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34 Cards in this Set
- Front
- Back
Sinusitis causes
- in normal - in immunocompromised/diabetics/cf |
normal: S. pneumo, G- coccobacilli (Moraxella, H.Influenzae)
ic/dm/cf: pseudomonas |
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otitis media
causes pe tx |
causes: s.pneumo, moraxella, h.flu
pe: bulging, erythematous tympanic membrane tx: decongestants and *amoxilliciln* (bactrim/augmentin/cephalosporin if failure |
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otitis externa
causes pe tx |
"swimmer's ear"
causes: pseudomonas pe: "tragal ear" -- hurts when pulled down tx: polymyxin - neomycin |
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pharyngitis
causes dx rx complications |
causes: strep throat -- s.pyogenes (group A strep)
other causes: viral, fungal, mycoplasma, tb, etc.) dx: throat cultures rx: penicillin (amoxicillin if allergy) compliations: toxic (scarlet fever, tss), pyogenic |
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deep tissue infections
sx types common bugs implicated |
types: peritonsillar abscesses, retropharyngeal infections, prevertebral space, parapharyngeal space, ludwig's angina
sx: "hot potato voice," headpain, fever, dysphagia, drooling, sore throat common bugs: staph, strep, mouth flora |
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acute epiglottitis
causes sx dx |
causes: h.flu (b/c of vaccine, this dz is mostly eradicated)
sx: dysphagia, fever, sore throat dx: cherry red epiglottis, "thumb" sign on lat neck film xray note: DO NOT CULTURE (could cause layrngospasm) -- protect airway first (tube/tracheostomy) |
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croup
causes rx |
causes: viral--*parainfluenza*, rsv, adenovirus
rx: cool mist, epinephrine, protect airway |
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how do you get pna
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inhalation of droplets
aspiration of mouth flora hemotogneous spread (e.g. endocarditis) |
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cxr findings types
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consolidated
necrotizing interstitial granulomatous |
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consolidated cxr pna -- bugs
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**s.pneumo**, h.flu
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necrotizing cxr pna -- bugs
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abscesses formed by anaerobic bac, s.aureus, g- coccobacilli
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granulomatous cxr pna -- bugs
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TB, fungi (histo, aspergillus)
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types of pnas
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community acquired
atypicals nosocomial immunocompromised (e.g. pcp) |
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pna: s.pneumo
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productive cough, pleuritic pain
rust colored sputum CXR: consolidation + patchy infiltrate ID: g+ cocci, + quelling rxn, encapsulated, IgA protease tx with penicillin, flouroquinolones if drug-resistant, or cephalosporin |
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pna: s.pyogenes
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productive
tx. with penicillin |
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pna: s.aureus
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productive cough
hospital acquired pink salmon-colored sputum CXR: patchy bronchial infiltration; seen in infants/immunocompromised/elderly ID: G+ cocci, Coagulase + Tx: methicillin, vancomycin for mrsa |
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pna: h.influenze
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productive cough, pleuritic pain, may be preceded by URI
CSR: patchy bronchial infiltration or lobar consolidation ID: G- coccobacillus, req's X and V, pili, IgA protease, encapsulated tx w/ HIB Vax; ampicillin, cephalosporins if resistant |
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pna: klebsiella
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**alcoholics** (aspiration)
reddish "currant jelly" sputum CXR: multiple lobes, abscesses tx: cephalospirines +/- aminoglycosides |
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pna: pseudomonas aeruginosa
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cystic fibrosis patients
hospital acquired productive cough ID: g- bacillus, blue-green colonies, fruity odor, gun-metal sheen |
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pna: mycoplasma pneumonia
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atypical (nonproductive cough) "walking pneumonia" -- looks fine, cxr horrible
community acquired cervical lymphadenopathy? CXR: patchy infiltrates, appears worse than sx ID: cholesterol membranes, cold agglutinins Tx: Erythromycin / Azithromycin |
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pna: legionella
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community/hospital acquired
atypical (productive?? cough), diarrhea, confusion, ataxia csr: patchy infiltrate +/- lobar consolidation ID: PMNs on gram stain, no bacteria epi: elderly male, alcoholic, exposed to water tx: erythromycin |
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pna: tb
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fever, cough, blood tinged sputum, weight loss, night sweats, anorexia
CXR: +/- ghon complex, cavitary lesion ID: ppd tx: inh, rifampin, more.. |
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pna: PCP
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opportunistic, slow appearance
CXR: minimal changes @ first |
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pna: viral
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most common in kids
causes: RSV parainfluenza influenza adenovirus cmv (noonates, IC) CXR: patchy infiltrates TX: amantadine for influA, gancyclovir for CMV |
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pna: chlamydia
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c. trachomatis: neontal PNA, retinits
c. psittaci: "parrot fever" c. pnemo: pna in young adults TX: tetracycline, erythromycine |
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pna: histoplasmosis
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starlings (bat shit)
fungal |
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typical pnas
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acute onset of fever, productive cough
s.pneumo h.flu klebsiella moraxella s.aureus |
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atypical pnas
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slow onset, nonproductive cough, minimal increase in wbc
mycoplasma pneumo tb chlamydia legionella coxiella viral |
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community-acquired pnas
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s.pneumo
h.flu legionella viral younger pts: mycoplasma chlamydia |
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hospital-acquired pnas
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s.pneumo
h.flu legionella e.coli klebsiella enterobacter proteus serratia pseudomonas s.aureus |
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alcohol abuse pnas
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klebsiella
s.pneumo h.flu |
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COPD pnas
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s.pneumo, h.flu, moraxella
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post influenza pnas
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s.aureus, h.flu, s.pneumo
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special exposure:
birds cattle, hides animals, white powders... |
birds: chlamydia psattaci
cattle: coxiella burnetti animals, white powders: bacillus anthracis |