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CARE - week 10 - pulm
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
2 mins
Influenza Virus
Characteristics
RNA Virus
Orthomyxovirus
Enveloped
Negative Sense
8 Segments
Helical
Hemagglutinin for Viral Entry
Neuraminidase for Virion Release
Genetic Shift
Reassortment of genome to cause major change
Genetic Drift
Minor Antigenic Mutations
Considerations
Reye Syndrome with Aspirin Use
Guillain-Barre Syndrome
3 mins
Haemophilus Influenzae Disease
Disease
Pneumonia
Cherry Red Epiglottitis
Meningitis
Otitis Media
COPD Exacerbation
Thumbprint Sign (on X-ray)
Treatment
Rifampin Prophylaxis
Ceftriaxone
2 mins
Haemophilus influenzae Characteristics
Characteristics
Gram-Negative
Coccobacilli
PRP Capsule in Type B
Positive Quellung Reaction
IgA Protease
Chocolate Agar
Factor V is NAD
Factor X is Hematin
Staph Aureus Provides Factor V
2 mins
Zanamivir (Relenza) and Oseltamivir (Tamiflu)
Indications
Influenza A and B
Treatment and Prophylaxis
Mechanism
Inhibits Release of New Virus
Inhibits Influenza Neuraminidase
1 min
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
2 mins
Parainfluenza Virus
Characteristics
Paramyxovirus
Signs and Symptoms
Croup
Barking Seal Cough
Inspiratory Stridor
Steeple Sign
2 mins
Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
1 min
Ethambutol
Mechanism of Action
Bacteriostatic
Blocks Arabinosyltransferase
Arabinosyltransferase Polymerizes Carbohydrates
Carbohydrate Polymers Make Mycobacterium TB Cell Wall
Side Effects
Red/Green Color Blindness
Reversible with Drug Discontinuation
40 secs
Rifampin
Tuberculosis (TB)
Blocks RNA Polymerization
Haemophilus influenzae Type B
Leprosy
Meningitis
P450 inducer
Red-orange urine
55 secs
Streptococcus Pneumoniae Characteristics
Characteristics
Gram-Positive
Diplococci
Lancet-Shaped
Catalase-Negative
Optochin-Sensitive
Bile Soluble
Alpha-Hemolytic
Polysaccharide Capsule
Positive Quellung Reaction
IgA Protease
1 min
Streptococcus Pneumoniae Disease
Signs and Symptoms
Sickle Cell Anemia
Sepsis in Patients with Splenectomy
Rusty Sputum
MOPS
Meningitis
Otitis Media
Pneumonia
Sinusitis
2 mins
Histoplasmosis
Fungi
2-5 um
Yeast Cells within Macrophages
Starling Bird Poop
Bat Poop
Caves
Mississippi and Ohio River Valleys
Pneumonia
Caseating Granuloma
Erythema Nodosum
1 min
Nocardia
Characteristics
Aerobic
Gram-Positive
Catalase-Positive
Urease-Positive
Acid Fast
Branching
Beaded Filament
AIDS/Immunocompromised
Soil
Signs and Symptoms
Lung Cavitation
Brain Abscess
Kidney Abscess
Treatment
TMP-SMX
2 mins
Actinomyces Israelii
Characteristics
Gram-Positive
Bacillus
Anaerobe
Branching
Oral Flora
Dental Work
Oral Trauma
Associated with IUDs
Signs and Symptoms
GU Infections
Draining Sinus Tract
Facial Abscess
Yellow Sulfur Granules
Treatment
Penicillin
2 mins
Cytomegalovirus (CMV)
Characteristics
Enveloped
Double Stranded DNA
Herpesvirus 5
Diagnosis
Non Heterophile Antibodies
Owl's eye inclusions
Signs and Symptoms
Congenital TORCH infection
Mononucleosis
Pneumonia
AIDS retinitis and esophagitis
Infection in transplant recipients
2 mins
Aspergillus fumigatus
Characteristics
Fungi
Monomorphic
Septate Hyphae
Branch at Acute Angles
Fruiting Bodies
Disease
Allergic Bronchopulmonary Aspergillosis (ABPA)
Eosinophilia
Increased IgE
Glucocorticoids +/- Azoles
Pulmonary Aspergillosis
TB Cavity
Lung Aspergilloma
Hemoptysis
Invasive Aspergillosis
AIDS/Immunocompromised
Chronic Granulomatous Disease
Hemorrhagic Infarction
Necrotizing Bronchopneumonia
Voriconazole +/- Caspofungin
3 mins
Pneumocystis jirovecii
Fungi
AIDS/Immunocompromised
Fever
Hypoxemia
Bronchoalveolar Lavage
Biopsy
Methenamine Silver Stain
Saucer/cup shaped yeast forms
Diffuse interstitial pneumonia CXR
TMP-SMX
Start prophylaxis when CD4 drops under 200
1 min
Cryptococcus neoformans
Characteristics
Monomorphic
Encapsulated
Polysaccharide Capsule
Narrow-Based Buds
Latex Agglutination
Pigeons
India Ink
Mucicarmine stain
Signs and Symptoms
AIDS/Immunocompromised
Meningitis
Soap Bubble Lesions in Brain
Pneumonia
Treatment
Fluconazole
Flucytosine
Amphotericin
3 mins
CN IX
Glossopharyngeal Nerve
Sensory
Taste from Posterior 1/3 of Tongue
Monitoring Carotid Body and Sinus
Motor
Stylopharyngeus
Swallowing
Salivation
1 min
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