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99 Cards in this Set

  • Front
  • Back
side effects of oseltamivir (tamiflu)
nausea and vomiting
side effects of zanamivir (relenza)
bronchospasms
sudden onset fever, malaise, non-productive cough and nasal discharge usually in winter months
influenza
pts who should get flu vaccine
nursing home residents
copd pts
pregnants in 2nd and 3rd trimester
fever, productive cough, pleurisy and sob
pneumonia
bacteria associated with pneumonia secondary to alcoholism
klebsiella pneumonia
organism causing pneumonia associated with exposure to bats
histoplasma capsulatum
bacteria associated with pneumonia due to cystic fibrosis
pseudomonas
bacteria associated to pneumonia due to birds contact
clamydia psittaci
Diffuse, granular infiltrates on xray
interstitial pneumonia (pcp and cmv)
what organisms can more commonly cause nodular lesions in the lungs?
fungi: histoplasma, cryptococcus and coccidiomyces
tx for community acquired pneumonia in outpt setting
MACROLIDE (Z-PACK)
DOXYCYCLINE 100 MG PO BID X 7-10 DAYS
LEVOFLOXACIN 500 MG PO QD X 7-14 DAYS
tx for capn in inpt setting
1- THRID GENERATION CEPHALOSPORIN (CEFTRIAXONE, CEFOTAXIME) AND A MACROLIDE
2- LEVOFLOXACIN
3- UNASYN
tx for aspiration pneumonia outpt setting
clindamycin
pen G
tx for aspiration pneumonia in a hospitalized pt
quinolones, ceftriaxone + clindamycin or
pipercillin-tazobactam (zosyn) or
ticarcillin-clauvanate (timentin)
tx for atypical pneumonias
tetracyclines and macrolides
mine worker from southern/ midwestern USA with pneumonia. what's the culprit?
histoplasma
(ohio, misissipi)
culprit for pneumonia in the west (california, arizona, new mexico,texas)
coccidiomyces
xrays show patchy infiltrates with mediastinal lymphadenopathy
histoplasmosis
sputum cx reveals spherules and eosinophilia
coccidiomycosis
diagnostic findings in pcp (4)
1.butterfly pattern on xray
2.cx neg for bacteria
3.elevated ldh
4.high gallium uptake in infected areas
calcified focus of infection involving lymph nodes in tb
ghon's complex
extrapulmonary tb affecting the spine
pott's dz
extrapulmonary tb affecting the cervical nodes
scrofula or tuberculous cervical lymphadenitis
pts in which a 5mm induration gives a positive ppd
active infection
immunocompromised
pts in which a 10mm induration gives a + ppd
children < 4 yo
confined
iv drug abusers
fever, cough productive or not, with a normal cxr
bronchitis
physical finding associated with aspiration pulmonary abscess
foul smell breath secondary to anaerobic infexn
use of abx for anaerobic infection
clindamycin if above the diaphragm
metronidazole if below the diaphragm
dx test for aspiration abscess
aspiration bx (cant cx sputum bc mouth anaerobes)
pt more likely to have h. flu pneumonia
smoker
test of choice for atypical pneumonias
serology
lung ca in which tumor cells contain mucins
adenocarcinoma
name the non-small cell ca of the lung
adenoca
squamous ca
large cell ca
syndromes associated with lung ca (3)
superior vena cava synd
horner's synd
pancoast's synd
unilateral facial anhydrosis, miosis and ptosis
horner's syndrome
horner's syndrome with shoulder and arm pain
pancoast's syndrome
due to tumor invasion to the apex and sympathetic nerves
areas where lung ca commonly mets
brain
bone
adrenals
liver
chemo and xrt combined with surgery are indicated for which type of lung ca?
non-small cell ca
dx test to localize carcinoid tumor
ocreotide scintigraphy
tx for carcinoid tumors
surgery only
chemo and xrt are not helpful
when a nodule become a mass?
> 3 cm in diameter
indication for resection of a solitary nodule
pts > 35 yo
mucus casts of small airways found in sputum of asthmatics
Curschmann's spirals
crystals indicative of eosinophilic involvement due to asthma or parasitic infections
charcot-leyden crystals
first line for asthma exacerbation
inhaled beta-agonist
tx for excercise induced asthma
beta-agonist or cromolyn sodium 15 min pre exercise
two mechanisms for respiratory failure
obstruction
resp muscle fatigue
pulsus paradoxus, no wheezing, intercostal retractions
status asthmaticus
ct finding due to thickening of bronchial walls in bronchiectasis
signet ring sign
standard test to dx bronchiectasis
ct
emphysema by late 30s, suspect...
alpha-1-antitrypsin deficiency
first line tx for emphysema
anticholinergics
ie. ipratropium (atrovent), tiotropium (spiriva)
cromolyn and nedocromil sodium are...
mast cell stabilizers
sob, pleuritic pain and absent breath sounds
ptx
findings on ekg and abg with pe
rbbb and resp alkalosis
sign on cxr seen in 2% of pe pts due to distal vasoconstriction of vessels distal to the embolus
westermark's sign
sign on cxr indicating pulmonary infarction and atelectasis in a pe
hamptom's hump
gold standard test for pe dx
pulm. angiography
gold standard tx for pe
heparin
exertional dyspnea, syncope but no orthopnea
primary pulmonary htn
3 types of pulmonary htn
pre-capillary: anything that increases pressure in arteries (pe, vsd...)
passive: anthing that raises pulmonary venous return ( lv failure, htn...)
reactive: mitral stenosis
dyspnea but no orthopnea, pnd or pulm. edema
pre-capilary htn
dyspnea, orthopnea, pnd and evident underlying condition
passive pulmonary htn
dyspnea and marked decreased exercise tolerance
reactive htn
cxr reveals prominent central pulmonary arteries
reactive p. htn
prominent upper lobe pulm. veins and kerley b lines
passive p. htn
mcc of cor pulmonale
copd
Pt presents w/ RUQ pain, SOB and weakness. PE shows wheezing, elevated JVP and pedal edema.Ekg shows right axis deviation plus prominent p waves as well as Q waves in leads 2, 3 and avf. MLDx?
cor pulmonale
half life of warfarin
36 hr
idiopathic interstitial pneumonia which shows excellent response to steroids
cryptogenic organizing pneumonia AKA BOOP (broncholitis obliterans w/ organizing pneumonia)
idiopathic interstitial pneumonia where complete recovery its unlikely
usual interstitial pneumonia
gold standard test to dx interstitial pneumonia
lung bx
mainstay of tx for interstitial pneumonia
steroids
ra and pneumoconiosis
caplan's syndrome
pneumoconiosis associated with nuclear weapons construction
berylliosis
Calcium oxalate and protein inclusions in a granuloma associated with sarcoidosis
schaumann's bodies
multisystem disorder presents with alveolitis and epitheloid granulomas
sarcoidosis
enzyme elevated in sarcoidosis
ace
side effects include hemorrhagic cystitis, leukopenia and n/v
cyclophosphamide
side effects include hyperglycemia, osteoporosis and edema
corticosteroids
side effects include anemia, leukemia and n/v
azathioprine (imuran) immunosuppresant
criteria for ards
pa02 to fi02 ratio</= 200
infiltrates on cxr
pwp</= 18
egg-shell pattern on x ray of a glass factory worker
silicosis
Most common benign tumor of the lung
Hamartoma
Accumulation of coal pigment in the lung parenchma w/o cellular reaction
ANTHRACOSIS
Pulmonary fibrosis and rheumatoid arthritis
CAPLAN'S SYNDROME
Describe Well's criteria for PE
- TACHYCARDIA
- HEMOPTYSIS
- HX OF PE/DVT
- SX/SI OF DVT
- IMMOBILE
- MALIGNANCY
Criteria for home oxygen tx (2)
1. PO2 < 55 AT REST
2. PO2 BETWEEN 55 AND 60 WITH EVIDENCE OF ERYTHROCYTOSIS OR COR PULMONALE
Pt presents w/ sx of pneumonia. Sputum production is scant, CXR reveals patchy infiltrates and consolidation and stain shows PMNs but no organisms. Dx?
LEGIONNAIRE'S DISEASE
Histologic analysis of lung parenchyma reveals cells w/ scant or no cytoplasm and a "salt and pepper" appearance of nuclei. Which malignancy is most likely?
SMALL CELL CA
Factors that make the oxyhemoglobin dissociation curve shift to the right...
- low ph
- high CO2
- high temperature
- high 2,3 diphosphoglycerate
Why should a pt using steroid inhaler rinse his/her mouth after use?
TO AVOID THE DEVELOPMENT OF ORAL CANDIDIASIS
Drug of choice for persistent asthma
INHALED CORTICOSTEROIDS
Most common causing mechanism of lung abscess?
ASPIRATION
Standard therapy for lung abscess?
CLINDAMYCIN
Most common cause of chronic lung disease in children and young adults?
CYSTIC FIBROSIS
A child presents w/ recurrent bacterial pneumonias, productive cough and diarrhea for a year. PE shows clubbing, nasal polyps and apical crackles. X-ray reveals increased AP diameter and hyperinflated lungs. Diarrhea analysis shows increased fat content. MLDx?
CYSTIC FIBROSIS
A pt diagnosed w/ Mycoplasma Pna is at risk of which blood complication and why?
AUTO-IMMUNE HEMOLYSIS 2/2 IGM HEMAGGLUTININ ANTIBODIES AGAINST RBC's