Respiratory Tract Infections

Question 1

CAP Pathogen: Alcoholism

Answer 1

Klebsiella

Question 2

CAP Pathogen: COPD/Smoker

Answer 2

S. pneumo
H. flu
Moraxella
Cararrhalis
Legionella

Question 3

CAP Pathogen: ECF Residence

Answer 3

S. pneumo
H flu
GNR
Staph aureus
Anaerobes
Chlamydia pneumoniae
TB

Question 4

CAP Pathogen: Hotel/Cruise ship

Answer 4

Legionella

Question 5

CAP Pathogen: Exposed to bats

Answer 5

histoplasma capsulatum

Question 6

CAP Pathogen: exposed to birds

Answer 6

chlamydia psittaci

Question 7

CAP Pathogen: travel to southwest USA

Answer 7

coccidiodomycosis

Question 8

CAP Pathogen: community with flu going around

Answer 8

s. pneumo
s. aureus
h. flu

Question 9

Respiratory virus with the highest mortality

Answer 9

Influenza

Question 10

1 cause of pneumonia in kids <6 months old

Answer 10

RSV

Question 11

2nd most common cause of viral pneumonia

Answer 11

RSV

Question 12

1 cause of sick visits/ absenteeism

Answer 12

common cold

Question 13

Centor Criteria for strep throat

Answer 13

1. fever
2. anterior cervical lymphadenopathy
3. exudate
4. NO COUGH
   (need 3/4)

Question 14

What is Ludwig’s Angina?

Answer 14

submandibular space infection, bilateral mouth floor
aggressive, rapidly spreading “woody cellulitis”
s/s: fever, mouth pain, stiff neck, drooling, dysphagia, enlarged tongue, indurated swelling, crepitus

Question 15

Common xray finding in epiglottitis

Answer 15

thumbprint sign in lateral film

Question 16

most common cause of epiglottitis in children

Answer 16

h. influenza

Question 17

Most common cause of mild hemoptysis

Answer 17

Tracheobronchitis

Question 18

Most common cause of croup

Answer 18

Parainfluenza

Question 19

In croup, when does coughing peak?

Answer 19

night 2-3 of illness

Question 20

Common xray finding in croup

Answer 20

steeple sign

Question 21

1 pediatric cause of upper airway obstruction

Answer 21

croup

Question 22

1 cause of bronchiolitis and pneumonia in infants

Answer 22

RSV

Question 23

Who has a PPD cutoff of 5mm?

Answer 23

HIV +
recent TB contacts
immunosuppressed (chemo/transplant pt)

Question 24

Who has a PPD cutoff of 10mm?

Answer 24

recent immigrant from endemic country
injection drug user
healthcare workers
prisoners, homeless

Question 25

Who has a PPD cutoff of 15mm?

Answer 25

those with no known risk factors | soccer moms

Question 26

BCG vaccination for tuberculosis- what's up with that?

Answer 26

it is used in high incidence areas, no good at preventing primary infection but is 60-80% effective in preventing reactivation in children. causes false positive PPD

Question 27

Classic TB drug regimen

Answer 27

Rifampin Isoniazid (INH) Pyrazinamide Ethambutol

Question 28

Tell me about latent TB

Answer 28

in most patients, it's the initial infection. smears and cultures will be negative and imaging will show little. Patient will have + PPD but is not sick or infectious

Question 29

What disease state shows asymmetric hilar adenopathy?

Answer 29

Primary TB

Question 30

Gold standard for TB diagnosis

Answer 30

sputum culture

Question 31

Tuberculoid vs. Lepromatous Leprosy

Answer 31

Causative agent: mycobacterium leprae Tuberculoid: cellular response, limits disease well, reversal reactions go back to this form Lepromatous: Ab-mediated, severe, peripheal nerve involvement and large # lesions

Question 32

In immunocompromised patients, what does MAC cause?

Answer 32

disseminated disease and febrile wasting syndrome

Question 33

#1 cause of CAP

Answer 33

s. pneumo

Question 34

CAP: Top 3 causes of lobar pneumonia

Answer 34

(typicals) 1. s. pneumo 2. h. flu 3. klebsiella

Question 35

CAP: Top 3 causes of diffuse pneumonia

Answer 35

(atypicals) 1. mycoplasma pneumoniae 2. legionella 3. chlamydia

Question 36

CAP: Top 2 causes of post-flu pneumonia

Answer 36

1. p. pneumo | 2. s. aureus

Question 37

Top 3 HAP/VAP pathogens

Answer 37

1. Psuedomonas 2. Acinetobacter 3. MRSA

Question 38

Common features of typical pneumonia

Answer 38

PRODUCTIVE cough, PURULENT sputum SOB +/- chest pain lobar consolidation

Question 39

Common features of atypical pneumonia

Answer 39

``` DRY, NON-PRODUCTIVE cough, scant sputum mild dyspnea extrapulmonary dz immune mediated diffuse infiltrate ```

Question 40

What pneumonia is characteristic of bullous myringitis?

Answer 40

mycoplasma pneumoniae

Question 41

What pneumonia shows inclusions and reticulate bodies on cytology?

Answer 41

chlamydophilia pneumoniae

Question 42

What is the #1 cause of blindness, worldwide?

Answer 42

chlamydia trachoma

Question 43

Which pathogen can lead to fulminant pneumonia?

Answer 43

chlamydophilia psittaci

Question 44

Which pathogen is seen on silver stain and needs iron and cysteine to grow?

Answer 44

Legionella

Question 45

Which atypical is in the top 5 causes of CAP that cause patients to be admitted to the ICU?

Answer 45

Legionella