Pance Pulm Review

Front 1

acute bronchitis most common during which months?

Back 1

winter and early spring

Front 2

Acute bronchitis S/S?

Back 2

cough preceded by nasal congestion, sore throat, malaise, HA and sneezing, Rhonchi, crackles, or wheezing

Front 3

Acute bronchitis TX

Back 3

1. supportive
2. decongestants and ihaled bronchodilators

Front 4

Most common cause of RSV?

Back 4

Acute bronchiolitis

Front 5

Acute bronchiolitis s/s?

Back 5

diffuse wheezing, variable fever, cough, tachypnea, difficulty fedding, cyanosis

Front 6

PE of acute bronchiolitis?

Back 6

hyperinflation, crackles and prolonged expiration and wheezing

Front 7

DX of acute bronchiolitis?

Back 7

based on clinical findings and isolation of offending organisms

Front 8

TX of acute bronchiolitis?

Back 8

1. bronchodilator for wheezing
2. antiviral-Ribavirin, by aerosolization for RSV

Front 9

Acute epiglottis is what?

Back 9

rare, medical emergency

Front 10

acute epiglottitis is noted in who and caused by what?

Back 10

1. adolescents and adults
2. h. flu type b
s. pneumoniae
staph aureus
candida albicans
herpes simplex virus

Front 11

decreased frequency of this dz in children w/dev. and use of the h. flu type b vaccine?

Back 11

acute epiglottitis

Front 12

Acute epiglottitis s/s?

Back 12

pt appears anxious and toxic
fever, muffled voice and cyanosis

2. prefer sitting position, children have "sniffing" or "tripod" position

3. sitting up with chin forward and neck slightly extended

Front 13

late symptoms of epiglottitis?

Back 13

stridor, drooling and trouble handling secretions

Front 14

what is important to know and seen in epiglottits?

Back 14

exam of upper airway should be avoided and if pt is examined the epiglottitis is cherry red and swollen

Front 15

DX of epiglottitis?

Back 15

lateral soft tissue neck xray show (THUMPRINT SIGN)

Front 16

Epiglottitis treatment?

Back 16

AIRWAY MANANGEMENT IS KEY!!!
2. humidified oxygen and IV fluids
2. cefuroxime
3. chloramphenicol
4. cefotaxime
4. ceftriaxone
5. cefazolin
6. ampicilling-sulbactam

Front 17

An acute inflammatory dz of the larynx involving mainly the subglottic area?

Back 17

Croup

Front 18

Croup affects who and occurs when?

Back 18

younger children, fall and early winter

Front 19

common cause of croup?

Back 19

1. RSV
2. Influenza
3. adenovirus
4. Mycoplasma pneumonia

Front 20

Croup s/s?

Back 20

barking cough and stridor

Front 21

What shows on lateral neck xray of croup?

Back 21

narrowing of hte subglottic area and normal epiglottitis

Front 22

treatment of croup?

Back 22

supportive care, oral hydration, mist therapy, and minimal handling for mild croup

Front 23

pts with stridor are treated?

Back 23

active intervention
1. oxygen
2. racemic epi
3. glucocorticoids
artificial airway may be needed in severe cases

Front 24

Influenza defintion?

Back 24

common resp. infxn caused by influenza A or B

Front 25

how is influenza spread?

Back 25

respiratory droplets

Front 26

this has a 1-3 day incubation period

Back 26

influenza

Front 27

abrupt onset of fever, chills, myalgias, HA and a non-productive cough

Back 27

influenza

Front 28

coryza and sore throat are common with this?

Back 28

influenza

Front 29

what does a PE show with influenza?

Back 29

mild pharyngeal erythema, cervical adenopathy, and clear nasal drainage

Front 30

how do you diagnosis influenza?

Back 30

Viral culture from throat and nasal or immunoassays can be used for rapid detection

Front 31

treatment of influenza A?

Back 31

1. rimantadine and amantadine-shorten the course

Front 32

Zanamivir and oseltamivir are active against what?

Back 32

influenza A and B

Front 33

S/E of zanamivir and oseltamivir?

Back 33

1. zanamivir-bronchospasms
2. oseltamivir-nausea and vomiting

Front 34

mainstay prevention of influenza?

Back 34

inactivated influenza vaccine

Front 35

Whooping cough is seen in what?

Back 35

Pertussis

Front 36

pertussis more common in who?

Back 36

young children and infants

Front 37

what is the organism in volved with pertussis and the incubation period?

Back 37

bordatella pertussis
6-14 days

Front 38

what are the three stages of pertussis?

Back 38

1. catarrhal
2. paroxysmal
3. convalescent

Front 39

this stage of pertussis is sneezing, injected conjunctivae, and nocturnal cough

Back 39

catarrhal stage

Front 40

this stage present with cough with whooping sound, mucous plug maybe expellled, vomiting and scattered rhonci

Back 40

paroxysmal stage

Front 41

this stage the cough disappears?

Back 41

convalescent stage

Front 42

dagnosis of pertussis?

Back 42

clinical findings and whooping cough, lymphocytosis and nasal swab culture for b. pertussis

Front 43

what is the the diagnostic procedure for b. pertussis

Back 43

nasal swab culture

Front 44

what is the antibiotic of choice for pertussis?

Back 44

erythromycin

Front 45

what other antibiotics can you use in pertussis?

Back 45

bactrim, azithromycin or clarithromycin

Front 46

what is the prevention of pertussis?

Back 46

exposed individuals should be treated with erythromycin and immunizations.

Front 47

what are the immunizations given for prevention of pertussis?

Back 47

DTaP every 8wks starting at 2mths for total of 3 injections. 4th dose at 15 to 18 mths, and booster at age 5

Front 48

microaspiration of oral contents, inhalation of small droplets or hematogenous spread?

Back 48

bacterial pneumonia

Front 49

productive cough, dyspnea and pleuritic chest pain and fever?

Back 49

bacterial pneumonia

Front 50

what are some other s/s of pneumonia that could occur?

Back 50

confusion, dehydration, loss of appetite or failure to thrive.

Front 51

foul-smelling sputum?

Back 51

aspiration pneumonia

Front 52

what is found on PE in bacterial pneumonia?

Back 52

increased resp. rate, bronchial breath sounds and egophony, dullness to percussion, decreased breath sounds

Front 53

what is the diagnosis of bacterial pneumonia?

Back 53

leukocytosis, positive sputum gram stain and culture

Front 54

Lobar pneumonia shows what on cxr?

Back 54

density involves a distinct segment of the lung.

Front 55

s. pneumoniae, h. flu and legionella species are noted in what pneumonia?

Back 55

Lobar pneumonia

Front 56

bronchopneumonia shows what on cxr?

Back 56

patchy infiltrates involving multiple areas of the lung

Front 57

what organisms are involved with bronchopneumonia?

Back 57

s. aureus, gram-negative bacilli, mycoplasma, chlamydia, and viruses

Front 58

interstitial pneumonia shows what on cxr?

Back 58

fine, diffuse, granular infiltrates.

Front 59

what organisms involved in interstitial pneumonia?

Back 59

influenza, CMV, and pneumocystis carinii

Front 60

this presents with loss of lung tissue and cavity formation?

Back 60

lung abscess-noted infections due to anaerobes

Front 61

histoplasmosis, coccidiomycosis and cryptococcosis show what on CXR?

Back 61

nodular lesions, multiple or single

Front 62

what is viral pneumonia caused by?

Back 62

M. pneumonia, C. pneumonia, adenovirus, parainfluenza, influenza a and b and RSV

Front 63

this pneumonia is seen in pts younger than 40yrs

Back 63

m. pneumonia

Front 64

late summer and early fall this pneumonia common in?

Back 64

m. pneumonia

Front 65

a non-productive cough, fever, malaise, and HA.

Back 65

viral pneumonia

Front 66

HA and sore throat are common in what pneumonia?

Back 66

mycoplasma, chlamydia infections

Front 67

what does a cxr show in mycoplasma and chlamydia pneumonia?

Back 67

unilateral or bilateral patchy lower lobe infiltrates

Front 68

rapid viral screens are available for detection of what?

Back 68

influenza

Front 69

whats the treatement of mycoplasma and chlamydia pneumonia

Back 69

tetracycline and macrolides

Front 70

what are considered fungal pneumonia?

Back 70

1. hisoplasma capsulatums and coccidioides immitis

Front 71

this is caused by bat exposure and more common in midwestern (ohio and mississippi river valleys) and SE US.

Back 71

Histoplasmosis

Front 72

this infection is noted in cave explorers, due to exposure to bat guano

Back 72

histoplasmosis

Front 73

coccidioidomycosis is more common in?

Back 73

central california, arizona, new mexico and texas and more common in summer

Front 74

2 wks after exposure pts have high fever, ha, nonproductive cough and dull chest pain

Back 74

histoplasmosis

Front 75

pts maybe asymptomatic or present w/fever, pleuritic chest pain, dry cough, and SOB

Back 75

coccidioidomycosis

Front 76

how do you diagnose histoplasmosis?

Back 76

fungal culture or antigen testing

Front 77

cxr shows what in histo?

Back 77

patchy infiltrate and mediastinal lymphadenopathy

Front 78

how do you diagnose coccidioid?

Back 78

fungal culture, eosinophilia, sputum may show spherules, organism can be noted on silver stain

Front 79

coccidoid treatment?

Back 79

most cases resolve spontaneously. Diseeiminated dz-AMPHOTERICIN B

Front 80

histo treatment?

Back 80

itraconazole or amphotericin B

Front 81

Organism in HIV pneumonia?

Back 81

pneumocystis carinii

Front 82

HIV pts have what cd4 count levl?

Back 82

cd4 count less then 200

Front 83

fever, dry cough, dyspnea, weight loss, fatigue and tachypnea?

Back 83

p. carinii

Front 84

how do you diagnose p. carinii?

Back 84

1. lactate dehydrogenase (LDH) elevated.
2. Gallium scan is positive

Front 85

what does p. carinii show on cxr?

Back 85

diffuse interstitial infiltrates. BUTTERFLY PATTERN

Front 86

what is the treatment of choice for p. carinii?

Back 86

bactrim or pentamidine is treatment of choice

Front 87

what can be given in P. carinii if presence of severe respiratory compromise?

Back 87

steroids

Front 88

lower resp. tract infxn in young?

Back 88

RSV

Front 89

low grade fever, wheezing, retractions, crackles and hyperinflation?

Back 89

RSV

Front 90

how do you diagnose RSV?

Back 90

rapid detection of RSV antigen thru enzyme-linked immunosorbent assay or fluorescent antibody staining in nasal or pulm secretion is very sensitive