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PT3 ID 1 (HIV) > RTIs > Flashcards

RTIs Flashcards

1
Q

normal respiratory flora

A 
strep pneumoniae
strep pyogenes
strep viridans
staph aureus
moraxella catarrhalis
haemophilus
neisseria
lactobacilla
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2
Q

signs/symptoms of pertussis

A
  • Stage 1 = 1-2 wks, runny nose, low grade fever, mild cough
  • Stage 2 = 2-10 wks, fits of rapid coughing with whoop on inspiration, vomiting, exhaustion
  • Stage 3 = 2-3 wks, coughing lessens, susceptible to other rtis
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3
Q

pertussis diagnosis

A
  • physical exam

- nasopharyngeal sample tested with PCR and cultures

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4
Q

main antibiotic for pertussis

A

macrolides

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5
Q

alternative treatment for pertussis

A

tmp/smz

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6
Q

group A strep pharyngitis presentation

A
  • sudden sore throat
  • age 5-15
  • fever, headache
  • N/V
  • tonsillar inflammation
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7
Q

viral pharyngitis

A
  • conjunctivitis
  • coryza (inflammation, runny nose)
  • cough
  • diarrhea
  • hoarsenes
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8
Q

strep throat workup process

A
  • swab throat
  • test using rapid antigen detection test (RADT)
  • if negative do culture in kids
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9
Q

treatment for strep pharyngitis

A
  • penicillin vk x 10d
  • amoxicillin x 10d
  • cephalexin x 10d
  • z-pak if penicillin allergy
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10
Q

rhinosinusitis presentation

A

inflammation of nasal mucosal lining for at least 4 weeks
one of the following:
-severe symptoms lasting more than 3-4 days
-persistent symptoms lasting over 10 days
-worsening symptoms after viral URI

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11
Q

major criteria for bacterial sinusitis diagnosis

A
  • purulent nasal discharge
  • nasal congestion
  • facial congestion
  • fever
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12
Q

minor criteria for bacterial sinusitis diagnosis

A
  • ear pain
  • dental pain
  • cough
  • fever
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13
Q

bacterial sinusitis treatment

A

amoxicillin/clavulanate
10-14 days in children
5-7 in adults

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14
Q

alternatives for sinusitis treatment

A

doxycycline
quinolones
ceftriaxone

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15
Q

if first treatment fails in sinusitis

A

children: double dose of augmentin
adults: augmentin XR

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16
Q

adjunctive therapies to do in bacterial sinusitis

A

hydrate
analgesics
antipyretics
irrigation

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17
Q

therapies to NOT do in bacterial sinusitis

A

decongestants

antihistamines

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18
Q

sinusitis cultures obtained from

A

middle meatus endoscopically

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19
Q

community acquired pneumonia bugs

A

s. pneumoniae (75%)
legionella pneumoniae
chalmydia pneumonia
mycoplasma pneumoniae

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20
Q

factors in pneumonia development

A
  • decreased clearance of airway debris
  • depressed macrophage activity
  • enhancement of aspiration
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21
Q

presenting signs of pneumonia

A
  • fever over 100.4
  • over 20 breaths/min
  • tachycardia
  • bradycardia if legionella
  • crackles w/ inspiration
  • infiltrates in chest x-ray`
22
Q

symptoms of pneumonia

A 
fever
chills
chest pain
cough
sputum
23
Q

WBC components

A
  • neutrophils
  • lymphocytes (infection fighters)
  • monocytes (lil macrophages)
  • eosinophils (hypersensitivity)
24
Q

signs of atypical pneumonia

A

nausea, vomiting, confusion

25
Q

atypical bacteria in pneumonia

A

mycoplasma
legionella
chlamydia

26
Q

pneumonia workup

A
  • gram stain from sputum
  • gram stain and culture from blood
  • urine test for legionella
  • chest xray for inflatrates
27
Q

empiric pneumonia treatment

A

if MIC < 2

  • amoxicillin/amp
  • IV pcn
  • imipenem
  • macrolides
  • quinolones
  • cefuroxime
28
Q

empiric treatment for outpatient CAP

A

macrolide w or w/o amoxicillin
3-7 days if no bacteremia
10-14 if bacteremia

29
Q

treatment of CAP if macrolide resistance

A
  • levo or moxi
  • amoxicillin TID
  • augmentin
  • cefpodoxime
  • doxy
30
Q

treatment for inpatient CAP

A

ceftriaxone + azithromycin

31
Q

patients at risk for pseudomonas

A
  • hospital stay >5 days
  • prolonged nursing home stay
  • structural lung disease
  • on steroids
  • neutropenia
32
Q

who to calculate ANC for

A

immunocompromised pts

33
Q

info needed for ANC calculation

A

WBC
%neutrophils
%bands

34
Q

duration of therapy for CAP

A

5 days - no immunocompromise or structural disease
7 days - moderate immunocompromise
10-14 days - poor clinical response, significant immunocompromise

35
Q

patients at risk for h.influenzae pneumonia

A 
adults
elderly
alcoholics
COPD
immune deficiencies
36
Q

treatment for non beta-lactamase h.influenzae

A

amoxicillin
zpak
cefdinir

37
Q

treatment for beta-lactamase producing h.influenzae

A

augmentin
cefpodoxime, cefdinir
zpak

38
Q

patients at risk for moraxella catarrhalis pneumonia

A

smokers
copd
steroid users

39
Q

treatment for moraxella catarrhalis

A 
augmentin
cefuroxime
zpak
moxi/levo
doxy
40
Q

patients at risk for legionella pneumonia

A 
smokers
elderly
liver disease
COPD
high dose steroids
41
Q

treatment for legionella

A

azithromycin (all macrolides)
levo/moxi
14-21 days for severe
7-14 days for mild-mod

42
Q

treatment for mycoplasma pneumonia

A

doxy
zpak
clarithromycin
levo/moxi

43
Q

treatment for chlamydia pneumoniae

A

doxy
zpak
clarithromycin
levo/moxi

44
Q

patients at risk for staph aureus pneumonia

A

head trauma
prolonged hospitalizations
post flu

45
Q

treatment for staph aureus

A 
nafciullin
cefazolin
dicloxacillin
clindamycin
vanco if PCN allergy
46
Q

specific monitoring parameters for patient undergoing treatment for pneumonia

A
  • pain
  • sleeping
  • cough productive or not
  • SoB
  • mental status
47
Q

monitoring parameters for infection in pneumonia

A
  • lung exam
  • chest xray
  • cultures
  • electrolyte changes
  • sputum changes
48
Q

monitoring parameters for antibiotic use in pneumonia

A
  • renal function
  • side effects of antibiotics
  • labs of vanco serum levels
49
Q

bacteria implicated in pneumonia of smoking/COPD patients

A

S.pneumo
H.flu
M.cat
legionella

50
Q

bacteria implicated in postviral bronchitis pneumonia patients

A

S.Pneumo

S.aureus

51
Q

bacteria implicated in pneumonia of healthy patients

A

mycoplasma
chlamydia pneumoniae
S.pneumoniae

52
Q

bacteria implicated in pneumonia patients that use alcohol

A

S.pneumonia

anaerobes

PT3 ID 1 (HIV) (5 decks)

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