how do you determine whether pt w/ community acquired PNA can be outpt, inpt, or ICU treated?
"CURB-65" Confusion Uremia (BUN >20) Respirations >30 BP 65yo
Oupt med treatments for healthy pt w/ community acquired PNA?
Macrolide (ie azithromycin, clarithromycin,etc) or doxy
Inpt med treatments for community acquired PNA?
Fluoroquinolone
OR
Beta-lactam + macrolide (ie azithromycin, etc)
Outpt med treatments for community acquired PNA pt w/ comorbid conditions (ie DM, malignancy, etc)?
Fluoroquinolone
OR
Beta-lactam + Macrolide
ICU med treatment for pt w/ community acquired PNA?
IV beta-lactam + macrolide
OR
Betalactam+ fluoroquinolone
dry cough and malaise 2mo w/ bilateral hilar adenopathy - think?
sarcoidosis
sarcoidosis due to?
noncaseating granulomatous inflammation
acute unilateral lymphadenitis in children - think what braod category causes?
bacterial infx
top 2 most common causes of acute unilateral lymphadenitis in kids?
- Staph a.
- Strep pyogenes (group A)
Anterior cerebral artery stroke clinical findings
- contralateral motor and/or sensory deficits more pronounced in lower extremities
- Urinary incontinence
- gait dyspraxia
- abulia (lack of will or initiative) and/or emotional disturbances
- primitive reflexes (babinski, grasp, suck, etc)
pt w/ R sided weakness worse in lower extremity, urinary incontinence, and pos babinski w/ full visual fields – what vessel stroke?
ant. cerebral artery
unilateral motor impairment w/ no visual field, sensory, or cortical (ie urinary incontinance) deficits - where is stroke?
lacunar infact at post. limb of internal capsule
contralateral motor and sensory deficits more pronounced in face or upper limb w/ homonymous hemianopia and aphasia - what vessel stroke?
middle cerebral artery stroke on Dominant lobe (bc aphasia)
*non dominant would have hemineglect or anosognosia
middle cerebral artery occlusion findings?
- contralateral somatosensory and motor deficit more pronounced in face and upper extremity
- conjugate eye deviation toward side of infarct
- homonymous hemianopia
- aphasia (dominant lobe) or hemineglect (non-dominant)
internal carotid artery supplies where in the brain?
anterior vasculature (inc ant and middle cerebral arteries)
occlusion of internal carotid artery findings?
contralateral impairments
- hemiplegia
- sensory
- visual
- language
- spacial
posterior cerebral artery stroke characterized by?
- homonymous hemianopia
- alexia w/o agraphia (dominent lobe; can’t read but can write)
- visual hallucinations
- sensory symp
- 3rd nerve palsy w/ paresis of vert and horizontal eye movements
- contralateral motor deficits
