Respiratory Diseases Flashcards
What are the most common causes of bronchitis/URI?
Viral (rhinovirus)
If an atypical bacteria or whooping cough is suspected, which antibiotic is best?
Azithromycin
Can exudate be present in both viral and bacterial pharyngitis?
Yes
What’s an emergent cause of pharyngitis that presents with fever and deviated uvula, and it needs a neck x-ray if suspected?
Peritonsillar abscess
What are the 2 tests for mono?
- Monospot
2. Heterophile antibody
What could atypical lymphocytes indicate?
EBV (mono)
What’s the best antibiotic for strep?
Penicillin
T/F: most cases of sinusitis are viral?
True
What’s the best first-line antibiotic for sinusitis?
Amoxicillin-clav
When are antibiotics indicated in sinusitis?
If worsening after 3-4 days, if lasts 10+ days, if fever 101+, patient >65, or if patient is immunocompromised
What are the 4 most common causes of otitis media?
- Viruses
- S pneumo
- H influe
- M catarrhalis
What does an air-fluid level behind the TM indicate?
Otitis media or effusion
What’s the best antibiotic for otitis media?
Amoxicillin
What are the 2 most common bacteria for otitis externa?
- S. aureus
2. Pseudomonas aeruginosa
What’s the best treatment for otitis externa?
Topical neomycin/polymyxin B + cortisone
What pneumonia bacterial infection causes GI sx and/or hyponatremia in the elderly?
Legionella
How is pneumonia spread?
Respiratory droplet or secretions
What would you expect on CBC of pneumonia?
Leukocytosis with a neutrophilic predominance or bands
Can pneumonia show air bronchograms or pleural effusion on CXR?
Yes
What’s the first line antibiotic for pneumonia in age <65?
Azithromycin
What’s the first line antibiotic for pneumonia in age 65+ or adults with comorbidities?
Azithromycin + high dose amoxicillin
OR
a floxacin
What’s the antibiotic treatment for children with drug resistent S pneumoniae?
High dose amoxicillin
What are some of the categories of the CURB-65 criteria for pneumonia severity (if 2+ then hospitalize)?
Confusion Uremia (BUN 20+) 30+ breaths/min BP <90/60 Age 65+
Which vaccines for pneumonia are given to age 65+ adults one year apart and in what order?
- 13-valent
- 23-valent
“Start with the lower number”
When is the pneumococcal vaccine given to kids?
2 mos
4 mos
6 mos
15 mos
How old does a baby have to be to get the flu shot?
6 mos
What’s the FEV/FVC ratio in obstructive lung dz?
<0.7
In asthma, is it obstructive or restrictive?
Obstructive
What would the FEV1 be in asthma compared to predicted?
80% of predicted
Can bronchodilator improve FEV1 in asthma?
Yes
What’s the chain of asthma treatment?
- SABA for acute exacerbations
- Inhaled glucocorticoids for long term control
- LABA (must be used with a steroid)
What should you do if you suspect COPD in a patient <45?
Test a-1 antitrypsin levels
What would you expect the FEV1/FVC to be in COPD?
<0.70 and not reversible with bronchodilator
What 3 main sx indicate a COPD exacerbation?
- Increased sputum production
- Increased dyspnea
- Increased sputum purulence
What’s the tx for an acute COPD exacerbation?
Oral steroids plus inhaler with SABA
When are abx indicated in COPD?
If 2-3 main sx are present
What antibiotic is used for uncomplicated COPD exacerbation?
Macrolide
What antibiotic is used for COPD that is complicated or with other risk factors?
Fluoroquinolone
Do you use asthma treatments for COPD?
Yes
What 2 tests can show a PE?
CT and V/Q scan
How long do you have to treat with anticoags after PE?
3 mos
T/F: LMWH has unpredictable metabolism in patients with poor kidney function?
True
