resp infections Flashcards
what viruses cause the cold?
-rhinovirus, coronavirus, or adenovirus
What complications of strep throat are prevented by treatment with abx? Which aren’t?
-abx prevent rheumatic fever and rheumatic heart disease, but not post-strep glomerulonephritis. untreated, 3% of strep throat cases lead to rheumatic heart disease
What are some signs of peritonsillar abscess?
difficulty opening mouth, asymmetric tonsils, dislplacement of the uvula
How can you test for viral influenza?
rapid antigen immunoassay of resp secretions. PCR more sensitive but takes hrs
who should get the flu vaccine?
everyone >6 months old, every year
What organisms cause acute sinusitis?
strep pneumo, haemophlius influenzae, moraxella catarrhalis, viral infection
What is chronic sinusitis?
sinusitis lasting >3 months. usually due to sinus obstruction, anaerobic infection
pts with DM at higher risk of mucormycosis
What are the radiographic findings of sinusitis?
opacification and fluid levels. CT is diagnostic but dx can also be made clinically
When would a CT for sinusitis be indicated?
sinusitis can cause unexplained persistent fevers. order CT to evaluate sinuses if unable to find another cause
treatment of sinusitis
amoxicillin for 2 wks if acute and for 6-12 wks if chronic. surigical drainage or correction of anatomical blockage may be necessary
acute bronchitis: causative agents and treatment
non smoker: usually viral. If bacterial, usually mycoplasma pneumoniae (see high cold agglutinin titer)
smoker or elderly may need abx- fluoroquinolones, tetracycline, erythromycin). in smokers, it may be due to h. flu or strep pneumo
What exam findings suggest pneumonia?
-decr breath sounds, rales, wheezing, dullness to percussion, egophony, tachypnea, incr tactile fremitus
Who should be admitted to the hospital for pneumonia?
elderly, multiple comorbidities, significant lab abnormalities, multilobar involvement, sepsis
What are the radiographic findings in TB?
- apical fibronodular infiltrates: reactivated disease
- lower lobe infiltrates: primary disease
- calcificed granulomas/lymph nodes- aka Ghon complex
What is the tx for active TB?
isoniazid, rifampin, pyrazinamide, and ethambutol initially; then INH and rifampin for 6 months
give B6 with INH to prevent neuritis (INH can also cause liver disfunction
