Wilbur Lectures Block 3 Spring 2011

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Can you name the Wilbur Lectures Block 3 Spring 2011?

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Acute cough is less than __ weeks
Name a DDx for pulmonary TB.Bronchopulmonary aspergillus, Other pulmonary fungal infections
Latent TB is treated with 9 months of daily ________ plus Vitamin B6. Vitamin B6 reduces the risk of neuropathy from INH
Current recommendation for AECB is a short course of antibiotics such as ______.Typical pathogens are Haemophilus influenza, Strep pneumoniae, Moraxella catarrhalis
______ Exacerbation of Chronic Bronchitis (AECB): when there is increased sputum, dyspnea, and purulence of sputum. Common cause of mortality in patients with Chronic Bronchitis type COPD
Typically pediatric and viral as in RSV. Occurs in airways
_______ TB: symptoms vary by location, often mistaken for another illness.
A calcified pulmonary caseating granuloma in the lung from M. tuberculosis.
_____TB: another name for disseminated TB or widely extra pulmonary tubeculosis infection. Very serious with high mortality.
Greater than _____mm is considered positive for TB skin testing in California. This differs from CDC guidelines which list >15mm as positive in low risk patients.
Chronic lung disease leading to a permanent distortion of the lung architecture, usually secondary to infection. Imaging studies may show dilated and thickened medium sized bronchi. Characterized by daily cough and thick sputum production.
Acute Bronchitis is managed with _______ care. Antibiotics are not proven to be helpful.
Bacterial cause of Community Acquired Pneumonia (85% of the time)15% are caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella
A calcified complex involving a Ghon focus and an adjacent hilar lymph node.
Tachypnea, Low O2 saturation, inability to clear secretions, fever, dusky skin color are clinical warning signs of what?
What do you look for in Hospital Acquired Pneumonia?Can occur from aspiration, inhalation, or hematogenous causes
Vaccine from an attenuated M. bovis strain, somewhat effective for preventing miliary TB and TB meningitis. Currently in use in over 100 countries. Limited use in the US
Infective process from inhalation of oropharyngeal contents. Serious complication for hospital patients and patients in nursing homes or bedridden.
There are ____ million deaths a year from TB 1/3 of the world population is infected with TB.
Localized necrosis leading to a walled cavity. Characterized by a gradual onset of foul smelling sputum, cough, and fever. Can be a complication of aspiration pneumonia. Treat with antibiotics, including anaerobe coverage, surgical treatment for complicated cases
______ containing cough suppressants are very commonly prescribed in treating URI associated cough and bronchitis. Two formulations are Guiafenesin (Robitussin) and Promethazine
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Name a risk factor for Pneumonia. Comorbidities include asthma, cerebrovascular disease, COPD, chronic renal failure, CHF, diabetes, liver disease, neoplastic disease
Walking pneumonia. Bullous myringitis can be an indicator. Can lead to exanthems such as erythema multiforme. Slow onset. 5-20yo most common, ranges up to 40yo. Tx typically with a macrolide such as azithromycin or a tetracycline such as doxycycline.
Children less than ____yo are more likely to develop active TB after infection and disseminate TB when actively infected.
Acute inflammatory reaction from inhalation of gastric contents.
Robust cell wall and long life of TB bacteria contribute to _______ infectionRisk of infection is higher in small, enclosed areas, poor ventilation, or frequent/prolonged exposure
Non-opioid, local anesthetic type cough suppressant. Chemically related to ester local anesthetics such as procaine. Related to PABA. Do not use if patient is allergic to PABA. For adults only, do not use in pediatrics
_______ Disease: Tuberculous Spondylitis. Check several areas of spinal x-rays for tumors and infection.
Common ingredient in OTC cold and cough meds. Works in the medulla by acting on the cough center to reduce cough.NMDA agonist, also affects the serotonin reuptake pump. Can lead to serotinergic syndrome when combined with SSRI medications.
A person with active TB typically infects _____ other people. Transmited by droplet nuclei. Up to 3000 organisms per cough
Secondary prevention of TB is early _______ and treatment of active or latent TB
Primary prevention of TB is limiting the _____.
______ Bronchitis: typically viral and self limited. Mucus color generally not indicative of bacterial cause. Antibiotics not proven to be helpful. Manage with supportive care.
A cytokine-based immunoassay measuring cell-mediated immune responses to two M. tubeculosis cell proteins not found in BCG vaccine.
TB lymphadenopathy. Cutaneous TB that goes to the lymph nodes. Immune system has a hard time slowing this down.
______ TB can occur in 25% of pulmonary TB cases. Difficult to diagnose.
Name a risk factor for Aspiration Pneumonia.
The rate of TB cases in California is ____ per 100,0002472 cases in 2009. 75% were foreign born.
Name a risk factor for Hosptial Acquired Pneumonia.
Name a risk for TB progression from latent to active TB Other medical conditions such as silicosis, diabetes mellitus, chronic renal failure, gastrectomy, jejunoileal bypass, solid organ transplant
_________ TB has insidous onset: cough, phlegm, weight loss, malaise, night sweats.
Name an advantage of Interference-Gamma Release Assay (Quantiferon TB-Gold)Cons are higher cost; Inadequate data for pregnant women, immunosuppressed or HIV infected patients, pediatric patients.

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