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pt w/ chest infxon

Patient with chest infection

QuestionAnswer
What lymph nodes are involved in latent TB Perihilar LN. Remains dormant there unless pt becomes IC'd
What bone/vertebral disease is implicatd with post-primary TB Potts disease.
What is the criteria for initiation of TB therapy regimen. Positive PPD + CXR suggestive of TB. Sputum culture is also taken but it takes 5 wka to grow, so tx is initiated while culture results are pending.
How long does a TB pt need to be quarantined for? Roughly 2 months, if they are compliant (ensure compliace with direct observed therapy (DOT)
What is the tx of a pt who only has a postiive PPD with no symptoms. Isoniazid therapy only (4 drug regimen is not indicated for post-exposure prophylaxis)
In a pt who received BCG vaccination the PPD will be positive, even if they haven't been exposure to TB, what is the protocol for tx in this situation? Tx is the same as for all assymptomatic positive PPD pts. Treat prophylactically with isioniazid
When do most pt with CF present with symptoms? In childhood, but 10% of pts do not show symptoms till they are adults.
What is the abnormality in CF Mutation in a channel for Cl- ion. Gene is in long arm of chr 7 in the cystic fibrosis transmembrane conductance regulator. (allow Cl- to move from IC to EC. Cl- goes in and Na+ goes out, trapping cl-inside
what bacteria is most often involved in CF chest infxon Staph and pseudomonas
tx of CF? prophylactic abx, physiotherapy, bronchodilators, and lung xpant.
Major cause of death in CF Cor pulmonale and bronchiectasis
What is bronchiectasis? Dialation of the bronchi (as opposed to emphysema which is dlation of the alveoli)
Possible causes of bronchiectasis? may be congenital in asso with kartagener's syndrome or secondary to chronic severe bacterial infection (most common: TB, CF, etc)
What is the presentation of of bronchiectasis? Chronic cough productive of large amount of purulent sputum that is **worse in the mornings**, hemoptysis, fever
What radiograph is most evident of bronchiectasis CT scan (CXR doesn't give good visualization of this)
Tx of bronchiectasis? aerosolized Abx, postural drainage, surgery. Severity based on amt of sputum produced per day (severe = >150 ml/day)
Major complications of bronchiectasis? Cor pulmonale, respiratory failure, and massive hemoptysis
What bacteria is most commonly seen in pneumonia Streptococcus(2nd most common is haemiphilus influenza
What region of lung would most likely produce altered percussion sounds in a patient with pneumonia? What is the landmark for this to us during PE? The middle right lobe. This region is located on the ANTERIOR chest, below the nipple line
What is the criteria for admission of a pt with pneumonia? Pt with extremes in age (very young or very old), confusion/impaired consciousness w/ dz onset, hypotension, hypoxia, comorbid conditions
What is the criteria for reporting a case of TB to the health department? Must have positive sputum culture.
What kind diseases give bronchiectasis as a complication. SEVERE chronic infections. TB, CF, etc. Kartenegers
Created by: rkirchoff
 

 



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