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Old DOOS > Respiratory 2 > Flashcards

Respiratory 2 Flashcards

1
Q

what is the average incubation period for URIs?

A

1-5 days

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2
Q

how long does viral shedding occur w/ URI

A

3 weeks

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3
Q

what eye condition is often seen with URIs?

A

Conjunctivitis

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4
Q

is it common for a URI to become pneumonia

A

no

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5
Q

does mucus color or lymph nodes matter for URI bacterial or viral diagnosis

A

No

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6
Q

how do you treat pharyngitis?

A

Amoxicillin, PCN, Erythromycin, Clindamycin (if positive rapid strep)

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7
Q

how much of laryngitis is viral?

A

90%

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8
Q

how much is otitis media is viral?

A

48%

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9
Q

what bacteria cause otitis media?

A

strepto pneumo
Moraxella
H. influenze

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10
Q

what are some symptomatic relief meds for URIs

A 
Pseudoephedrine
Phenylephrine
Ipratropium  bromide: effective but expensive
NaCl  Nasal drops
Afrin, Neosynephrine 
Antihistamines
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11
Q

what are 2 very powerful vasoconstrictors that can lead to necrosis in the nose

A

afrin, neosynephrine

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12
Q

contraindications for symptomatic relief meds?

A 
HTN
hx of arrhythmia
BPH
urinary retention 
glaucoma
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13
Q

what are some expectorants?

A

Guaifenesin

SSKi (potassium iodine)

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14
Q

what are some cough suppressants

A

dextromethorphan (OTC meds)
codeine
hydrocodone
tessalon perles (benzonatate)- anesthetic

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15
Q

where is bronchitis found

A

south of the larynx

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16
Q

for kids 2-5 years old what are the most common causes of bronchitis

A

RSV

adenovirus

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17
Q

when should you give abx to a 2-5 year old?

A

culture + for heavy growth strep, H. flu, associated sinusitius or not improving in a week

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18
Q

are abx needed in adolescents and adults with acute bronchitis?

A

No, usually self limited

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19
Q

common causes of adolescents with bronchitis

A

viral
mycoplasma
chlamydia
pertussis

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20
Q

what can a persistent cough of >14 days be?

A

pertussis

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21
Q

how do you tx pertussis

A

erythromycin
azithromycin
bactrim

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22
Q

what is the tx for COPD exacerbations?

A

antibiotic and steroid

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23
Q

what is the typical pneumonia?

A

lobar

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24
Q

In HIV or non-HIV what is the number one cause of pneumonia?

A

stret. pneumo

25
Q

Rigors (chills), fever, purulent sputum and “lobar infiltrates”

A

Typical pneumonia

26
Q

what etiology of pneumonia is a lobar consolidating infiltrate

A

strept pneumo

legionella

27
Q

what is the etiology of lobar enlargement for penumo?

A

klbsiella

28
Q

who do you see anaerobe pneumonia with?

A

poor teeth

foul smelling

29
Q

bronchopneumonia can have what etiologies

A

mycoplasm
strep pneumo
h. flu

30
Q

if you see a cavitation on x-ray waht should you suspect

A

anaerobic bacteria, TB

31
Q

what 4 organisms cause atypical pneumonias?

A

mycoplasm
chlamydia
legionella
viral- influenza

32
Q

what do you do for atypical pneumonias?

A

serologic studies: convalescent titers

33
Q

outpatient tx of pneumonia of someone who is previously healthy
no use of macrolide <3 months

A

macrolide or doxycycline

34
Q

pneumonia tx

patient with comorbidities or used macrolides <3 month ago or in a high macrolide resistant area

A

respiratory flurorquinolone or

macrolide + beta-lactam

35
Q

For inpatient, non-ICU tx for pneumonia

A

Resp Fluoroquinolones or anti pneumoccocal beta-lactam + Macrolide

36
Q

ICU pneumo tx

3 options

A
  1. Anti pneumococcal Beta-lactam and azithromycin
  2. Anti pneumococcal Beta-lactam and resp fluoroquinolo.
  3. (PCN allergies) resp fluoroquinolone +Aztreonam
37
Q

if someone has CAP with CA-MRSA what should you add?

A

Vanco

Linezolid

38
Q

Buboes in groin, exposure to animals

A

Bubonic plagues

39
Q

Begins as flu-like illness, respiratory symptoms, hemoconcentration and thrombocytopenia, typical blood smear

A

Hantavirus

40
Q

if a person has bilateral, fever, and hypoxemia what should you get?

A

blood and sputum gram stains and cultures

41
Q

what empiric therapy do you start on someone with bilatreal infiltrates, fever, hypoxemia

A

ceph de jour plus macrolides/ doxy or flouroquinolones

42
Q

Severe hypoxemia
V/Q mismatching PaO2/FiO2 ratio <150)
bilateral diffuse infiltrates on CXR

A

ARDS

43
Q

Is ARDS caused by a heart problem?

A

No

44
Q

what are some causes ARDS?

A

sepsis
pneumonia
severe trauma

45
Q

in the developing world what is there a high correlation with TB?

A

HIV/ AIDS

46
Q

what lobe of the lung usually has TB?

A

RUL

47
Q

where can TB go?

A

anywhere

lymph nodes

48
Q

if someone has no risk of TB exposure what is considered positive?

A

> 15 mm

49
Q

what populations is a positive TB test >5 mm

A

HIV infection
contact to active TB case
abnormal CXR
immunosupression

50
Q

what populations do you use >10 mm as positive TB test?

A 
Recent immigrants
IV drug users
children
high risk medical
residents of jails/ hospitals/ nursing homes
51
Q

what test is an alternative to tuberculin skin test?

A

whote blood interferon (IFN)-gamma assay

52
Q

if a patient is an alcoholic and you can’t treat TB b/c INH would ruin the liver would you do the test?

A

No

53
Q

if there is a positive TST test what should you get?

A

sputum for AFB smear and culture x 3 mornings

54
Q

what med should you also give with INH?

A

B6 (pyridoxine)

55
Q

if a pregnant lady has any risk factors for TB what do you do?

A

give INH

56
Q

what should a patient report while on INH

A

any abdominal pain

57
Q

if a person has active TB how long should they be in isolation?

A

minimum of 2 weeks

58
Q

how long should you treat for TB?

A

6 months

Old DOOS (21 decks)

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