Cough

Question 1

What are the 4 stages of bacterial pneumonia?

Answer 1

• Congestion
• Red hepatization (consolidation)
• Grey hepatization
• Resolution (complete recovery)

Question 2

What is Tactile Fremitus?

Answer 2

• Vibration felt on patient’s chest during low frequency vocalization
• Increased over areas of consolidation
• Absent w/ effusion or pneumothorax

Question 3

How does Bronchial Obstruction present?

Answer 3

• Absent breath sounds
• Decreased percussion
• Tracheal deviation

Question 4

How does Pneumothorax present?

Answer 4

• Decreased breath sounds
• Hyperresonate to percussion
• Tracheal deviation away from side of lesion

Question 5

How does Asthma present?

Answer 5

• Hyperresonate to percussion
• Wheezing

Question 6

What is the most common bacterial pneumonia?

Answer 6

Streptococcus Pneumoniae

Question 7

How are these etiologies differentiated?

• Bacterial pneumonia
• Wheezing
• Barky cough
• Sore throat, myalgia
• Rash in May

Answer 7

• Bacterial pneumonia
  
  • Fever, cough, tachypnea
• Wheezing
  
  • Viral or asthma
  • RSV/parainfluenza in winter
• Barky cough
  
  • Croup
• Sore throat, myalgia
  
  • Influenza
• Rash in May
  
  • Viral

Question 8

How are these differentiated?

• CAP
• Sinusitis
• Bronchitis
• Influenza

Answer 8

• CAP
  
  • Cough, SOB, Fever, Abnormal lung exam
• Sinusitis
  
  • Day & night cough, fever, sinus tenderness, post-nasal drip
• Bronchitis
  
  • Pediatrics, reactive airway disease, wheezing, afebrile, cough
• Influenza
  
  • Sudden onset, high fever, myalgia, cough, sore throat, seasonal

Question 9

How do you treat CAP in….?

• Outpatient young child
• Outpatient adolescent
• Inpatient young child

Answer 9

• Outpatient young child
  
  • Amoxicillin
• Outpatient adolescent
  
  • Azithromycin
• Inpatient young child
  
  • **Ampicillin or Cephalosporin **
  • **+ Azithromycin **

Question 10

What are the 3 distinct stages of whooping cough?

Answer 10

• Catarrhal
• Paroxysmal
• Convalescent