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URT

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