical pneumonia in alcohol

A

klebsiella or oral anaerobe from aspiration

60
Q

typical pneumonia in nursing home

A

enteric gram neg (enterobacter, klebsiella, e coli)

61
Q

typical pneumonia in copd

A

H flu, klebsiella

62
Q

typical pneumonia in IV drug user

A

staph aureus

63
Q

typical pneumonia in elderly or w recent flu

A

staph aureus

64
Q

typical pneumonia in military, dorm, young people

A

neisseria meningitidis

65
Q

atypical pneumonia bugs

A

mycoplasma pneumoniae

66
Q

atypical pneumonia keys

A

gradual onset, well looking, nonproductive cough, mucoid sputum, low fever, rare pleurisy, rare consolidation

sputum: rare mononuclear cells, WBC>15K
interstitial infiltrate

67
Q

atypical pneumonia presentation

A

subacute onset, 1 week to develop symptoms, paroxysmal cough w mucoid/no sputum

68
Q

afebrile pneumonia

A

neonates, chlamydia trachomatis

69
Q

atypical pneumonia IC

A

pneumocystis jiroveci

70
Q

aspiration pneumonia presentation

A

like typical pneumonia, except with recurrent chills

consolidations in dependent lung segments

50% have foul sputum

increased minute ventilation

71
Q

TB

A

mycobact tb

insidious onset, night sweats, low fever, wt loss, productive purulent cough, dyspnea, coin lesions

72
Q

chronic pneumonia- histoplasmosis bugs

A

histoplasma capsulatum

73
Q

chronic pneumonia- histoplasmosis presentation

A

erythema nodosum and hilar adenopathy, fungal pneumonia

74
Q

chronic pneumonia- histoplasmosis keys

A

yeast cells in PMNs or monocytes

when grown in vitro at RT= hyphae and tuberculate macroconidia

captains wheel

75
Q

chronic pneumonia coccidioidmycosis bugs

A

coccidiodes immitis

76
Q

chronic pneumonia coccidioidmycosis presentation

A

erythema nodosum and hilar adenopathy, fungal pneumonia

77
Q

chronic pneumonia coccidioidmycosis keys

A

spherule seen in lung material (round with many speckles inside)

78
Q

chronic pneumonia blastomycosis bug

A

blastomyes dermatitidis

79
Q

chronic pneumonia blastomycosis presentation

A

fungal pneumonia which may also show verrucous skin lesions

80
Q

chronic pneumonia blastomycosis keys

A

broad based budding yeast

81
Q

psittacosis bug

A

chlamydophilia psittaci

82
Q

psittacosis presentation

A

pneumonia with bradycardia, epistaxis, horder spots (rose spots), low leukocyte count

caretakers of birds

83
Q

Q fever bug

A

coxiella burnetii

84
Q

q fever presentation

A

pneumonia w bradycardia, hepatomegaly, endocarditis, abnl LFT.

farmers with recently birthed livestock

85
Q

legionnaire’s disease bug

A

legionella pneumophilia

86
Q

legionnaire’s disease presentation

A

pneumonia with bradycardia, abd pain, V/D, hematuria, confusion, abl LFT/renal fxn tests, increase CPK

S3 IDIS CP (4 decks)

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