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Advance Adult I > TB/CAP/Influenza > Flashcards

TB/CAP/Influenza Flashcards

1
Q

What is the most common pattern of TB

TB is reportable by law.

A

Post Primary Disease

Pt is asymptomatic with + TST test

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2
Q

Latent TB

+ Tests

CXR result
can they spread bacteria?
do they get treated?

A

Asymptomatic
+ TST/IGRA result
CXR nl

does not spread bacteria but needs to be treated

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3
Q

Pulmonary TB

A

Symptomatic
fever, cough, c.p., weight loss, nigh sweats, hemoptysis, dc appetite, irregular menses

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4
Q

What is the diagnostic of TB

Does this test for active TB?

A

TST or Quantiferon (IGRA) Postive Negative Indeterminate

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5
Q

For those who have been treated for TB or had + TST, should you keep doing TST?

A

NO

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6
Q

How much induration for +TST with no known risk factors

A

> 15 mm

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7
Q

What is anergy

A

DC or absent response to TST that is caused by severe illnesss or pulmonary disease

Not useful for the immunocomp

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8
Q

What should you do for false negative testing

A

Repeat TST in 1 -3 weeks. + mean boosted reaction

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9
Q

What does a CXR indicate in TB

AFB Culture in TB

A

Suggestive of TB

3 sputum cx needed + specimen

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10
Q

Class 2 TB
+ TST/Quant
- CXR

A

INH x 9 months
INHRPT x 12 weeks

so LTBI don’t become Active

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11
Q

Class 3 TB
M. Tuberculosis cultured

A

Multi drug therapy
See TB Specialist

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12
Q

Class 5
TB suspected Diagnosis pending
Clinically active (with symptoms)

A

start MD Therapy

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13
Q

First Line Drugs TB RRRIPE

A

Rifampin
Rifabutin
Rifapentine
INH**
Pyrazinamide
Ethambutol

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14
Q

Isoniazid: #1
300 mg x 9 months
which lab work q month
a.e.

DORTT

A

INH induced hepatitis. No ETOH
Monthly LFT and physical exam
Take with Pyridoxine

DORTT (meds that inc INH Hepatitis
Dilantin, Ortho-Est, Reglan, Tylenol, Tapazole

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15
Q

INH-RPT 12 week course LTBI
what color secretions turn

What should you not take Rifapentine with

A

Monthly physical exam
Secretions turn red, in liver enzyme, neutropenia, stain contact lenses.

Don’t take with Coumadin and methadone

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16
Q

When should you use Rifampin

A

INH intolerant pts. Turns secretions orange urine sweat tears, don’t give to HIV pts.

17
Q

Clinically active RB pts are considered no longer a threat after how many weeks

A

2 weeks.

18
Q

Hospital Acquired PNA
Ventilator Associated PNA

A

48 hours after admission
48 hours after intubation

19
Q

How long should you have been in the community to be DIAGNOSED with CAP

Most common bacterium

DIEHR Rule

A

14 days
S. Pneumoniae (mucopurulent sputum)

Predict PNA probability in primary care

20
Q

Outpatient setting DX

A

CXR and CBC with Diff

21
Q

What is gold standard for dx PNA

A

CXR AP/Lateral :Shows infiltrate

22
Q

Medication for CAP
Healthy <65 y.o , no abx in 3 month
(AD/ACE)

A

Amoxicillin
Doxycycline
Azithro/Clarithro/Erythro

23
Q

Medications for CAP
>65 y/o, comorbidities, used abx in 3 mo
B Lactam/Fluoroquinolone
x 5 days

A

Amoxicillin/Amoxicillin-clauvunate (Augmentin)

Alt: Cefpodoxime (Vantin) , Cefuroxime (Ceftin) PLUS Macrolide Doxycycline, Azithro,Clarithro,Erythro

OR

Fluoroquinolone Moxiflox,Gemiflox, Levoflox

24
Q

Primary Care Tool for admission of PNA

Greater than 1 point - HOSPITAL

A

CRB-65 Score
Confusion
RR
BP 90/60
Age > 65

25
Q

What is the vaccine for PNA >65 y.o.

What should you give first PCV13 or PPSV23?

A

PPSV23. give 5 years apart

Give PCV13 should be given first before PPSV23 then one year later give PPSV23

but depends on patient and provider convo.

26
Q

Influenza A
Influenza B

Gold standart test for flu

A

Influenza A: birds and pigs
Influenza B: Humans
Droplet ‘

Viral culture or RT-PCR

27
Q

Antivirals for Influenza A and B

How Many hours should you start after fever

A

Tamiflu- oral
Relenza ZanavimirL Puff
RapIVab - IV use

Start 48 hrs

28
Q

Allergy to egg , what immunization

Intranasal option

A

Recombinant

FluMist

Advance Adult I (3 decks)

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