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15 Cards in this Set
- Front
- Back
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27. What does the paediatric pt older than ~5 yrs old with pneumonia typically have (aetiology)?
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a. Mycoplasma!
b. However, most of the viral and bacterial aetiologies previously listed are possible, except GBS and listeria. |
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28. What are abx in the >5yo age group directed towards for pneumonia?
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a. Mycoplasma and typical bacteria (pneumococcus)
b. Tx options: 1. Macrolides (Azithromycin) or 2. Cephalosporins (ceftriaxone or cefuroxime |
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29. 2 possible aetiologies in pneumonia in the intubated ICU pt w/central lines?
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a. Pseudomonas aeruginosa or fungal species (candida)
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30. 2 possible aetiologies in pneumonia in the pt w/chronic lung disease (cystic fibrosis)?
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a. Pseudomonas and Aspergillus
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31. When should varicella pneumonia be considered?
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a. In pts w/typical skin findings and pneumonia.
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32. When to consider CMV pneumonia?
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a. When CMV retinitis is present.
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33. When to consider Legionella pneumophila pneumonia?
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a. If the pt has been exposed to stagnant water.
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34. When to consider Aspergillus pneumonia?
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a. If pt has refractory asthma or a classic “fungal ball” on chest radiograph.
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35. Pneumonia to consider with travel to Southwestern US?
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a. Coccidioides immitis?
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36. Pneumonia to consider with exposure to sheep or cattle?
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a. Coxiella burnetii.
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37. Pneumonia to consider with Spelunking of working on a farm east of the Rocky Mountains?
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a. Histoplasma capsulatum.
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38. Presentation of TB?
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a. Range from traditional cough, bloody sputum, fever, and weight loss to subtle or nonspecific symptoms.
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39. Positive ppd definition?
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a. Indurated diameter in the context of the pt’s exposure history, radiographic findings, and immune status.
b. i.e a 5-mm induration may be considered a “positive” PPD at 48-72 hours in a pt w/confirmed exposure, abnormal CXR, or immunodeficiency. c. The same measurement in an otherwise healthy child w/o exposure would not be considered positive. |
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40. Possible sources for acid-fast bacilli for stain and culture?
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a. First-morning sputum samples
b. Gastric aspirates c. Bronchial washes d. Biopsy obtain via bronchoscopy e. Empyema fluid analysis or pleural biopsy if surgical intervention is required. |
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41. Standard Tb rx while awaiting culture and sensitivities in children?
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1. INH
2. Rifampin 3. Pyrazinamide b. For possible drug-resistant organisms, ethambutol can be added temporarily as long as visual acuity can be followed! c. Typical abx course consists of initial phase of approx. 2 months duration on 3 or 4 meds, followed by a continuation phase of 4-7 months on INH and rifampin. |
