Pneumonia
When is pneumonia determined to be hospital acquired?
What is development after 48 hrs of admission
45 year old pt presents with acute onset of a productive cough and fever. He also has dyspnea, headache, and sweats. What is the gold standard for you suspected diagnosis?
What is CXR
RSV is the most common etiology of
What is Acute bronchiolitis
Inhalation of mycobacterium tuberculosis and deposition in the lungs leads to one of four possible outcomes:
1: Immediate clearance of organism
2: Primary disease
3: Latent infection
4: Reactivation disease
What is the difference between morbidity and mortality?
Morbidity: Departure from state of physiological or psychological well being
Mortality: Death
What are the 3 most common typical and atypical etiologies?
Typical: S. pneumoniae, S. aureus, and H. influenzae
Atypical: M. pnuemoniae, C. pneumoniae, and Legionella
What unique diagnostic test can be done to confirm Legionella?
A 60 year old patient with a history of smoking and COPD presents with a cough, body aches, malaise, and fever x 3 days. Pulmonary exam is normal for this patient. What is the most concerning complication?
What is pneumonia?
The majority of pulmonary TB infections are clinically and radiographically...
What is inapparent
What is difference between incidence and prevalence?
Incidence: Number of new events in a defined population over a specific period of time
Prevalence: Proportion of people in a population who have some attribute or condition at a given point in time or during specific period
A 7 year old pt presents with acute onset of cough, fever, chills, and sputum production. Upon physical exam, you note increased tactile fremitus and dullness to percussion. What are 2 treatment options?
What is amoxicillin or macrolide
A 60 year old male smoker with a history of COPD is discharged from the hospital after 3 days of pneumonia treatment. He follows up a week later with you, his PCP. You should consider ordering what to rule out what? (2 answers)
CXR
Rule out malignancy/Document resolution
What is the most sensitive and specific diagnostic evaluation of Influenza?
DAILY DOUBLE
A pt presents with cough, fever, hemoptysis, and weight loss. He is diagnosed with reactivation of TB. What would a CXR show?
Upper lobe involvement- infiltrates and/or cavities
What are the 3 core functions of public health
Assessment, policy development, and assurance
25 year old patient presents to your clinic with a cough of 4 weeks, developing GI Issues, and a new rash. What are your 3 treatment option?
What are macrolides, fluoroquinolones, or tetracyclines
Pt presents after going tubing down the chip with a fever, muscle aches, and diarrhea. His friend told him it could be "Pontiac Fever." What is you suspected diagnosis (1 answer) and how could you confirm this (2nd answer)
What is legionella pneumonia
Sputum culture, CXR, or urine test (any)
Pt presents with fever, headache, myalgia, sore throat, and a cough. Pulmonary exam is unremarkable. What 2 treatments should be avoided?
What are antibiotics and cough suppressants
2 part question
Pt returns from vacation in China. They present with acute onset fever, cough, hemoptysis, and recent weight loss. What is the most rapid and inexpensive diagnostic tool for you suspected diagnosis?
What does this assess in relation to the Pt's lifestyle?
Acid-fast bacilli stain
It is important for assessing pt's infectiousness.
What is at the center of the 10 essential public health services?
Equity
A pt hospitalized for 4 days has an acute development of fever, leukocytosis, and increased sputum production. The pt was hospitalized due to COPD exacerbation. What diagnostic tool should be done (Probably redone at this point)
What are blood cultures- need to confirm etiology if it has changed
Taylor brings Grace into the local ER after she has an acute development of fever, cough, and increased sputum production. Taylor says she saw Grace pass out at The Bird Saturday and possibly puke. What should be Grace's treatment?
What is Clindamycin
67 year old patient with lymphoma presents with 3 days of congestion, cough, and fever. Upon physical examination, you notice the patient breathing rapidly. On auscultation, you note wheezing and crackles. What adjunct therapy may be useful?
What is Ribavarin?
A pt sees you in clinic for a skin test of TB. They had recently traveled to Eastern Europe. Their induration measured out to 12mm. What treatment would you recommend to this pt (if any) for highest compliance rate? (specific drugs)
Isoniazid and Rifampin- 3 months, daily
OR
Isoniazid and Rifapentine- 3 months, once weekly
Where is the only spot the Federal government has a defined role in public health?
The preamble- "General welfare"