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Respiratory 2 > Pulmonary Infections- Clinical > Flashcards

Pulmonary Infections- Clinical Flashcards

1
Q

What is the most frequent cause of viral respiratory tract infections in the summer and fall?

A

Coxsackievirus

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2
Q

Zanamivir and oseltamivir are effective against which infections?

A

Influenza A and B

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3
Q

What is teh subtype of avian influenza A?

A

H5N1

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4
Q

What is the reservoir for the hantavirus?

A

Deer mouse

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5
Q

What are the initial Sx to hantavirus infections?

A

abrupt onset of respiratory distress, shock, and hypoxemia

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6
Q

What groups are at risk for hantavirus infections?

A

native american males

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7
Q

What shows on CXR for hantavirus infections?

A

b/l pulmonary infiltrates with pleural effusions

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8
Q

What shows on labs for hantavirus infections?

A

hemoconcentration, throbocytopenia, and prolonged aPTT

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9
Q

Which virus causes SARS?

A

Coronavirus

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10
Q

What are the initial Sx of SARS?

A

fever, headache, malaise, myalgia –> dry cough, dyspnea

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11
Q

Where are there reported cases of SARS?

A

Asia (hong kong, taiwan, china)

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12
Q

What is the #1 cause of acute sinusitis?

A

Pneumococci

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13
Q

What is the #1 cause of crhonic sinusitis?

A

Streptococcus

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14
Q

True or False: Pneumococci, H. influenzae, Streptococcus, and Staphylococcus all contribute to acute AND chronic sinusitis.

A

True

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15
Q

What is the #1 cause of community acuqired pneumonia?

A

strep pneumo

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16
Q

What are the initial Sx of strep pneumo?

A

fever, cough with blood/rusty tinged sputum

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17
Q

What shows on CXR for strep pneumo?

A

normal early, late shows lobar PNA, can se cavitations or effusions

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18
Q

Who are the pts at risk for S. aureus PNA?

A

Severe diabetes, IC pts, dialysis pts, IVDU, pts with influenza or measles

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19
Q

What shows on CXR for S. aureus PNA?

A

abscesses with air-fluid levels, consolidation, bronchoPNA, pneumotcele, pneumothorax, empyema

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20
Q

What are the 3 pts at risk for P. aeruginosa PNA?

A

CF
Bronchiectasis
COPD

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21
Q

What are the 2 drugs for the Tx of P. aeruginosa?

A

Cefepime (b-lactam) + Gentamicin (aminoglycoside)

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22
Q

What are the 2 underlying conditions that most pts with H. influenza PNA have?

A

COPD and alcoholism

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23
Q

What are the 3 diseases caused by moraxella catarrhalis?

A

Sinusitis
Otitis Media
PNA

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24
Q

What Hx do pts usually have to get morazella catarrhalis?

A

COPD, IC, or alcoholism

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25
Q

What are the lab characteristics for moraxella catarrhalis?

A

beta-lactamase +, resistant to PCN and amicillin

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26
Q

What are the Sx to Legionella infections?

A

Abrupt cough + pulm Sx

High fever, diarrhea + ALOC

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27
Q

What can u measure in the pee pee for legionella?

A

Legionella urinary Ag

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28
Q

What is the Tx for legionella?

A

Azithromycin or levofloxicin

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29
Q

What are the 3 bacterial etiologies of anaerobic PNA?

A

Bacteriodes melaninogenicus
Fusobacterium nucleatum
Anaerobic cocci + streptococci

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30
Q

What is the big risk factor for anaerobic PNA?

A

ALOC (aspiration)

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31
Q

What is the big Sx for anaerobic PNA?

A

foul-smelling sputum (anaerobes!)

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32
Q

What are the initial Sx for mycoplasma pneumonia?

A

Cough, fever, pneryngitis, coryza, and tracheobronchitis

hemolytic anemia, erythema multiforma, or guillian barre syndrome

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33
Q

What shows on CXR for myocoplasma PNA?

A

unilateral bronchoPNA with lower lobe involvement

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34
Q

What appears during the 2nd week of infection on labs for M. PNA infections?

A

Cold agglutinins and Complement fixation

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35
Q

What is the Tx for mycoplasma pneumonia?

A

Macrolides or fluoroquinolones

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36
Q

Where do u find chlamydia pneumoniae?

A

schoolchildren, families, military recruits

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37
Q

What are the Sx to clamydia pneumoniae?

A

Pharyngitis, PNA, brinchitis, sinusitis

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38
Q

What shows on CXR for chlamydia pneumoniae?

A

Unilateral segmental patchy opacity

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39
Q

What carries psittacosis?

A

parrots and other birds

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40
Q

What is the causitive agent for Q fever?

A

Coxiella burnetii

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41
Q

How do u get coxiella burnetii?

A

Cows

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42
Q

How do u get Franciesella tularensis?

A

wild animals and bites by ticks or deer flies

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43
Q

What do u see on physical exam for F. tularensis infecions?

A

Cutaneous ulcers and lymphadenopathy

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44
Q

What shows up on CXR for F. tularensis infections?

A

Unilateral lower lobe patchy infiltrates and pleural effusion

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45
Q

What shows up on gram staining for F. tularensis?

A

Nothing.

46
Q

What is diagnostic for F. tularensis on serologic tesitng?

A

Agglutinins if it shows a 4-fold increase in titer

47
Q

What is the bug to cause plague?

A

Yersinia pestis

48
Q

What carries Yersinia pestis?

A

spread by rodents via fleas or direct contact

49
Q

What are the Sx to Yersinia pestis infections?

A

fever, headache, bubo (groin or axilla), cough, and tachypnea

PNA in 10-20% of pts

50
Q

True or False: pneumonic plague is milder than the regular plague with better outcomes.

A

FALSE. it’s the most serious fand fulminant form of this disease.

51
Q

What shows on CXR for pneumonic plague?

A

b/l lower lobe alveolar infiltrates and pleural effusion

possibly nodules and cavities

52
Q

What is the leukocyte levels in pneumonic plague?

A

higher than 15 x 10^9

53
Q

An IC pt or pt with pulmonary alveolar proteinosis, necrotizing PNA, and lung abscesses is a sign of what infection?

A

Nocardia

54
Q

A pt with severe dental caries, tissue necrosis, aspiration, fever, cough, pulmonary lesions, pleural effusion, and fistula and sinus tracts prolly has what infection?

A

Actinomycosis

55
Q

Actinomycosis is common in pts with what problem?

A

Poor oral hygeine

56
Q

What make up 60, 20, and 10% of hospital-acquired PNA?

A

Aerobic gram neg (60%)
S. aureus (20%)
Strep pneumo (10%)

others- other 10%

57
Q

This is a cavity in the lung with an air-fluid level with a collection of pus.

A

Lung abscess

58
Q

What is the 30-50, 25, and 5-12% of causes for lung abscesses?

A

anaerobic bacilli (30-50%)
aerobic gram + cocci (25%)
aerobic gram neg bacilli (5-12%)

59
Q

What shows up on CXR for a lung abscess?

A

air-fluid level

60
Q

What is the primary cause of lung abscess?

A

oral infection

61
Q

This is the term for a person who does not have active TB but has a + PPD test.

A

Latent TB infection (LTBI)

62
Q

This is the diffuse presence of small (<2mm) nodules throughout the body.

A

Miliary TB

63
Q

What are the 3 most common organs for miliary TB?

A

Spleen, liver, lung

64
Q

This is the most common form of extrapulmonary TB and is common in kids.

A

TB lymphadenitis (scrofula)

65
Q

What are the most common lymph nodes affected by TB lymphadenitis?

A

cervical lymph nodes

66
Q

What is the most common location for skeletal TB?

A

Lumbar vertebrae (potts disease)

67
Q

Where is the msot common location for TB meningitis?

A

base of the brain

68
Q

What shows up on urine tests for genitourinary TB?

A

sterile pyuria

69
Q

This is when a healthcare provider monitors a pt as every dose of a 6mo regiment is taken.

A

Directly Observed Therapy (DOT)

70
Q

Which pt populations require DOT?

A

homeless, chronic alcoholics, IVDU, AIDS pts, and prisoners

71
Q

What shows up on CXR for TB?

A

Fibronodular or cavitary disease in the APEX

72
Q

This is the continuous uninterrupted mycobacterial proliferation, common in infants, kids, and immunosuppressed adults.

A

Primary TB

73
Q

This is the form of TB where the bacteria go dormant and alter activate, producing active TB, causing the disease and Sx.

A

Latent TB

74
Q

What is the nonTB mycobacteria that causes a chronic indurated nodule on the finger and hand?

A

Mycobacterium marinum

75
Q

How do u get M. marinum?

A

swimming pools or cleaning and aquarium

76
Q

What is the nonTB mycobacteria that is a cause of infection in AIDS pts?

A

Mycobacterium avium-intracelulare

77
Q

What is the Tx for MAI? (2)

A

Clarithromycin and Azithromycin

78
Q

What is the most important toxicity for anti-TB drugs (RIPE)?

A

Hepatitis

79
Q

What are the side effects to isonazid?

A

peripheral neuropathy, skin rash, purpura, drug-induced systemic lupus erythematosus, seizures, optic neuritis, and arthritis

80
Q

What are the side effects to rifampin?

A

GI tract upset, thrombocytopenia, flulike syndrome, hemolytic anemia, and cholestatic jaundice (your skin might turn orange)

81
Q

What are the side effects to pyrazinamide?

A

liver damage, minor are hyperuricemia w/o gout, arthralgia, skin rash, nausea

82
Q

What are the side effects to ethambutol?

A

main is retrobulbar neuritis, vision problems like blurry and color blindness and central scotoma

83
Q

True or False: histoplasmosis generally resolves within a month without treatment.

A

True

84
Q

IF there is severe histoplasmosis, what is the DOC?

A

Amphotericin B

85
Q

Where is the endemic zone for Coccidioides Immitis?

A

extends from northern California to Argentina

86
Q

What are teh common clinical presentations of coccidiodomycosis?

A

valley fever, acute PNA, disseminated disease, chronic cavitary disease

87
Q

What happens if a woman gets coccidiodomycosis in late pregnancy?

A

Theres a higher risk of maternal and fetal mortality

88
Q

What is the DOC for severe coccidiodomycosis or in pregnant women?

A

Amphotericin B

89
Q

Where is the geographic location of blastomycosis?

A

southern, south-central, and Great Lakes states

90
Q

What are the 4 organs affected by disseminated blastomycosis?

A

skin, bone, prostate, or central nervous system

91
Q

What is the most characteristic CXR finding for blastomycosis?

A

perihilar mass that mimics carcinoma

92
Q

What is the DOC for blastomycosis?

A

Amphotericin B

93
Q

What are the occupations at risk for sporotrichosis?

A

farmers, florists, gardeners, horticulturists, and forestry workers

94
Q

What are the clinical signs and symptoms of sporotrichosis?

A

Cutaneous nodules along lymphatic vessels

inhalation- induced pulmonary disease mimics cavitary tuberculosis

95
Q

What are the two methods of transmission of sporotrichosis?

A

cutaneous inoculation and inhalation

96
Q

What is the DOC for sporotrichosis?

A

cutaneous- itraconazole

disemminated- amphotericin B

97
Q

Invasive aspergillosis in immunosuppressed hosts is the most serious form of infection and occurs mainly in what pts?

A

granulocytopenic patients with a hematologic malignancy

98
Q

This is a mass of fungal hyphae in preexisting lung cavities, almost always in the upper lobes.

A

Aspergilloma (fungus ball)

99
Q

What are the Sx to a aspergilloma?

A

hemoptysis, cough, low fever, and weight loss

100
Q

How do u treat an aspergilloma?

A

intracavitary instillation of amphotericin

101
Q

Though the lung is the portal of entry, what is the most common clinical presentation for cryptococcal infections?

A

subacute or chronic meningitis

102
Q

Where do u culture cryptococcus for the Dx?

A

CSF

103
Q

What are the 2 DOC’s for crytptococcus?

A

Amphotericin B or fluconazole

104
Q

Crytopcoccal infections are common in which pts?

A

AIDS pts

105
Q

You try to control the cryptococcal infection intially with amphotericin B and then give what drug indefinitely?

A

Fluconazole

106
Q

Which pts get Pneumocystis jiroveci?

A

immunosupressed pts, like AIDS, malignancy, or post-transplant pts.

107
Q

What shows up on CXR for Pneumocystis jiroveci infections?

A

alveolar and interstitial inflammation and edema with plasma cell infiltrates

108
Q

Who gets a gradual onset of Sx for Pneumocystis jiroveci infections, AIDS pts or non-AIDS pts?

A

AIDS pts

109
Q

What is the typical CT finding for Pneumocystis jiroveci infections?

A

Ground-glass attenuation

110
Q

What is the DOC for Pneumocystis jiroveci infections?

A

Cotrimoxazole

Respiratory 2 (7 decks)

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