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Pulm 2 (Low Resp.)
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Question | Answer |
---|---|
What is the reversal agent for heparin? | protamine sulfate |
Which class of antihypertensive is contraindicated in the following patient: COPD | nonselective b-blockers |
Which class of antihypertensive is contraindicated in the following patient: bilateral renal artery stenosis | ACE-I/ARBs |
Which class of antihypertensive is contraindicated in the following patient: pregnancy | ACE-I/ARBs |
Which class of antihypertensive is contraindicated in the following patient: advanced renal failure with hyperkalemia | ACE-I or ARBs, and K+ sparing drugs |
Which class of antihypertensive is contraindicated in the following patient: gout | diuretics(thiazides and loops can raise uric acid level) |
What is the mcc of HTN in young women? | OCPs |
What are the mcc of pneumonia in newborns? | GBS>Gram neg coliforms(ecoli), listeria, chlamydia trachomatis |
What are the mcc of pneumonia in 1-4 month old? | RSV, chlamydia trachomatis, parainfluenza, bordetella, step.pneumo, staph aureus |
What are the mcc of pneumonia in 4mo-4yrs old? | RSV or other virus, strep. pneumo, H.Flu, mycoplasma, staph.aureus |
What are the mcc of pneumonia in 5-15 yrs old? | strep pneumo.>mycoplasma, C.pneumoniae, other viruses(rhinovirus, influenza, parainfluenza, adenovirus, coronavirus) |
What is the empiric tx for pneumonia in a 2 month old? | macrolide |
What is the empiric tx for pneumonia in a 2 year old? | amoxicillin or ampicillin |
What organism is associated with the following: atypical pneumonia in young adults | mycoplasma pneumonia |
What organism is associated with the following: atypical pneumonia in the elderly and very young | chlamydia pneumonia |
What organism is associated with the following: most common pneumonia in children (infant to 5yr) | RSV |
What organism is associated with the following: mcc of pneumonia in neonates | GBS |
A hospital has multiple admissions of elderly pts presenting with atypical pneumonia. All were present at the grand re-opening of an old bingo establishment that has an indoor waterfall. What is the likely causative organism? | Legionella pneumonia |
Cystic fibrosis pts are at risk for aquiring pneumonia from which organism? | pseudomonas aeruginosa |
What xray and lab finding would lead you to highly suspect PCP as a cause of respiratory distress? | CXR with diffuse, b/l, intertitial infiltrates(most common finding). CD4<200, LDH level usually >220 |
What is the tx for PCP? | 21 days of abx: Bactrim, pentamidine(IV), or Primaquine(PO) + clindamycin (IV or PO) |
What is the ddx (Short list) for ground-glass opacities of the lung on CXR? | interstitial pneumonia, PCP, pulmonary edema, pulmonary hemorrhage, hyersensitivity pneumonitits. |
How is the dx of active TB made? | sputum acid-fast stain (in 3 different samples over 3 days in the early am), sputum culture for TB, bronchoscopy with bronchoalveolar lavage or biopsy |
5mm induration on a PPD test is considered postitive in which situations? | HIV+, close contact with TB infected person, CXR signs of TB |
10mm induration on a PPD test is considered postitive in which situations? | homeless, immigrants from endemic regions, IV drug user, chronically ill, health care worker, recently incarcerated |
15mm induration on a PPD test is considered postitive in which situations? | Always considered positive |
Which infectious agent(s) fit the following description: common cause of pneumonia in immunocompromised pts | PCP |
Which infectious agents fit the following description: mcc of atypical pneumonia | mycoplasma pneumonia, legionella and chlamydia pneumonia |
Which infectious agent(s) fit the following description: pneumonia associated with "current jelly" sputum | klebsiella pneumonia |
Which infectious agent(s) fit the following description: can cause an interstitial pneumonia in bird handlers | chlamydophilia psittaci |
Which infectious agent(s) fit the following description: often the cause of pneumonia in a pt with a history of exposure to bats and bat droppings | histoplasmosis |
Which infectious agent(s) fit the following description: often the cause of pneumonia in a pt who has recently visited south california, new mexico, or west texas. | Coccidioidomycosis |
Which infectious agent(s) fit the following description: common causative agent for pneumonia in alcoholics | Klebsiella |
Which infectious agent(s) fit the following description: Q fever | coxiella burnetti |
Which infectious agent(s) fit the following description: associated with pneumonia acquired from air conditioners | Legionella pneumophilia |
Which infectious agent(s) fit the following description: mcc of pneumonia in kids 1 yr or younger. | RSV |
Which infectious agent(s) fit the following description: mcc of pneumonia in neonates | GSB, ecoli |
Which infectious agent(s) fit the following description: mcc of pneumonia in young adults(including college kids, military recruits, and prison dudes) | mycoplasma pneumonia |
Which infectious agent(s) fit the following description: common cause of pneumonia in pts with other health problems | klebsiella |
Which infectious agent(s) fit the following description: mcc of viral pneumonia | RSV, influenza |
Which infectious agent(s) fit the following description: causes woolsorters' dz | bacillus anthracis |
Which infectious agent(s) fit the following description: common bacterial cause of COPD exacerbation | haemophilus influenza |
Which infectious agent(s) fit the following description: pontiac fever | legionella pneumophilia |