Term
What is the most common cause of Community Acquired pneumonia
what has 'currant jelly' sputum
what has 'foul smelling, rotten eggs'
what has gastrointestinal/ CNS sympoms
what has a ,200 CD4 cells? |
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Definition
Strep pneumo
Klubsiella
Anaerobes
Legionella
Pneumocystis |
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Term
What is the BIT for all respiratory infections?
the next best step
what is the Diagnostic test for M pneumonia |
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Definition
CXR
Sputum Gram stain (controversial)
PCR, cold agglutins, serology, special media culture |
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Term
What is diagnostic test for:
Chlamydophilia pneumoniae
Legionella
Chlamydia psittaci
Coxiella burnetii
Pneumocystis jiroveci |
|
Definition
CP: Titers
L: Urine antigen, culture on charcoal yeast
CP: titers
CB:titers
PCP: Bronchwalveolar lavage |
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Term
| what is the emperical treatment for pneumonia in a outpatient setting? |
|
Definition
If healthy pt with no antibiotics within past 3 months:
1. Macrolides: Azithromycin or clarithromycin or
Doxycycline
If pt has Comorbidities or antibiotics within 3 mo:
Respiratory Fluoroquinolones (levofloxacin or moxifloxacin) |
|
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Term
| what is the empirical inpatient treatment for pneumonia? |
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Definition
Respiratory fluoroquinolones: levofloxancin or moxifloxacin
or
Ceftriacone and azithromycin |
|
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Term
| when should a pneumonia pt be admitted to the Hostpital? |
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Definition
CURB65
>2
Confustion, Uremia, Resp distress, BP low, age >65 |
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Term
| what is the treatment for Ventilator Ass Pneumonia? x3 |
|
Definition
combine 3 different drugs:
1.Antispeudomonal beta lactam
-Ceph, pen, Carbapenem
2. Second antipseudomaonal agent
-aminoglycosid, Fluoroquinilone,
3. Methicillin resistant antiphylococcal agent
-Vanco, linozolid |
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Term
what is the sole cause of lung abscesses?
What is the most common ass on the boards
What is the BIT?
then what?
MAT is lung biopsy |
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Definition
large volume aspiration
Sputum that is foul smelling due to anarobes
BIT: CXR showing cavity
Chest CT
then
MAT is lung biopsy |
|
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Term
Pneumocystis pneumonia
What is the BIT&R x2
What is the MAT&R |
|
Definition
BIT:CXR showing bilateral infiltrates
OR
Atreial blood gas showing increases a-A gradient
MAT is Bronchoaveolar lavage showing positive sputum stain
if that is negative say bronchoscopy is the best diagnostic test |
|
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Term
what is the treatment for Pneumocystis Pneumonia
what is the toxicity
what is the alternative |
|
Definition
TMP/SMX
and Steroids
TMP/SMX causes rash and bone marrow supression
if toxicity
Clindamycin and primaquine or pentamide |
|
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Term
At what CD4 count is Pneumocystis Pneumonia a problem and should have prophylaxis?
What is the Prophylaxis? |
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Definition
TMP/SMX
if there is a rash or neutropenia use
Atovoquone or dapson |
|
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Term
What is the BIT for TB with symptoms?
MAT?
What has to happen to exclude TB |
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Definition
BIT: CXR
MAT: Pleural biopsy
Sputum stain have to be negative three times to exclude TB. |
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Term
What is the Treatment for an active case of TB?
what are the Adverse effects of each one. |
|
Definition
RIPE
Rifampin- Red pee
Isoniazid- B6 def and perph neurop
Pyrazinamide-Hyperuricemia
ethambutol-Optic neuritis/color vision
all have hepatotoxicity
Glucocorticoids lower chance to have constrictive pericarditis |
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Term
| What are the people who if having an induration of 5 millimeter considered positive x5 |
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Definition
HIV,
Glucocorticoid users,
Close contact with active TB,
Abnormal CXR calcifications
Organ transplant recipiancts |
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Term
| What are the people who if having an induration of 10 millimeter considered positive x7 |
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Definition
Recent immigrants (past 5 yrs)
Prisoners
Healthcare workers
Close contact with TB
Hematologicic malignancy
Alcoholics,
Diabetics |
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Term
when is a person with no risk factors considered positive?
when should a stage 2 testing be done
what should the treatment for postive ppd negative CXR be? |
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Definition
greater than 15 mm
when it is a pts first ppd.
9 month of Isoniazid |
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