| Asthma | Streph Vs. Mono | COPD | TB VS. Pneumonia | MISC |
|---|---|---|---|---|
|
What is the number one predominant symptom
Coughing
|
What is the causative bacteria for strep
Streph Pyogenes
Group strep A |
what two conditions make up COPD
Emphysema (decrease oxygen)
and chronic bronchitis (junky lungs) |
What will a CXR show with Tb
Upper lobes infiltrates
|
What is the two types of acute bronchitis and which is more common
1. Viral -most common 95%
2. bacterial 5% |
|
What is the order of severity measured by and what is the ranges
FEV1
Intermittent FEV1 >80% Mild FEV1 >80% Moderate FEV1 60-80% Severe FEV1 <60% |
What is the diagnostic test for both strep and mono
Strep test-Throat Swab- Palentine petechiae
mono test-Finger prick-Spleen U/S (Splenomegaly) |
What is the diagnosis criteria
FEV1/FVC Ratio < 0.70
|
What is the mm elevation for a positive tb skin test for the 1. immunocompromised 2. immigrants 3. general public, and 4. healthcare workers
1. 5MM
2. 10MM 3.15MM 4. 20MM |
Patient comes in with recurrent URI symptoms such as cough and runny nose, she complains of pain when bending and left she of her mouth hurts what is the dx and treatment
Acute sinusitis
Treatment- Augmentin EXTRA: Chronic sinusitis causes nasal polyps |
|
What is the symptom escalation for each level of severity
Intermittent- all the 2's
Mild- more than two days but less than daily Moderate- daily with nighttime awakening Severe- daily with nighttime awakenings |
When can patients return to regular activities after mono
when they have a normal spleen U/S
|
What are the common signs and symptoms
Hyper resonant sounds with chest percussion
barrel chest clubbing of the fingers chronic cough |
How do you confirm Tb
Sputum cultures
|
What is treatment for allergic rhinitis and what marker would be positive
first line- intranasal steroids (Flonase)
second line- antihistamine (Benadryl) IgE |
|
What is the treatment escalation for each level of severity
SABA- albuterol (every asthmatic pt)
L-ICS- suffix -ide or -sone LABA- suffix -terol but not albuterol (NEVER Prescribe alone) Refer to pulmonolgy |
1. What is signs of untreated strep and
2. untreated mono
1. Renal failure and scarletena rash and headache
2. Hodgkins lymphoma |
What is a common concern with COPD patients
weight loss and Lung Cancer increased risk (#1 Cancer in both men and women)
|
What is the CURB-65 Criteria for pneumonia
Confusion
BUN > 19 RR > 20 BP < 90/60 65 years or older 1 point each 3+ points is admission criteria |
What drug do you want to avoid in pneumonia patients
Cough supressants
|
|
How do you determine success in treatment and what affects it
Pulmonary function test and peak flow readings at home
Height, Age, Gender (HAG) |
What is the treatment for
1. positive strep 2. positive mono 3. both positive strep and mono
1. PCN
2. Symptom management only 3.Macrolide and celapsporin |
Pt comes in with increased tactile fremitus, cough, fever, chills 1. what do you suspect 2. how will you confirm 3. how will you treat
1. Pneumonia
2. CXR -Lower lobe infilatrates 3. MAD-Lung (macrolide, amoxicillin/azithromycin/doxy- Levaquin Levaquin only if above 65 with co-morbidities or recent antibiotic use. |
What is the black box warning for levaquin
Achilles tendon rupture
|
|
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