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URT
| Question | Answer |
|---|---|
| bacterial pharyngitis | group a beta strep, most common |
| bacterial pharyngitis symptoms | fever, pain, swollen glands, exudate on tonsils/pharynx. diff swallowing, no cough |
| bacterial pharyngitis collection | swab tonsillar area/posterior pharynx. avoid tongue + other surfaces. get exudate, |
| bacterial pharyngitis diagnosis | culture: blood, sxt. non-culture: rapid enzyme immunoassays, if pos = group A(highly specific) fairly sensitve(follow neg with cultrue) |
| Trench mouth | Vincent's angina. inflamed bleeding gums |
| Trench mouth gram stain | spirochete + fusiforms |
| pharyngitis viral | rhinovirus, adenovirus, RSV, influenza |
| barriers to infection | nasal hair, ciliated mucosal cells, coughing, normal flora, phagocytes |
| uncommon pharyngitis cause | Corynebacterium diptheriae-when no DPT vaccine |
| sinusitis bacteria | S. pneumoniae, H. influenzae, S. pyo. Moraxella catarrhalis(children), S. aureus |
| sinusitis virus | rhinovirus, parainfluenza, influenza |
| sinusitis diagnosis | CT, MRI, culture aspirate of direct sinus puncture(rare), culture secretions(unreliable) treated empirically(symptoms) |
| otitis media pathogens | Strep pneumoniae, Haemophilus influenza |
| otitis media complications | damage to tympanic membrane, hearing loss, meningitis(spread to CNS-close proximity) |
| otitis media diagnosis | empirical antibiotic treatment |
| otitis media culture | not usually done, blood, chocolate(H.influenza) |
| Epiglottitis pathogen | Haemophilus influenzae type b |
| epiglottitis | rapid, edema causing airway obstruction |
| epiglottis diagnosis | gram stain-"intracellular very small pleomorphic coccobacillus white cells" |
| epiglottis diagnosis | chocolate agar, capnophile 5-10% CO2 |
| pertussis | Bordetella pertussis + parapertussis, "whooping cough" |
| bacterial bronchitis | secondary infection following viral. |
| bacterial bronchitis most common pathogens | Strep pneumoniae, H. influenzae |
| bacterial bronchitis uncommon causes | mycoplasma, chlamydophila, bordetella |
| bronchitis diagnosis | viral cultrues not in uncomplicated cases, 2ndary bact. pneumonia-culture sputum |
| CA pneumonia | 1. RSV(children) 2. Parainfluenza 3. Bacterial |
| CA pneumonia bacteria adults | S. pneumoniae(adults),mycoplasma pneumoniae(young adults) H.influenzae type b, |
| CA pneumonia bacteria neonates | group B strep, Chlamydia trachomatis |
| CA pneumonia bacteria | S aureus, Legionella pneumophila |
| bacterial pneumonia symptoms | rapid onset, chills, fever, productive cough (purulent, blood tinged) high WBC |
| viral pneumonia symptoms | slower onset, less sputum |
| HA pneumonia | Pseudomonas aeruginosa, MRSA |
| HA pneumonia risks | unconscious patients, intuvation of airway, immunosuppressed |
| pneumonia diagnosis | gram stain (WBC + squamous) culture sputum - blood, chocolate, EMB/MacConkey |
| good gram stain | more than 25 polys, less than 10 epis |
| poor gram stain | more than 25 epis, don't culture |
| aspiration pneumonia - at risk | elderly, immumosuppressed, periodontal disease, altered lung defense(smoke, lung disease) |
| Empyema | thick fluid in plerual space, bacterial |
| Chronic pneumonia | TB, NTM, fungal |
| Pneumocystis jiroveci | carinii, LRT infection in immumosuppressed |
| sputum specimen | most common, least relevant, normla flora |
| Thoracentesis | aspirates pleural fluid, excellent=pneumonia |
| bronchial washing | sterile saline instilled into bronchial tree |
| BAL Bronchoalveolar lavage | deeper, diagnosis - pneumocystis, fungi, TB/ snip tissue |
| better specimens | thoracentesis, bronchial washing, BAL - surgery needs to be done, not routine |
Created by:
sara.
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