Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/58

Click to flip

58 Cards in this Set

  • Front
  • Back
4 ways to get pneumonia
aerosolized
aspiration
hematogenous spread (bacteremia --> lungs)
contiguous spread (injury to chest wall)
normal host defenses against pneumonia
cough
mucociliary clearance
alveolar macrophages
complement, AB, etc
impairment of mucocialary clearance
smoking
COPD
influenza-denuded resp epi
how long do sx last if they are from bacterial pneumonia?
fungal, anaerobic, mycobacterial, etc?
hrs - days
days - weeks
extrapulm sx of legionella pneumonia

influenza?
MS changes and diarrhea

severe malaise
what are rhinitis and pharyngitis associated with
viruses
is tactile fremitus increased or decreased in pneumonia
increased
when is lobar pneum usually seen?
infiltrative
bacterial infx

CMV, legionella, P. carinii, C. neoformans, asergilus, VZV
which pneumonias --> pulmonary infarct
aspergillus
mucormycosis
pseudomonas
what are some of the viral causes of pneumonia
CMV
VZV
measles
sx of viral pneumonia
CXR?
dry cough
dyspnea
constitutional sx
nterstitial infiltrates
which viral pneumonias can be treated?
VZV
measles
when is s. pneumo --> pneumonia
what sx usually preceeds it
usually follows viral URI
coryza and URT sx usually precede
where is s. pneumo found
normal colinizer of nasopharynx
sx of s pneumo
cough
fever
sputum production
pleuritic CP
dyspnea
complications of s. pneumo
meningitis
endocarditis
pericarditis
arthritis
increased risk factors for s pneumo infx
asplenia
AIDS
post-influenza
MM
smokers, alcoholics, extreme ages
who should get pneumococcal vaccine
<65 yo
comorbid illnesses
HIV
sickle cell
MM
asplenia
CSF leak (b/c of meningitis risk)
morph of HiB
Gm - coccobacillus
who get HiB
those with COPD, bronchitis and infants
when to suspect Hib
increase in cough and change in sputum porduction
fever
new infiltrate on CXR
who gets infected with gm - bacilli --> pneumonia
chonic alcoholics
cystic fibrosis
neutropenia
dm
malignancy
comorbid dz of kidney, heart, lungs
hospitalized
who gets klebsiella pneumonia
alcoholics
who gets e. coli pneumonia
those with UTI
who gets pseudomonas infx
cf
nosocomial
who are the msot likely to get pneumonia from staph
persistent nasal colonization
post-viral infx
nosocomial
which is the most common bacteria --> pneumo following viral illness?
2nd most common?
strep pneumo
staph
how does pneumo from staph spread
hematogenously, from seeding of thrombophlebitis, endocarditis, infected IV device
extrapulm sx of staph pneumonia
skin lesions (boils, abscesses)
what are the primary atypical pneumonias?
mycoplasma pneumoniae
legionella pneumoniae
chlamydia pneumoniae
who get m. pneumoniae?
young adults (5-30 yo)
where does m. pneumo normally occur?
usually a URT infx, but 10% --> lower tract
clinical sx of m. pneumo
extrapulm?
dry cough
myalgias, arthralgias, skin lesions, neuro probs
what kind of skin lesions are seen in m. pneumo
e. nodosum
e. multiforme
stevens-johnson
what neuro probs are in m. pneumo
meningitis
myelitis
CN or peripheral neuritis
morph of legionalla
gm - bacilli
incubation of legionella
2-10 day s
sx of legionella
incl extrapulm sx
dry cough
dyspnea
fever, rigors, constitutional sx
HA
confusion
diarrhea
lab findings of legionella
no organsisms seen
lots of neutrophils though
leukocytosis
radiologic findings of legionella
lobar
patchy
pleural effusions
dx of legionella
indirect fluorescen AB takes 8 wks
direct fluoresence AB on resp secretions, very high specificity
legionnal ag in urine in certain types
presentation of clamydia pneumoniae
sx are gradual
URI sx preceed infx
fever
CP
nonproductive cough
HA
bronchitis
sinnusitis
pharyngitis
radiologic findings of chlamydia pneumoniae
50% bilateral infiltrates
sometimes pleural effusions
can be normal looking
why do foreign bodies get seeded?
there is no vascular supply to foreign objects
why does general anesthesia --> infx
dries out respiratory surfaces
reduces ciliary and cough activity
compromises the airway
Which organisms are ppl with T cell impairment at risk for getting?
mycobacteria
DNA viruses
fungi
Which organisms are ppl with Bcell impairment at risk for getting?
encapsulated organsism
what can cause reticulendotelial system defects
what results
splencectomy
iron storage dz

streptococcus clearance impaired
what are ppl with IgA deficiency susceptible to?
giardiasis
what are ppl with complement probs susceptible to
pyogenic cocci
esp neisseria (get neisseria recurrently)
what are most infx from BMT or stem cell transplants caused by?
endogenous flora
latent DNA viruses
what immunologic defect do BMT and stem cell transplant recipients have btwn 0-50 days?
50+ days?
neutropenia and mucositis
CMI (and humoral immunity starting by day 100) and GVHD
Who is extremely susceptible to a strongyloides stercoralis infection? what results?
those wiht skin adn T cell deficiency
w t cell deficiency, it can invade the bloodstream and CNS, carrying intestinal flora w it --> polymicrobial meningitis
what shoud you think about in an unexplaned gram negative rod meningitis (esp in a t cell deficient pt)
s. stercoralis
how do pts with neutropenic fever present
with fever, but other sx and si of systemic infx are absent
physical finding in pts with fever and neutropenia (as well as those with severe sepsis)
ecthyma gangrenosum
what is ecthyma gangrenosum
what can be assoc with it
infarctive process fo skin
can also have perirectal infx
who is likely to have perirectal infx
pt w leukemia