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