Pulmonary Flashcards

1
Q

Patient presents with low-grade fever, cough, bullous myringitis (vesicles on the TM), cold symtoms, crackles on pulm exam and cxr shows focal infiltrate. What is the organism?

A

Mycoplasma pneumonia

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2
Q

patient with pneumonia and interstitial infiltrates is more hypoxic on pulse ox than appears on chest radiography and has an increased LDH. What is the organism?

A

PJP

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3
Q

Patient with CHF or COPD presents with pneumonia, hyponatremic with an episode of diarrhea, what is the organism?

A

Legionella

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4
Q

Patient with pneumonia presents with rigors and rust colored sputum. What is the organism?

A

Strep pneumo

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5
Q

Alcoholic or chronic illness pt with pneumonia presents with currant jelly sputum, what is the organism?

A

Klebsiella pneumo

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6
Q

What organism is associated with alcohol abuse and pneumonia?

A

Klebsiella pneumo

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7
Q

What organism is associated with COPD and pneumonia?

A

Haemophilus pneumo

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8
Q

What organism is associated with cystic fibrosis and pneumonia?

A

Pseudomonas

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9
Q

What organism is associated with young adult in college and pneumonia?

A

Mycoplasma or chlamydia pneumo

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10
Q

What organism is associated with air conditioning/aerosolized water and pneumonia?

A

Legionella

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11
Q

What organism is associated with post splenectomy patients and pneumonia?

A

encapsulated organisms, strep and haemophilus pneumo

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12
Q

What organism is associated with leukemia/lymphoma and pneumonia?

A

Fungus

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13
Q

What organism is associated with children <1 year and pneumonia?

A

RSV

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14
Q

What organism is associated with children <2 and pneumonia?

A

Parainfluenza virus

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15
Q

What is the most common bacterial pathogen in all groups for pneumona

A

strep pneumo

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16
Q

What type of pathogen is suspected with elevated procalcintonin levels in a patient with pneumonia?

A

Bacterial

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17
Q

What is the initial management for outpatient pneumonia?

A

simple uncomplicated patient: macrolide or doxy, patient with chronic disease fq or macrolide + beta lactam

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18
Q

What are the indications for hospitalization of a patient with community acquired pneumonia?

A

neutropenia, multilobar or poor host resistance, patients > 50 yo with comorbidities, altered mental status or hemodynamic instability

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19
Q

What patients are recommended to receive the pneumococcal vaccine?

A

Children 2-5 yo, > 65 or people with chronic illness which predisposes an increased risk of pneumonia (COPD, sickle cell, Tobacco, splenectomy, liver disease)

20
Q

Young patient presents with low-grade fever for a week, non-productive cough, myalgias and fatigue. WBCs are normal. CXR shows segmental RLL infiltrate. What is the likely organism?

A

Mycoplasma

21
Q

What is the initial treatment for atypical pneumonia?

A

emycin or doxy

22
Q

A patient has confirmed influenza A induced pneumonia. What is the treatment?

A

Combination treatment with oseltamivir and rimantadine

23
Q

At what point in a hospital admission is a pneumonia considered hospital acquired?

A

48 hours after admission

24
Q

What is the typical isolation period for a person with active TB?

A

2 weeks after combination therapy has begun

25
Q

How many medications are used and what is the duration of therapy for active TB?

A

4 medications for 2 months then 4-7 additional months of organism specific therapy

26
Q

Which TB medication has side effects of hepatitis, peripheral neuropathy and requires B6 administration?

A

Isoniazid

27
Q

Which TB medication has side effects of hepatitis, flu syndrome, and orang body fluid?

A

Rifampin

28
Q

Which TB medication has the side effect of optic neuritis (may cause red-green vision loss)?

A

Ethambutol

29
Q

What is the typical cause of acute bronchitis?

A

viruses

30
Q

How do you differentiate between acute bronchitis and pneumonia?

A

CXR

31
Q

what is the first line treatment for acute bronchitis in a COPD patient or patient with > 7 days of symptoms?

A

2nd gen cephalosporin then macrolide or bactrim

32
Q

What is the treatment for a child with confirmed RSV bronchiolitis?

A

Admission and treatment with ribavirin, nebulized albuterol, IV fluids, antipyretics, humidified oxygen

33
Q

What is the initial antibiotic management for epiglottitis?

A

3rd gen cef for 7-10 days

34
Q

Child presents with harsh barking, seal-like cough and inspiratory stridor , low-grade fever. What is the diagnosis? Treatment?

A

Croup - usually viral, usually treatment is supportive but may require steroids, humidified oxygen and epinephrine nebs in severe cases

35
Q

A patient diagnosed with lung CA via sputum cytology likely has which type of CA?

A

SCC

36
Q

What is the most common type of lung CA?

A

AdenoCA

37
Q

A patient with a primary lung CA and paraneoplastic syndrome likely has which type of CA?

A

Small (oat) cell

38
Q

Which lung cancer is chemo/rad before surgery?

A

Small (oat) cell

39
Q

What is the standard monitoring procedure for solitary pulmonary nodule?

A

CT q3 months for 1 year then q6 months for 2 years

40
Q

What are the treatment options for pulmonary carcinoid tumors?

A

Octreotide may help with symptoms but excision is definitive

41
Q

What are the results of a spirometry study for an asthmatic?

A

FEV1/FVC < 75% with greater than 10% increase in FEV1 after bronchodilator administration

42
Q

What are the indicators for starting oxygen on a COPD patient?

A

Resting hypoxemia PaO2 < 55, or SaO2 < 88%

43
Q

What types of malignancies are more common in cystic fibrosis patients?

A

GI tract CAs

44
Q

What is the definitive diagnostic test for cystic fibrosis?

A

Sweat chloride test/DNA testing

45
Q

What is the duration of anticoagulation for PE?

A

3 months at minimum

46
Q

Patient with chronic dyspnea, bilateral hilar adenopathy, splenomegaly and erythema nodosum has noncaseating granulomatous inflammation on lung biopsy. Diagnosis?

A

Sarcoidosis