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DU PA LRI
Duke PA Lower Respiratory Tract Infections
| Question | Answer |
|---|---|
| lower respiratory tract starts below what anatomic structure | vocal chords |
| diagnosed by new infiltrate on exam or x-ray | pneumonia |
| #1 cause of death from infectious diseas in the US is from | pneumonia |
| hospital aquired pneumonia is defined as symptom onset >___ hours after hospital admission | 48 |
| most common bacterium associated with pneumonia world wide | Streptococcus pneumoniae |
| pneumococcus colonizes ____% of healthy adults | 5-10 |
| May have associated non-respiratory syndromes (CNS, immune hemolytic anemia) | Mycoplasma pneumoniae |
| the original atypical pneumonia organism, although it is present in up to 1/3 of cases | Mycoplasma pneumoniae |
| ‘Discovered’ in 1976 during an outbreak of pneumonia. Found in aquatic environments | Legionella pneumophilia |
| 50% of 20 year olds have serologic evidence of past infection. Organism is associated with chronic inflammatory diseases (atherosclerosis) | Chlamydia pneumonia |
| may cause necrotizing infiltrates or pneumatoceles | Staphylococcal pneumonia |
| may cause necrotizing infiltrates or pneumatoceles | gram negative |
| Inhalation of oropharyngeal or gastric contents (volume-dependent) | aspiration pneumonia |
| may cause necrotizing infiltrates or pneumatoceles | aspiration pneumonia |
| what is a factor that increases risk of infection with a drug resistant-pneumococci | recent beta lactam therapy (withing the past 3 months) |
| what is a factor that increases risk of infection with a drug resistant-pneumococci | >65 years of age |
| factor that increases the risk for gram negative infection | residence in a nursing home |
| factor that increases the risk for enteric gram negative infection | underlying cardiopulmonary disease |
| factor that increases the risk for infection with pseudomonas aeruginosa | Corticosteroid therapy (> 10 mg/d of prednisone) |
| factor that increases the risk for infection with pseudomonas aeruginosa | Structural lung disease (bronchiectasis) |
| factor that increases the risk for infection with pseudomonas aeruginosa | Broad-spectrum antibiotics (> 7 d in past month) |
| Advanced generation macrolide | azithromycin or clarithromycin |
| Respiratory quinolone | Moxifloxacin, gatifloxacin, levofloxacin, or gemifloxacin |
| Outpatient therapy for pneumonia in otherwise healthy patients | Advanced generation macrolide |
| Outpatient therapy for pneumonia in otherwise healthy patients | azithromycin or clarithromycin |
| Outpatient therapy for pneumonia in otherwise healthy patients if patient is allergic to macrolides | doxycycline |
| Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors | Anti-pneumococcal fluoroquinolone |
| Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors | macrolide PLUS b-Lactam (oral cefpodoxime, cefuroxime, high-dose amoxicillin, amox/clavulanate; or parenteral ceftriaxone followed by oral cefpodoxime |
| rates of influenza has _____ compared to previous decade, possibly due to aging population and/or change in predominating viral strains (H3N2) | doubled |
| influenza has an incubation period of ___ days | 1-4 |
| Fever, myalgia, headache, malaise, nonproductive cough, sore throat, rhinitis are all symptoms of | influenza |
| Resolution in ___ days, though cough and malaise can persist for over 2 weeks | 3-7 |
| Children with influenza may present with | otitis media, nausea, vomiting |
| Viral cultures are optimal from ______ specimens and require specific viral culture media | nasopharyngeal |
| Only _______ effective against both Influenza A and B | ostelmavir and zanamivir |
| Who needs annual influenza vaccinations | Long term aspirin therapy |
| Who needs annual influenza vaccinations | pregnancy |
| Who needs annual influenza vaccinations | Chronic medical conditions (pulmonary, cardiac, metabolic, renal, neurologic, immunodeficiency, hemoglobinopathy) |
| Who needs annual influenza vaccinations | nursing home residents |
| Who needs annual influenza vaccinations | Age 6 months-18 years or >50 yr |
| Radiographic findings include infiltrates in mid or lower lung fields, hilar adenopathy, cavitation | tuberculosis |
| Cough, weight loss, fever, night sweats, hemoptysis, fatigue, decreased appetite, chest pain can be the clinical presentation of _____ | reactivated tuberculosis |
| CXR with upper lobe infiltrates, particularly the apical and posterior segments, cavitation common | reactivated tuberculosis |
Created by:
bwyche
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