Respiratory 2 Flashcards
chronic bronchitis - lung auscultation will reveal
expiratory wheezing, rhonchi, and coarse crackles
what is the FEV1/FVC cutoff score for dx COPD
FEV1/FVC 0.7; as <0.7 = <70% of lung function
preferred choice of therapy for mild COPD (Group A) is
long acting bronchodilator
COPD/smoker w/ PNA is at higher risk for what bacteria
H. influenzae
what med is recommended for all patients with COPD for relief of dyspnea and early tx of exacerbations
SABAs
when you are treating a COPD patient for PNA, pick an abx that has what coverage
H. influenzae (gram neg) and step pnuemoniae (gram postivie)
group A med rec
either a short or long acting bronchodilator
group B med recs
LAMA and LABA combo
group E med recs
LAMA and LABA combo
acute bronchitis - tx for wheezing
albuterol inhaler QID or nebulized tx PRN
acute bronchitis - tx for severe wheezing
consider short term oral steroid
atypical pneumonia #1 organism
mycoplasma pneumoniae
paroxysms of dry and severe cough that interrupts sleep
acute bronchitis
cough lasting 3 weeks or longer; pleuritic chest pain; hemoptysis w/ fatigue; weight loss; night sweats
TB
intermittent cough that becomes more severe with inspiratory whoop; cough worse at night
pertussis
atypical pneumonia is most common in who
children and young adults
top two bacteria in atypical pneumonia
M. pneumoniae
chlamydia pneumoniae
gold standard to dx atypical pnuemonia with mycoplasma pneumoniae
polymerase chain reaction PCR of sputum or oropharyngeal swab
atypical PNA tx abx
4
azithromycin or clarithromycin
doxy
levofloxacin
top two bacteria in CAP
strep pneumoniae
H. influenzae
rust colored or blood tinged sputum in CAP more likely points to what bacteria
S. pneumoniae
gold standard test for dx CAP
chest x ray
CAP tx for patient < 65 years old with no comorbidities
first line monotherapy amoxicillin 1 G TID 5-7 days OR doxy OR macrolide
CAP tx for patient with comorbidities
combo therapy (beta lactam plus macrolide or doxy); Augmentin plus macrolide OR doxy
pertussis aka
whooping cough
pertussis is caused by
bordetella pertussis bacteria - gram neg
pertussis is a
highly contagious coughing illness of at least 14 days duration with one of the following findings - paroxysmal coughing, inspiratory whooping, or post tussive vomiting w/o apparent cause
severe hacking cough for over two weeks, low grade fever, cough then becomes severe with inspiratory sound
whooping cough
pertussis - less than 2 weeks (and 2-4 weeks) cough cold standard lab test
nasopharyngeal swab for culture and PCR for B. pertussis
pertussis first line treatment
azithromycin
adolescents should get Tdap when
11-12 y.o.
what vaccine do pregnant patients get weeks 27-36
Tdap
adult who has never received Tdap
administer a single dose of Tdap followed by a Td or Tdap booster every 10 years
