Respiratory 3 Flashcards
TB is caused by what bacteria
mycobacterium tuberculosis
CBC recommended drugs for TB
3
isoniazid
rifapentine
rifampin
Gold standard for dx pulmonary TB infection (can take up to 8 weeks to grow)
sputum C/S
classic findings of TB on chest x ray
pulmonary nodules and/or cavitations (round black holes) on the upper lobes w/ or w/o fibrotic changes/scares
if you suspect allergic asthma, check was lab
serum immunoglobulin G allergy panels
which forms of TB require tx
both active and latent forms
restrictive lung diseases include
3
pulmonary fibrosis
pleural disease
diaphragm obstruction
obstructive lung diseases include
3
asthma
COPD
bronchiectasis
sound heard over normal lung tissue filled with air
resonance
normally heard over solid areas such as bones
flatness
first line abx for pertussis
azithromycin
group E COPD patients tx
LABA and LAMA together
a patient with TB infection has
no symptoms, cannot spread TB to others, usually has a positive TB skin test or blood test, and may develop TB disease if they do not receive tx
the best method to assess the severity of an asthma attack is
measurement of maximal expiratory airflow w/ a peak flow meter
which vaccine can cause false positive TB skin reaction
BCG vaccine
BCG vaccine can show false positive for how long
up to three months
per CBC guidelines, for adults 65 years and older who have received PPSV23 - what should be administered for PNA
one dose of PCV15 or PCV20 at least 1 year after the most recent PPSV23
the CDC recommends pneumococcal vaccine for adults 19-64 with certain medical conditions - which vaccines can they get
one dose of PCV 15 or PCV 20; if they get PCV15 they then need PPSV23 1 year later
most sensitive tool to detect TB and gold standard for dx drug resistant TB
sputum C/S
most rapid and inexpensive TB dx method
sputum acid-fast bacilli smear
COPD group A med
long acting bronchodilator e.g. LAMA is preferred over a short acting bronchodilator alone
COPD group B med
dual bronchodilator therapy LAMA-LABA
asthma step 1 GINA
low dose ICS and rapid onset LABA
asthma step 1 NAEPP
SABA prn
people with COPD or emphysema and those who smoke are more likely to have PNA from what organisms
2
H. influenzae as the predominant organism along with S. pneumoniae
options for treating PNA in older adult (65 +) with comorbidities
risk factors for this patient are for H. influenzae infection (gram neg) and also assume the presence of S. pneumoniae (gram pos) because it is the most common bacteria in CAP; treat with beta-lactams plus a macrolide or doxy… OR monotherapy with a respiratory fluoroquinolone
major risk factors for fatal asthma include
3
multiple hospital admissions in the past year
ICU admission and/or intubation
recent history of poorly controlled asthma
preferred reliever medication for asthma GINA guidelines
low dose ICS w/ formoterol (which is a rapid onset LABA) or an ICS-LABA combo
