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Respiratory Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the description of bronchiectasis?

A

Chronic infection of the bronchi and bronchioles leading to permanent dilatation of these airways.

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2
Q

What are some symptoms of bronchiectasis?

A 
Productive cough (yellow-green sputum, can become haemoptysis)
Recurrent febrile episodes, malaise
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3
Q

What are some signs of bronchiectasis?

A

Clubbing
Coarse inspiratory crepitations
Wheeze

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4
Q

What are the causes of bronchiectasis?

A

Congenital
Cystic fibrosis
Bronchiole obstruction (tumour, foreign body)

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5
Q

How do you diagnose bronchiectasis?

A

CXR - dilated + thickened bronchiole walls
CT - thickened bronchi which are wider than the adjacent blood vessel, cysts
Sputum culture - S. aureus, Pseudomonas, HiB
IgA deficiency

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6
Q

What are some complications of bronchiectasis?

A

Pneumonia, pneumothorax
Empyema
Metastatic cerebral abscesses
Life-threatening haemoptysis

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7
Q

What is the treatment of bronchiectasis?

A
  • Postural drainage twice daily
  • Physiotherapy
  • Antibiotics (mild: cefaclor/ciprofloxacin,
    flucloxacillin if S. aureus, persistent: ceftazidime)
  • Bronchodilators (e.g. nebulised salbutamol) + anti-inflammatory agents (e.g. corticosteroids such as prednisolone)
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8
Q

What is the description of cystic fibrosis?

A

Autosomal recessive disorder in which there is a defect in the CFTR gene.
Failed opening of Cl channel -> increased cAMP -> increased viscosity of airway secretions.

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9
Q

What are some symptoms of cystic fibrosis?

A 
Recurrent infections, cough, wheeze 
Sinusitis, nasal polyps
Breathlessness
Haemoptysis
Steatorrhoea
Malabsorption
Failure to thrive as a neonate
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10
Q

What are some signs of cystic fibrosis?

A

Cyanosis
Finger clubbing
Bilateral coarse crackles

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11
Q

How do you diagnose cystic fibrosis?

A 
Sweat test 
Genetic testing (common CF mutations)
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12
Q

What is the treatment of cystic fibrosis?

A 
Lifestyle advice (smoking, vaccines)
Antibiotics (as per bronchiectasis)
SABAs, ICS for symptoms
Physiotherapy to develop techniques for better breathing
Gene therapy is not yet possible
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13
Q

What is the description of allergic bronchopulmonary aspergillosis?

A

An allergic condition caused by type 1 and type 2 hypersensitivity reactions to Aspergillus fumigatus.

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14
Q

What are some symptoms of allergic bronchopulmonary aspergillosis?

A 
Wheeze
Cough
Sputum
Dyspnoea
Recurrent pneumonia
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15
Q

How do you diagnose allergic bronchopulmonary aspergillosis?

A

CXR- transient segmantal collapse or bronchiectasis

Sputum culture - Aspergillus

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16
Q

What is the treatment of allergic bronchopulmonary aspergillosis?

A

Prednisolone for acute attacks

Bronchodilators for asthma

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17
Q

What is the description of aspergilloma?

A

A fungus ball within a pre-existing cavity (usually caused by TB or sarcoidosis)

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18
Q

What are some symptoms of aspergilloma?

A

Cough
Haemoptysis
Lethargy +/- weight loss

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19
Q

How do you diagnose aspergilloma?

A

CXR- round opacity within an apical cavity

Sputum culture

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20
Q

What is the treatment for aspergilloma?

A

Only if symptomatic

Surgical excision

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21
Q

What is the description of invasive aspergillosis?

A

Occurs when the immune system fails to prevent Aspergillus spores from entering the bloodstream via the lungs

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22
Q

What are some risk factors for invasive aspergillosis?

A 
Immunocompromised patients (HIV, leukaemia, burns)
Broad-spectrum antibiotic therapy
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23
Q

What are some symptoms of invasive aspergillosis?

A

Fever and chills
Haemoptysis
Shortness of breath
Chest and joint pain

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24
Q

How do you diagnose invasive aspergillosis?

A

Lung biopsy

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25
Q

What is the treatment for invasive aspergillosis?

A

Voriconazole

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26
Q

What is the description of extrinsic allergic alveolitis?

A

Widespread diffuse inflammatory reaction in small airways and alveoli due to inhalation of foreign antigens, usually from animals.
Cigarette smokers actually have decreased risk.
Type III hypersensitivity

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27
Q

What are some symptoms of extrinsic allergic alveolitis?

A 
Fever and malaise
Cough
Breathlessness
Wheeze
Coarse end inspiratory crackles
Weight loss
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28
Q

How do you diagnose extrinsic allergic alveolitis?

A

CXR - fluffy upper zone nodular shadows
CT - ground glass opacity
Restrictive lung pattern
Raised leucocytes + T cells

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29
Q

What is the treatment for extrinsic allergic alveolitis?

A

Oral prednisolone in early stages

Prevent exposure to allergen

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30
Q

What is the description of lung cancer?

A

Carcinomas of the lung, bronchial carcinoma being the most common

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31
Q

What are some risk factors of lung cancer?

A

Cigarette smoking
Asbestos
Radiation

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32
Q

What is the histology of lung cancer?

A

Squamous cell carcinoma (35%)
Adenocarcinoma (27%)
Small cell carcinoma (20%)
Large cell carcinoma (10%)

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33
Q

What is the description of SCC of the lung?

A

Arise from epithelial cells
Local, slow metastasis.
Hypercalcaemia, PTH

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34
Q

What is the description of adenocarcinoma of the lung?

A

Common in non-smokers
Arises from mucus-secreting glandular cells
Metastasises widely

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35
Q

What is the description of small cell carcinoma of the lung?

A

Arise from APUD cells; secrete ACTH
Often centrally located
Rapid metastasis

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36
Q

What is the description of large cell carcinoma of the lung?

A

Poorly differentiated

Metastasises early on

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37
Q

What are some symptoms of lung cancer?

A 
Cough
Haemoptysis
Dyspnoea
Chest pain
Weight loss
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38
Q

What are some signs of lung cancer?

A

Cachexia
Anaemia
Clubbing
Hypertrophic pulmonary osteoarthropathy => wrist pain
Consolidation, collapse, pleural effusion
Metastasis - bone tenderness, hepatomegaly, confusion, fits

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39
Q

What are some complications of lung cancer?

A 
Local - recurrent laryngeal nerve palsy
            phrenic nerve palsy
            Horner's syndrome (pan coast tumour)
            pericarditis
Metastatic - Bone pain
                     Anaemia
                     Hypercalcemia
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40
Q

How do you diagnose lung cancer?

A

Cytology - sputum and pleural fluid
CXR - mass lesions, pleural effusion, hilar adenopathy, slow resolving consolidation, collapse, reticular shadowing
CT - stage the tumour
Bronchoscopy - to give histology and assess operability

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41
Q

What is the treatment of lung cancer?

A

Non-small cell tumours - Surgical excision or radical radiotherapy
Small cell tumours - chemotherapy

Surgery - can be curative. In stage III, treat with chemo to shrink tumour before surgery. Contraindicated if tumour is near hilum and/or evidence of metastasis.

Drugs - analgesia, steroids, anti-emetics, bronchodilators, anti-depressants

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42
Q

What is the description of asthma?

A

A lung disorder in which inflammation causes the bronchi to swell and narrow the airways.

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43
Q

What are some symptoms of asthma?

A

Chest tightness
Wheeze
Dry cough
Breathlessness

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44
Q

What are some signs of asthma?

A

Hyperinflated chest
Hyperesonant percussion note

Severe attack - inability to complete sentences, pulse more than 110bpm, respiratory rate >25bpm, PEF 33-50% predicted

Life-threatening attack - silent chest, confusion, exhaustion, cyanosis, SPO2 less than 92%, bradycardia, PEF less than 33% predicted

Near fatal attack - Highly increased PaCO2

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45
Q

How do you diagnose asthma?

A

Acute attack - PEF, sputum culture, FBC, U&E, CRP, ABG analysis (shows signs of hyperventilation)

Chronic - PEF monitoring, spirometry, FEV1/FVC ratio

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46
Q

What is the treatment of an acute attack of asthma?

A

O - Oxygen

S - Salbutamol (nebulised)
H - Hydrocortisone (IV)
I - Ipratropium (nebulised)
T - Theophylline (oral)

M - Magnesium sulfate (IV)
AN - Anaesthetist

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47
Q

What is the treatment of chronic asthma?

A

Step 1 - SABA for symptoms relief
Step 2 - Add inhaled corticosteroids (e.g. beclometasone)
Step 3 - Add LABA every 12 hours by inhaler
Step 4 - Increased dose of corticosteroid and add theophylline (oral), SABA (oral) or leukotriene receptor antagonist (oral)
Step 5 - Add daily oral prednisolone

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48
Q

What is the description of COPD?

A

Encompasses 2 main clinical syndromes: chronic bronchitis and emphysema.
Characterised by airflow obstruction that is mostly irreversible.

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49
Q

What are the two types of COPD patients?

A

Pink puffers - high alveolar ventilation, near normal PaO2 and low PaCO2. Breathless but not cyanosed. May progress to type 1 respiratory failure.

Blue bloaters - low alveolar ventilation, low PaO2 and a high PaCO2. They are cyanosed but not breathless. May go on to develop cor pulmonale. Supplemental oxygen should be given with care.

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50
Q

What are some symptoms of COPD?

A

Productive cough
Wheeze
Breathlessness
Infective exacerbations

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51
Q

What are some signs of COPD?

A

Tachypnoea
Use of accessory muscles of respiration
Hyperinflation
Cyanosis

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52
Q

What are some potential complications of COPD?

A 
Hypertension
Osteoporosis
Weight loss
Cor pulmonale
Respiratory failure
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53
Q

How do you diagnose COPD?

A

FBC - increased PVC
CXR - hyperinflation, large pulmonary arteries, cor pulmonale
ABG - PaO2 decreased
Lung function - Obstructive (FEV1 low, FEV1/FVC ratio reduced)

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54
Q

What is the treatment of COPD?

A

Smoking cessation and lifestyle advice

Mild - SABA (salbutamol)
Moderate/severe - LABA (salmeterol)

SAMA (ipratropium) or LAMA (tiotropium)

Mild - Inh. corticosteroid (beclometasone)
Severe - PO corticosteroid if severe (prednisolone)

Also add:
Seretide (salmeterol + beclometasone)
Xanthine (theophylline)
Anti-mucolytic (carbocysteine)

55
Q

What is the treatment for an acute exacerbation of COPD?

A

i - Ipratropium (nebulised)

S - Salbutamol (nebulised)
O - Oxygen
A - Antibiotics (e.g. amoxicillin, doxycycline)
P - Prednisolone (oral)

56
Q

What is the description of acute respiratory distress syndrome?

A

Respiratory distress due to stiff lungs (reduced pulmonary compliance) and gas exchange impairment

57
Q

What are some causes of acute respiratory distress syndrome?

A

Lung injury
Severe sepsis
Pneumonia
Haemorrhage

58
Q

What are some symptoms of acute respiratory distress syndrome?

A

Breathlessness
Tachypnoea
Increasing hypoxaemia, central cyanosis
Fine bilateral crackles

59
Q

What are some signs of acute respiratory distress syndrome

A

CXR shows bilateral pleural infiltrates

60
Q

How do you diagnose acute respiratory distress syndrome?

A

4 main diagnosing features:

  • Acute onset
  • CXR => bilateral infiltrates
  • Lack of congestive heart failure
  • Refractory hypoxaemia
61
Q

What is the treatment of acute respiratory distress syndrome?

A

Respiratory support - Continuous positive airway pressure with 40-60% oxygen
Circulatory support - fluid management with diuretics

Treat underlying condition - e.g. Sepsis

62
Q

What is the description of type I respiratory failure?

A

Hypoxia (PaO2 < 8kPa) with a normal or low PaCO2.

63
Q

What is type I respiratory failure caused by?

A

Mismatch in ventilation/perfusion e.g. pneumonia, PE, asthma, emphysema, ARDS, pulmonary oedema

64
Q

What is the description of type II respiratory failure?

A

Hypoxia (PaO2 < 8 kPa) and hypercapnia (PaCO2 > 6 kPa)

65
Q

What is type II respiratory failure caused by?

A
  • Pulmonary disease (asthma, COPD, pneumonia, fibrosis, obstructive sleep apnoea)
  • Reduced respiratory drive (sedation drugs, CNS tumour/trauma)
  • Neuromuscular disease (cervical cord lesion, diaphragmatic paralysis, poliomyelitis, Guillain-Barre Syndrome)
  • Thoracic wall disease (flail chest, kyphoscoliosis)
66
Q

What are some signs and symptoms of respiratory failure?

A

Hypoxia - dyspnoea, restlessness, agitation, confusion, central cyanosis, pulmonary hypertension

Hypercapnia - headache, peripheral vasodilation, tremor/flap, tachycardia, bounding pulse

67
Q

How do you diagnose respiratory failure?

A

Do investigations to figure out the underlying cause:

  • Blood tests => FBC, U&E, CRP, ABG
  • Radiology => CXR
  • Microbiology => Sputum culture, blood culture
  • Spirometry => COPD, Guillain-Barre syndrome
68
Q

What is the treatment for type I respiratory failure?

A

Treat underlying cause
Oxygen (15L) non-rebreather (hypoxia)
Assisted ventilation if PaO2 < 8kPa despite 60% O2

69
Q

What is the treatment for type II respiratory failure?

A

Oxygen (24%)
Recheck ABGs after 20min
- If PaCO2 is steady/lower, increase O2 concentration to 28%
- If PaCO2 rises > 1.5kPa and patient is still hypoxic, consider a respiratory stimulant (doxapram) or assisted ventilation (NIPPV)

70
Q

What is the description of pulmonary embolism (PE)?

A

A blockage in one of the blood vessels in the lung.

71
Q

What are some symptoms of pulmonary embolism (PE)?

A 
Acute breathlessness 
Pleuritic chest pain
Haemoptysis
Dizziness
Syncope
72
Q

What are some signs of pulmonary embolism (PE)?

A 
Pyrexia (fever)
Cyanosis
Tachypnoea
Tachycardia
Hypotension
Raised JVP
73
Q

What are some causes of pulmonary embolism (PE)?

A

DVT

Septic emboli

74
Q

What are some risk factors for pulmonary embolism (PE)?

A 
Recent surgery
Prolonged bed rest/reduced mobility
Pregnancy
Contraceptive pill
Previous PE
75
Q

How do you diagnose pulmonary embolism (PE)?

A
  • CXR usually normal, possible blunting of costophrenic angle
  • ECG may be normal or show tachycardia
  • D-dimer – if undetected, exclude diagnosis of PE
  • V/Q scan shows underperfused areas
76
Q

What is the treatment for pulmonary embolism (PE)?

A
  • Oxygen - if hypoxic
  • Morphine - IV and an anti-emetic
  • If haemodynamically stable => vasopressors
  • If haemodynamically unstable => thrombolysis

Then consider long-term anticoagulation

77
Q

What is the description of pneumothorax?

A

Air in the pleural space leads to a collapsed lung.

May be spontaneous (tall, thin males) or the result of trauma to the chest.

78
Q

What are some symptoms of pneumothorax?

A

Sudden onset of dyspnoea and pleuritic chest pain

Pale

79
Q

What are some signs of pneumothorax?

A

Reduced expansion
Hyper-resonance to percussion
Diminished breath sounds on affected side
Trachea deviated away from affected side (tension pneumothorax)

80
Q

How do you diagnose pneumothorax?

A

Presentation of symptoms

CXR

81
Q

What is the treatment of pneumothorax?

A
  • Needle aspiration (2nd IC space, mid-clavicular line)

- Chest drain if recurs using large bore cannula into 5th IC mid-axillary line

82
Q

What is the description of pleural effusion?

A

Fluid in the pleural space

83
Q

What are the types of pleural effusion?

A 
Transudate - <25g/L  
Exudate -  >35g/ L
Blood - haemothorax
Pus - empyema
Chyle (lymph with fat) - chylothorax
84
Q

What are some symptoms of pleural effusion?

A

Breathlessness

85
Q

What are some signs of pleural effusion?

A

Stony dull percussion note
Decreased expansion
Diminished breath sounds on the affected side
Tracheal deviation away from the affected side

86
Q

What is the cause of pleural effusion?

A

Presentation of symptoms
CXR - Small ones blunt the costophrenic edges, larger ones are seen as water-dense shadows

Ultrasound - identifies the fluid present and guides aspiration

Diagnostic aspiration

87
Q

What is the treatment for pleural effusion?

A

Drainage - If symptomatic, can drain repeatedly
Pleurodesis - with talc, may be help recurrent pleural effusions
Surgery - May be necessary for large effusions

88
Q

What is the description of empyema?

A

Pus in the pleural space

Usually a complication of pneumonia

89
Q

What are some symptoms of empyema?

A

Ongoing fever

Pneumonia-like persistent symptoms

90
Q

What is the treatment for empyema?

A

Surgical - drainage

91
Q

What is the description of obstructive sleep apnoea?

A

Airway becomes closed during sleep.

Partial occlusion results in snoring; complete occlusion results in apnoea.

92
Q

What are some symptoms of obstructive sleep apnoea?

A 
Loud snoring
Daytime somnolence
Poor sleep quality
Morning headache
Nocturia
93
Q

What are some of the causes of obstructive sleep apnoea?

A

Obesity
Pre-existing COPD
Narrow pharyngeal opening
Respiratory depressants

94
Q

What are some potential complications of obstructive sleep apnoea?

A

Pulmonary hypertension

Type II respiratory failure

95
Q

How do you diagnose obstructive sleep apnoea?

A

Overnight pulse oximetry (sometimes video recordings can be all that is required for diagnosis)
Polysomnography
EMG - chest and abdominal wall movements during sleep - can be diagnostic

96
Q

What is the management of obstructive sleep apnoea?

A

Weight reduction
Avoidance of tobacco and alcohol
CPAP via a mask
Surgery is occasionally needed

97
Q

What is the description of cor pulmonale?

A

Right heart failure due to chronic pulmonary hypertension

98
Q

What are some symptoms of cor pulmonale?

A

Progressive breathlessness
Ankle oedema
Fatigue

99
Q

What are some signs of cor pulmonale?

A 
Cyanosis
Tachycardia
Parasternal heave, tricuspid regurgitation
Pulmonary hypertension
RV hypertrophy
Elevated JVP, ascites
100
Q

How do you diagnose cor pulmonale?

A

FBC - Hb and haematocrit are high
ABG - hypoxia, with or without hypercapnia
CXR - enlarged right atrium, prominent pulmonary arteries
ECG - p-pulmonale, right axis deviation

101
Q

What is the management of cor pulmonale?

A

Treat the underlying condition
Treat the respiratory failure - give oxygen
Treat cardiac failure - diuretics

102
Q

What are some causes of cor pulmonale?

A

Lung disease - COPD, bronchiectasis, pulmonary fibrosis
Pulmonary vascular disease - emboli, vasculitis
Sleep apnoea
Scoliosis or kyphosis

103
Q

What is the description of sarcoidosis?

A

Multi-system, non-caseating, granulomatous, type IV hypersensitivity disorder of unknown aetiology.

104
Q

What are some symptoms of sarcoidosis?

A 
Dry cough
Progressive dyspnoea
Reduced exercise tolerance
Chest pain
Weight loss
Fatigue
105
Q

What are some signs of sarcoidosis?

A 
Erythema nodosum
Lymphadenopathy
Uveitis
Hepatomegaly
Splenomegaly
106
Q

How do you diagnose sarcoidosis?

A
  • CXR multiple abnormalities, BHL
  • Restrictive lung pattern
  • Hypercalcaemia, raised ACE level
  • Transbronchial biopsy
107
Q

What is the treatment of sarcoidosis?

A

Most recover spontaneously
Acute sarcoidosis - bed rest and NSAIDs
Otherwise - corticosteroids

108
Q

What is the description of interstitial lung disease?

A

Term used to describe a group of lung conditions which affect the lung parenchyma (part of the lung which is involved in gas exchange) in a diffuse manner.

109
Q

What are some symptoms of interstitial lung disease?

A

Dyspnoea on exertion
Non-productive paroxysmal cough
Restrictive pulmonary spirometry
Abnormal breath sounds

110
Q

What are the pathological features of interstitial lung disease?

A

Fibrosis and remodelling of the interstitium
Chronic inflammation
Hyperplasia of type II epithelial cells or type II pneumocytes

111
Q

What is the classification of interstitial lung disease?

A

Those with known cause:

  • Occupational/environmental e.g. asbestosis
  • Drugs e.g. bleomycin
  • Hypersensitivity reactions
  • Infections e.g. TB
  • Gastro-oesophageal reflux

Those associated with systemic disorders:

  • Sarcoidosis
  • Rheumatoid arthritis
  • Ulcerative colitis

Idiopathic:
- Idiopathic pulmonary fibrosis

112
Q

What is the description of idiopathic pulmonary fibrosis

A

Patchy scarring of lung with collagen deposition,
Most common type of interstitial lung disease.
Late onset.
Commoner in males.

113
Q

What are some symptoms of idiopathic pulmonary fibrosis?

A 
Dry cough
Exertional dyspnoea
Malaise
Weight loss
Arthralgia
114
Q

What are some signs of idiopathic pulmonary fibrosis?

A

Cyanosis
Clubbing
Inspiratory crepitations

115
Q

How do diagnose idiopathic pulmonary fibrosis?

A

ABG - decrease in PaO2, if severe then increase in PaCO2

Blood - increase in CRP, increase in immunoglobulins

CXR - initially ground-glass appearance, then honeycomb lung in advanced disease

CT - bilateral changes, essential for diagnosis

Spirometry - restrictive pattern

116
Q

What is the treatment for idiopathic pulmonary fibrosis?

A

Supportive care - oxygen, pulmonary rehab, corticosteroids (oral prednisolone), anti-fibrotic (pirfenidone)

117
Q

What is the description for coal worker’s pneumoconiosis?

A

A dust disease that occurs from the inhalation of dust particles typically 2-5 micrometres in diameter which are retained in small airways and alveoli.

118
Q

What are the two types of coal worker’s pneumoconiosis?

A

Simple pneumoconiosis - simple, more common form of the disease. Refers to coal dust deposition in the lung. Symptoms COPD-like.

Progressive massive fibrosis - round fibrotic masses several cm in diameter develop on the upper lobes

119
Q

What are the symptoms of coal worker’s pneumoconiosis?

A

Considerable effort dyspnoea
Cough
Black sputum

120
Q

What is the treatment for coal worker’s pneumoconiosis/

A

Avoid exposure to dust
Treat bronchitis
Claim compensation

121
Q

What is the description of silicosis?

A

A lung disease cause by the inhalation of silica particles which are very fibrogenic.

122
Q

What are the symptoms of silicosis?

A

Progressive dyspnoea
Increase in incidence of TB
CXR - shows diffuse nodular pattern in upper and mid zones

123
Q

What is the treatment of silicosis?

A

Avoid exposure to silica

Claim compensation

124
Q

What is the description of asbestosis?

A

Fibrosis caused by asbestos dust exposure.

125
Q

What are the symptoms of asbestosis?

A

Progressive dyspnoea
Clubbing
Fine-end inspiratory crackles
Pleural plaques

126
Q

What is the treatment of asbestosis?

A

Claim compensation

Corticosteroids might help symptoms

127
Q

What is the description of pneumonia?

A

A lower respiratory tract infection.

128
Q

What are the different types of pneumonia?

A

Community acquired pneumonia
Hospital acquired pneumonia
Aspiration pneumonia
Immunocompromised acquired pneumonia

129
Q

What are some symptoms of pneumonia?

A
  • Fever and rigors
  • Pleuritic chest pain
  • Anorexia
  • Breathlessness
  • Cough – dry or productive
130
Q

What are some signs of pneumonia?

A

Pyrexia
Cyanosis
Tachypnoea
Tachycardia

131
Q

How do you diagnose pneumonia?

A
  • CXR consolidation, effusions, collapse
  • FBC + U&Es, CRP
  • Sputum culture to detect organisms
  • CURB65 score for CAP
132
Q

What does the CURB65 score assess?

A

Confusion
Urea
Respiratory rate
BP

Age > 65

133
Q

What is the treatment for pneumonia?

A

Community acquired pneumonia
- Mild/Moderate: (7 days) PO amoxycillin
If penicillin allergy PO doxycycline
if IV required IV clarithromycin
- Severe: (10 days) IV co-amoxiclav + IV clarithromycin/PO doxycycline

       If penicillin allergy	IV levofloxacin

Hospital acquired pneumonia

  • Severe: (7-10days) amoxicillin + metronidazole + gentamicin
  • Non-severe: (7 days) amoxicillin + metronidazole

Specific

  • Staph. aureus flucloxacillin/vancomycin if MRSA
  • Klebsiella cefotaxime
  • Pseudomonas ceftazidime/ciprofloxacin + aminoglycide
  • Mycoplasma clarithromycin/ciprofloxacin
  • Legionella levofloxacin/moxifloxacin/consider rifampicin
  • Chlamydophila doxycycline/clarithromycin
  • Pneumocystis jiroveci co-trimoxazole
  • Fungal amphoterecin

Medical Conditions (3 decks)

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