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11 Cards in this Set

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What are the factors associated with adverse outcome or complications in pneumococcal pneumonia?
E: Bacteremia
Older age
Immunodeficiency or AIDS
Preexisting lung disease
Nosocomial infection
Initial body temperature < 38°
Who should receive the pneumococcal vaccine?
E: People older than 65 years.
People aged 2-64 years with cardiopulmonary disease, diabetes, alcoholism, chronic liver disease, CSF leaks, cochlear implant, or residence in special environments or chronic care facility.
Immunocompromised people older than 2 years: HIV, malignancy, splenectomy, immunosuppressive treatment, transplant.
Which are the two commonest organisms commonly involved in noscomial pneumonia?
E:Nosocomial pneumonia is caused most commonly by gram-negative organisms, including Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Enterobacter spp. Staphylococcus aureus, including methicillin-resistant organisms, Streptococcus pneumoniae, anaerobes, Candida spp., enterococci, and polymicrobial infections are also common. Overall, Pseudomonas and S. aureus are most common.
Describe the common anatomic distribution of chest x-ray changes in postprimary (reactivation) TB.
E: Apical and posterior segments of the upper lobes (85%). A lesion found only in the anterior segment suggests a diagnosis other than TB (e.g., malignancy).
Superior segments of the lower lobe (10%).
Remainder of the lower lobe (less than 7%).
The right lung is more often affected than the left.
How do you monitor for adverse drug reactions during TB therapy?
E: Before therapy is started, the following tests should be performed: baseline liver function tests (INH, rifampin, PZA); CBC with platelets (ethambutol), blood urea nitrogen, creatinine, and calcium (INH, rifampin); uric acid (PZA, ethambutol); and visual acuity (retrobulbar optic neuritis, ethambutol). Patients receiving INH should be questioned monthly about potential symptoms, including peripheral neuropathy.
Which infections can mimic TB?
E: Fungal infections, especially histoplasmosis and coccidioidomycosis, and Nocardia spp. (gram-positive, aerobic, partially acid-fast organisms).
A: Histo, blasto, nocard
How is nocardiosis treated?
E: Nocardiosis is most commonly associated with underlying disease, such as pulmonary alveolar proteinosis. Most strains are susceptible to sulfonamides.
A: Sulf
A PPD greater than 5 mm is considered positive under which circumstances?
E: HIV+, TB contact, CXR changes consistent with old TB, organ transplant, immunosuppression.
A PPD greater than 10 mm is considered positive under which circumstances?
E: Arrival from endemic zone, IVDA, prisons, nursing homes, homeless shelter, DM, CRI
A PPD greater than 15 mm is always considerd to be positive. True/False?
E: True
What are the three ranges from PPD interpretation?
E: More than 5, more than 10, more than 15
A: 5,10,15