Pulmonology Part I

  1. Inflammation of the alveoli or interstitium of the pulmonary parenchyma caused by microorganisms that affect the lower respiratory system
  2. this disease is the leading cause of morbidity and mortality worldwide
  3. the type of pneumonia that is acquired at home, and non-hospital envirnonment
    community acquired pneumonia
  4. The MC identified infectious agent of CAP?
    Strept pneumonia
  5. 1-10 day history of increasing cough, purulent sputum, SOB, tachycardia, pleuritic chest pain, fever or hypothermia, sweats and rigors
    Symptoms of CAP
  6. physical exam includes: breath sounds, crackles, dullness to percussion if effusion present, bronchial breath sounds over area of consolidation
  7. what is the MC viral pneumonia caused by
    Influenza virus
  8. low-grade fever, cough, + cold agglutination test, bullous myringitis (ear drum pain)
    mycoplasma pna
  9. treatment of for atypical pneumonia (mycoplasma)
    Azithromycin 500 mg day 1, 250 mg day 2-5.
  10. PJP, or PCP treatment
    TMP- SMX 160/800 mg BID x 7-10 days
  11. slow onset, immunosuppression, increased LDH, more hypoxic than CXR shows, CXR shows interstitial infiltrates
    PJP/ PCP
  12. strept pna produces this color of sputum
    Rust colored
  13. pseudomonas is MC in these people
    Ventilators (HAP), and Cystic Fibrosis ppl
  14. S Aureus produces this type of sputum, it is MC in these ppl
    Salmon colored, nursing home and healthcare staff
  15. A/C, aerolized H2O, GI symptoms, high fever, these are MC in this type of pna
  16. Special test for Legionella pna
    Urine antigen test
  17. college age ppl, with c/o sorethroat and hoarseness, long prodrome period, type of pneumonia
    Chlamydia pna
  18. CXR of CAP pneumonia MC shows (think of the most common type too)
    Unilateral lobar infiltrate
  19. MC type of pna found in people who are risk for alcohol consumption and/or aspiration
  20. treatment for Klebsiella pna
    • Augmentin 875 mg BID x 10 days, or 500 mg TID x 10 days
    • or
    • Clindamycin 500 mg TID x 7-10 days
  21. COPD have this MC type of pneumonia
    Haemophilus pna
  22. people with leukemia, or lymphoma get this pna MC
  23. children less than 1 are most prone to this type of lung infection
  24. children less than 2 are most prone to this infection in lungs
    Parainfluenza virus
  25. If pna is bacterial, what will WBC show? Procalcitionin? Supports bacterial instead of viral
    elevated WBC and increased procalcitonin levels
  26. lung infection, but otherwise healthy free of distress or complications can be treated inpatient or outpatient
  27. CRP will be negative or positive in pna, how about bronchitis
    • CRP + in pna
    • CRP - in bronchitis
  28. you treat uncomplicated outpatient CAP pna with...
    Antibiotics (macrolide or doxycycline) and antipyretics, cough suppressants, tell them to increase their fluids and rest
  29. you treat CAP in a person who has comorbid conditions with
    Fluroquinolone or macrolide (azitho) + betalactam (aug or cephalo)
  30. if a person with pna has neutropenia and involvement of more than one lobe, or poor host resistance (abx resistance), or altered mental status you should consider
    Hospitalization, esp if over the age of 50 with comorbidities
  31. in CAP patient, but they are in hospital, you will consider coverage these pathogens also and treat with
    Strept pna and Legionella, treat with fluroquinolone or ceftriaxone 1 g IV QD x 5 days/ cefotaxime and macrolide (zpac-5 days)
  32. what are the vaccines that can be given for prevention of pneumococcal pna
    Prevnar PCV-13, and pneumovax PPSV23
  33. PCV13 first, then 1 year last PPSV23 is recommended for what age groups
    Ppl >65 or children >2 that are immunocomprimised
  34. atypical pna look like this on xray
    Segmental unilateral  lower lung zone infiltrates or diffuse infiltrates
  35. viral pna is treated with
    supportive measures: analgesics, fluids, cough suppressants...unless influenza is suspected, then tamiflu may be given
  36. what type of patients are at highest risk for developing HAP
    Greater than 48 hrs in hospital and are in the ICU or on ventilators
  37. what is/are the MC HAP infectious agent
    S aureus and gram neg bacilli (Kleb)
  38. ICU patient’s MC pathogen
  39. these diagnostics should be orders if HAP
    • Gram stain and cx of sputum and blood
    • CXR
  40. HAP is treated with
    Low risk for DR—>single agent such as flouroquinolone (levaquin 500 mg QD 7 days-IV and PO same dosage) or single ceftriaxone 1g IV QD x 7 days, if concern for DR or MRSA combo ceftriaxone and macrolide
Card Set
Pulmonology Part I