Pulmonary Disorders
What should you never use to treat acute bronchitis?
Antibiotics is not recommended, regardless of cough duration.
Acute onset often associated with systemic illness (caused by adenovirus), profuse tearing, photophobia or foreign body sensation, preauricular adenopathy, hyperemia.
What kind of conjunctivitis is this?
How do you treat it?
Viral Conjunctivitis
Txt: Supportive treatment, cool compresses, artificial tears
Bilateral tonsillar exudate, tender, enlarged cervical lymph nodes, fever, petechiae of soft palate, halitosis (distinct smell), absent cough will lead you to suspect what disease?
Strep pharyngitis
GOLD standard for diagnosing COPD:
Spirometry
75 y/o patient: Non-tender, progressive loss of visual acuity, blurred vision or hazy, haloes or significant glare with bright lights, difficulty driving at night, progressive loss of vision.
What disease is it?
Cataracts
Physical exam in people with asthma is often normal, but the most frequent finding is ________________, especially on forced expiration
wheezing on auscultation
Pain and tenderness on palpation of the tragus, erythematous and edematous canal, may be filled with debris and sloughed tissue, erythematous tympanic membrane, hearing deficits.
What disease is it?
How do you treat it?
Otitis Externa
Clear debris from canal (irrigate with 1:1 dilution of hydrogen peroxide with water), manage pain, treat infection and inflammation (topical medications such as antibiotics with glucocorticoid combinations, ciprofloxacin hydrocortisone (1st line) or Neomycin-polymyxin B-hydrocortisone (Cortisporin)
Acute bacterial rhinosinusistis is treated by?
Bacterial (analgesics and NSAIDS, nasal saline, topical nasal steroids to improve nasal congestion, amoxicillin-clavulanate (1st line), doxycycline (PCN allergy)
HIV infection is one of the most significant risk factors for what disease?
Tuberculosis (TB)
What symptom from infectious mononucleosis would tell someone to refrain from contact sports?
Splenomegaly
What are the 3 cardinal symptoms of COPD?
Dyspnea, chronic cough, and sputum production (colorless sputum, usually worse in the morning).
Stuffiness, fullness, popping, cracking, or gurgling sounds when chewing, yawning, or blowing nose, loss of auditory acuity in the affected ear. Mostly asymptomatic!
What disease am I?
Otitis media with effusion (OME)
What is the GOLD standard to diagnose epiglottitis?
Definitive diagnosis via laryngoscopy with a flexible fiberoptic score
What is the most appropriate initial antibiotic regimen for a 60-year-old otherwise healthy outpatient diagnosed with CAP, with no drug allergies or significant comorbidities?
Amoxicillin plus doxycycline
You as the provider suspect someone has epiglotittis, what must you AVOID doing in a physical exam?
AVOID examining the pharynx with a tongue depressor because this may precipitate an airway emergency; inspection of the oral cavity may cause sudden airway occlusion, tripod position!
The presence of an infiltrate on pain chest radiograph is considered the GOLD standard for diagnosing _________.
Pneumonia.
PLUS, supportive clinical and microbiologic features (fever, dyspnea, cough, sputum production).
Patient presents with tenderness of affected left eyelid, tearing in left eye, sensitivity to light. Upon observation you see an inflamed bump on the eyelid. There is redness and swelling.
What is your diagnosis?
How would you treat this?
Hordeolum (Stye)
Treatment: warm, wet compresses and place it gently over the affected eye, do this 5 times several times a day, change the washcloth frequently.
Patient has Unilateral throat pain (report ear pain), trismus, dysphagia, dysphonia, muffled voice, drooling, possible epiglottitis, and a hot potato hoarse voice. What do you suspect?
Peritonsillar abscess (PTA)
ALL patients with COPD should receive a ______________ for relief of episodic dyspnea and early treatment of exacerbations
short acting bronchodilator
Patient comes in complaining of inflammation of their right eyelid. Upon observation you notice some crusting on the eyelid margins. The patient has scaling of the eyelid, light sensitivity, and blurred vision.
What is your diagnosis?
How do you treat it?
Blepharitis
Treatment: Frequent cleansing of the eye margins to remove scales and reduce inflammation, warm compresses. Clean cotton ball soaked with warm water and a drop of baby shampoo or olive oil or diluted hydrogen peroxide, gently scrub eyelid with eye closed!
Antibiotics: Bacitracin, erythromycin (works best for anterior blepharitis), azithromycin (posterior blepharitis), place ointment directly on lid margin once daily at bedtime for 2 weeks, oral antibiotics-if unresponsive to topical agents (Doxycycline, tetracycline, and azithromycin)
Most common early symptom of Lung cancer?
Smoker's cough
Lesions develop over a couple of days, decrease in vision, decrease corneal sensitivity, unilateral involvement, caused by HSV.
What is the disease?
What are the triad of symptoms for Infectious Mononucleosis?
Triad of symptoms: Fever, tonsillar pharyngitis, and posterior cervical lymphadenopathy.
First line agents that treat TB
(Give acronym)
(RIPE): Rifampin, Isoniazid, pyrazinamide, ethambutol
Streptococcus pneumonia (most common)