Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ID Boards > Respiratory > Flashcards

Respiratory Flashcards

1
Q

sudden onset F/chills, malaise, sore throat

12-48hrs later: exanthum trunk → periphery
rest of skin = sunburn-like erythroderma (sandpaper-like)

petechiae in linear distribution along creases (Pastia lines)

strawberry tongue (erythematous papillae)

A

streptococcal scarlet fever
d/t strep pyogenes erythrogenic toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PEP for pertussis

A

for all individuals w/ face-to-face contact w/in 3ft

same as tx: macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

sore throat/URI → PNA

late summer/early fall

bullous myringitis

other extrapulm findings occ seen: CNS, renal, skin, blood)

A

Mycoplasma pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PNA (can be severe) + relative bradycardia

A

legionella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

subacute/chronic respiratory symptoms

ill-defined nodules/occasional cavitary lesions on imaging

respiratory secretion smears: gram-positive, beaded, fine right-angle branching filaments. Weakly AF staining

A

think nocardia

tx w/ TMP/SMX. Minimum 6mos often (this is w/o CNS involvement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

subacute/chronic respiratory infection
poor dentition/periodontal disease
chronically-ill appearing (not toxic)

classic image: direct extension of cavity/mass through interlobar fissure

can invade tissues → empyema, mediastinitis, pericarditis, vertebral osteo

A

think actinomyces (from oropharyngeal source)

tx w/ penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Meliodosis

  • typical region
  • bacterium
  • RF (climate, personal)
  • Tx
A
  • SE Asia, Australia. Found in soil, vegetation, water in tropical regions
  • GNR, grows readily on routine media
  • RF: typhoons, heavy rainfall. DM, CKD, EtOH
  • carbapenems or ceftaz 1st → 3mos of TMP/SMX
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

localizing infection in immunocompentent vs opportunistic in immunocompromised

often see nodules, cavitation, pleural effusions, abscesses

horse exposure

pleomorphic GP coccobacillus with salmon-pink color on cx

A

rhodococcus

should be on every ddx for cavitary lung lesions in immunocompromised pts (along with nocardia, mycobacterium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  • classic picture: elderly women on abx for mos-yrs –> chronic/insidious pneumonitis
  • can have acute/atypical PNA picture (can see IgG/IgE)
  • What rx would be typical in this situation?
A

nitrofurantoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extra-pulm manifestations of M pneumoniae

A
  • SJS
  • EM
  • hemolytic anemia
  • hepatitis
  • CNS - encephalitis, meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute Eosinophilic PNA (list for full review)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

culture media for legionella

A

BCYE agar = small, pearly white colonies

20-80% sens (100% spec) - detects all spp, but slow and technically difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentations of acute eos PNA d/t dapto

A

Early: hypersensitivity - acute/subacute, GGO+effusions, eosinophilia (>25%)

Later: interstitial pneumonitis, BOOP, mixed GGO/fibrosis/consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clues for “Atypical” CAP (along w/ helpful table)

  1. C psittaci -
  2. C pneumoniae -
  3. M pneumoniae -
  4. Legionella pneumophila -
A
  1. HA
  2. sore throat
  3. CXR > sx
  4. MF CXR, hypoNa, sputum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mild bronchitic - severe PNA/ARDS

exposure to birds

A

Chlamydia psittaci

pic above = intracellular (state in which it is replicative)

also w/ infectious extracellular state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adenovirus concerns in transplant pts

A
  • more common with alemtuzumab (Campath)
  • high mortality (LRTI in 50%)
  • may disseminate - severe hepatitis, encephalitis
  • hemorrhagic cystitis, tubulointerstitial nephritis
  • may lead to loss of graft in SOT
17
Q

Severe complications of influenza

A
18
Q

Stages of hantavirus pulmonary syndrome (HPS)

A
  1. Incubation (4-30 days)
  2. febrile - fever, myalgia, malaise, N/V/abd pn
  3. cardiopulmonary phase
  4. diuretic phase
  5. convalescent phase
19
Q

Transmission of hantavirus

A

aerosolized rodent (esp rat) excreta (urine, feces, or saliva)

20
Q

H7N9 Avian Flu

A
  • avian to human transmission
  • >1500 cases in 5yrs; 22% case fatality
  • some intrinsic and emergent R to oseltamivir
21
Q

Viruses that cause hemorrhagic fever and renal syndrome (Hantavirus)

A
  • Hantann virus (Korea, China, Russia)
  • Dobravirus (Balkan peninsula)
  • Seoul Virus (US)
  • Puumala virus (Scandanavian region) - causes nephropathia epidemic (milder version of HPS)
22
Q

URI

bronchiolitis

croup

PNA in children

a/w with COP (aka BOOP)

A

parainfluenza virus

23
Q

Facts re influenza in transplant pts

A
  • LRTI more common
  • Virus may not be present in NP (need lower specimen)
  • Prolonged shedding common
24
Q

Influenza A Strain a/w conjunctivitis (outbreak in Netherlands)

A

H7N7

25
Q

2 syndromes caused by Hantavirus (group Bunyaviridae)

A
  1. Hemorrhagic fever and renal syndrome
  2. HPS (Sin Nombre Virus)
26
Q

Groups at highest risk for complications of influenza

A
  • <5yo, >65yo
  • Pregnancy
  • Chronic CVD (HTN not an independent risk)
  • Chronic lung disease
  • metabolic d/o (DM)
  • renal, hematologic (includes SCD)
  • neurologic disorder
  • IS
  • morbid obesity
  • Am Indian/Alaskan native
27
Q
  • PNA a/w:
  • URI, pharyngitis
  • conjunctivitis
  • hemorrhagic cystitis
  • GIE
  • hepatitis

**no real seasonality

*a/w outbreaks in day care, closed settings, stressed populations (military barracks)

A

adenovirus

28
Q

Cardiopulmonary phase of HPS

A
  • acute onset dyspnea
  • rapid progression of shock/pulm edema (2-24hrs)
  • hypoV d/t progressive leakage from blood to lung interstitium/alveoli and decreased cardiac function

***Critical clues

  • hypotension, oliguria
  • thrombocytopenia (98%)
  • hemoconcentration
  • left shift w/ atypical lymphs
  • elevated PT, abnormal LFTs
29
Q

Non-respiratory complications of influenza

A
30
Q

Diagnosis of hantavirus

A

IgM in serum

PCR in serum/tissue

31
Q

Infuenza A Strain affecting Hong Kong

A

H5N1

32
Q

Influenza A Strain w/ sporadic cases a/w poultry

A

H9N2

33
Q

characterizations of HFRS

A

(Hantavirus)

  • fever
  • severe thrombocytopenia (bleeding, hemorrhagic petechiae)
  • renal failure (AIN)
  • HD instability
34
Q

Influenza A Strain affecting farm workers

A

H7N3

35
Q
A

ID Boards (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions