Vsr levels for lung pathology
T1-T7
TB symptoms
Fever, night sweats, cough, hemoptysis
active tuberculosis tx
RIPE therapy for first 2 months => rifampin, isoniazid, pyrazinamide, ethambutol
- after 2 months, if tb is fully susceptible to R and I, P and E can be stopped
- R and I continued daily or intermittent for 4 more months
Outpatient management of community acquired pneumonia
Azithromycin
- New regimen for latent tuberculosis for pts 12+ y/o at risk of developing active TB
- Who else may use this?
- Isoniazid 900 mg + rifapentine 900 mg 1x weekly for 3 months
- pts with HIV who r otherwise healthy and not taking retrovirals
Who is at high risk for developing active TB?
- ppl w recent exposure to contagious TB
- conversion from - to + on a test for TB infection
- chest radiograph indicating prior TB
Most commonly used tx for latent TB
Isoniazid daily for 9 months
How to dx latent TB
By a positive protein purified derivative (PPD) test
Other option if a pt is unable to tolerate isoniazid therapy for latent TB
Rifampin for 4 months
TB typically presents in what pts?
- immunocompromised
- pts from or traveling to developing countries
3 typical bacterial pathogens that cause community acquired pneumonia
- streptococcus penumoniae
- haemophilus influenzae
- moraxella catarrhalis
Drug of choice for suspected s. Aureus pneumonia
Vancomycin
S. Aureus pneumonia usually presents with
Recent upper respiratory tract infection and/or an immunocompromised state
Sputum gram stain of streptococcus pneumonia shows
Gram positive (blue) cocci in chains
Sputum grain stain of haemophilus influenza shows
Gram negative (red) coccobacillus
Klebsiella pneumoniae community acquired pneumonia occurs primarily in ____
Chronic alcoholics
What will the sputum gram stain of the following show?
- Klebsiella pneumoniae
- Moraxella catarrhalis
- Staphylococcus aureus
- Haemophilus influenza
- streptococcus pneumoniae
- gram - (red) rod
- gram - (red) diplococci
- gram + (blue) cocci in clusters
- gram - (red) coccobacillus
- gram + (blue) cocci in chains
Most common cause of community-acquired pneumonia?
Streptococcus pneumonia
Virus common in SW USA/Grand canyon area
hantavirus (gives ARDS)
Organisms commonly found in Ohio + Mississippi River Valleys area (2)
Blastomyces dermatidis (fungal) (also in Great Lakes area) Histoplasma capsulatum (fungal)
1 cause of AIDS associated meningitis
Cryptococcus neoformans (yeast)
How to dx cryptococcus neoformans
With an India ink stain in a CSF sample
- Common cause of cough, fever, and respiratory distress with wheezing and hyper-inflated lungs in infants during winter
- DOC to tx
- Respiratory syncytial virus
(This causes cold-like symptoms in older siblings and adults, but since infants have smaller bronchiole sizes the virus-induced inflammation can cause respiratory distress) - ribavirin
Lambert-Eaton myasthenic syndrome
- morning weakness that is relieved with repeated stimulation
- paraneoplastic condition
- antibody binds calcium channels on the pre-synaptic membrane => prevents release of acetylcholine
