Pulmonology Flashcards
What are the four hallmark signs you might see in a Typical pneumonia patient
Chills, cough, fever, and SOB
Who is most at risk for a community acquired pneumonia
Elderly, black, men,
Factors within the host that predispose them to CAP
alcohol/smoking, COPD, Hypoxeia, acidosis, malnutrition, bronchial obstruction
Drugs-H2 blockers, ACE blockers, glucocorticoids
name 3 examples of pathogens causing typical CAP
Strep. pneumonia, staph aureas, Hemophilis influenza
name 3 examples of pathogens causing atypical CAP
mycoplasma pneumononia
chlamydia pneumonia
Legionella
Which patient population would you typically see Hemophilus influenza
common in older patients with COPD or Cystic Fibrosis
describe the bacterial charecteristics of hemophilus influenza
small, pleomorphic, gram - rods
facultatively anaerobic
nonmotile & oxidase +
how would you treat Hemophilis influenza
beta-lactam agents (amoxicillin) preferred otherwise azithromycin, fluroquinolones
mycoplasma pneumonia; which pt population is most susceptible
younger than 40, in close contact with others-PTP schools, military
What are the charecteristics of mycoplasma pneumonia
neither gram + or - *no cell wall, smallest organism that can survive alone… aerobic & anaerobic, adhere to host and glide
what atypical features would you see with mycoplasma pneumonia
gradual onset, headache, malaise, low-grade fever,
how would you treat mycoplasma pneumonia
macrolides (azithromycin) or fluroquinolone
Which pt population would you expect to find Legionella spp
adults who have traveled within the last two weeks, been surrounded by misty environments
what are the charecteristics of Legionella
gram - bacilli, aerobic (grow on special media)
what are the atypical features associated with Legionella
high fever, GI problems and the usual 4 symptoms
how would you treat Legionella
macrolides (azithromycin) or fluoroquinolones
chlamydia pneumonia ; describe pt population
mildly ill, not necessarily winter time, close to virulent factors (care facilities/military)
describe charecteristics of the chlamydia pneumonia
obligate, intracellular bacteria. 2nd smallest.
no peptidoglycan cell wall
what are the atypical features of chlamydia pneumonia
usual plus gradual onset, pharyngitis, hoarseness (wheezing)
how would you tx chlamydia pneumonia
since its rarely dx, start with azithromycin… if documented however consider doxycycline
describe pt population of strep pneumonia
not severly sick, but becoming sick in winter or early spring
describe charecteristics of strep pneumonia
Strep. pneumonia- gram + aerobic, catalase -, alpha hemolytic. MOST COMMON CAUSE CAP! *adheres to epithelial cells of nasopharynx and forms bridges btw body sites
Whats the most common cause of CAP worldwide
strep pneumonia
how do you treat strep pneumonia
macrolides (azithromycin) or fluoroqunolone; or combine macrolide with beta-lactum (amoxicillin)
describe Klebsiella pneumonia
*nosocomial altho can be CAP in alcoholics, diabetics, or COPD
what is the pt population of Klebsiella
typically severe and within ICU
describe charecteristics of Klebsiella pneumonia
gram - bacilli , clear capsule
what are 3 examples of infrequent pneumonia
e-coli, enterobacter spp. pseudomonas aeroginosa
what are the signs of Klebsiella pneumonia
fever, cough, bloody sputum “currant jelly”, leukocytes, and crackles
list 3 viral pathogens that cause CAP pneumonia
influenza, respiratory syncytial virus (RSV) and adenovirus
SARS (Asia), MERS-CoV
what is a unique characteristic of ____that differentiates it from a bacterial pneumonia
typically start with UR symptoms….
What studies would u obtain and expected findings?
PA & lateral chest xray-infiltrate.
CBC-WBC 15-30,000
what differentiates bronchitis from pneumonia
-wheezing/rales, possible mucus, won’t see infiltrate on xray or as much raised WBC
describe bronchiolitis
usually in kids < 2 yrs. characterized by UR symptoms followed by LR infection resulting in wheezing/crackles
Pertussis
whooping cough
TB
serious
histoplasmosis
fungal infection from bat droppings
Pt has dullness to percussion, decreased breath sounds, rales, and pleural rub incidacting
bronchitis
Macrolides ONLY act as bacteriocidal agents to strep pneumo otherwise they are
bacteriostatic
chlamydia pneumonia causes both:
pneumonia and bronchitis
Describe the unique atypical characteristic of chlamydia pneumonia
obligate intracellular parasite.
how would u rx acute bronchitis in COPD pts which is not successful in chronic bronchitis
Bronchodilaters, corticosterioids and Abx if bacteria…. altho usually viral.
how to treat bronchitis in healthy pt
treat cough (anti-tussives), airflow humidifier, and steroids to reduce inflammation
describe the history of SARS
originated in asia, coronavirus jumped from cat to man
Describe MERS-CoV
Middle Eastern Respiratory Syndrome, coronavirus.
Histoplasmosis
fungal RI from bat droppings.
Most common cause of bronchiolitis
Respiratory Synctial Virus and adenovirus
This disease is associated with nasal flaring, tachypnea, accessory muscle use and grunting to breath
bronchiolitis
Which stage does the actual whooping in pertussis occur?
the 2nd of three known as paroxysmal stage
describe the catarrhal stage of pertussis
lots of coughing at night becomes diurnal
convalescent stage of pertussis would be described as:
decrease in cough, but still sick.
list the 3 stages in pertussis
Cattarrhal stage, Paroxysmal and convalescent
The DTap vaccine is used prophylactically against
pertussis
What area of lungs most affected by TB
top, apices of lungs in a military pattern
histoplasmosis is treated with this drug that has terrible side effects
amphotericin
Pneumocystosis (P jiroveci) is a major cause of death for this pt population when not on prophylaxic tx
AID’s up to 80%
Fatal
Fungal respiratory infections
pneumocystosis, coiccidomycosis, histoplasmosis
