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Pulmonary Infections C. Richard Finley, Ed.D, PA-C Associate Professor Physician Assistant Department College of Allied Health & Nursing Nova Southeastern University
Objectives ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
A 44-year-old male presents to your office complaining of a “bad cough” for the past 3-4 weeks. Over the past several days he has developed a low-grade fever, chills, and night sweats. Physical exam is notable for cachexia, hypoxia, and bilateral rales with scant hemoptysis. Which of the following is the most likely diagnosis? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanics of Pulmonary Infections ,[object Object],[object Object],[object Object]
[object Object],[object Object]
Symptoms of Pulmonary Infections
Which of the following is a hallmark symptom of bronchitis? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pneumonia   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tuberculosis   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute Bronchitis ,[object Object],[object Object],[object Object]
Causes of Pulmonary Infections
Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tuberculosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Influenza ,[object Object],[object Object]
Acute Bronchitis ,[object Object],[object Object],[object Object]
A 35-year-old male presents to the clinic with complaints of a sore throat and a “harsh cough with chest congestion” over the past 3-5 days.  He relates slight yellowish sputum production.  Which of the following would confirm your suspicions? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosing Pulmonary Infections
Pneumonia   ,[object Object],[object Object]
Tuberculosis   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Influenza   ,[object Object],[object Object],[object Object],[object Object]
Acute Bronchitis ,[object Object],[object Object]
Treating Pulmonary Infections
Your 30-year-old male patient is a household member of a patient being treated for active TB.  Which of the following is an acceptable treatment regimen? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pneumonia ,[object Object],[object Object],[object Object]
Tuberculosis   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Influenza   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute Bronchitis ,[object Object],[object Object],[object Object],[object Object],[object Object]
A b-lactam 7 ; vancomycin plus a respiratory fluoroquinolone 1 ; or an advanced macrolide 3   An antipseudomonal agent 10  plus ciprofloxacin; an antipseudomonal agent 8  plus a respiratory fluoroquinolone 1 ; or an advanced macrolide 3   ICU therapy      Pseudomonas  not an issue      Pseudomonas  a concern  A respiratory fluoroquinolone, 1  or an advanced macrolide 3  plus a b-lactam 7   A respiratory fluoroquinolone, 1  or an advanced macrolide 3  plus a b-lactam 7   Inpatient therapy      No recent antibiotics       Antibiotic therapy within 3 mo Amoxicillin-clavulanate 8  or clindamycin 9   A b-lactam 7  or a respiratory fluoroquinolone 1   Suspected aspiration pneumonia       Influenza with suspected bacterial superinfection  A respiratory fluoroquinolone 1  or an advanced macrolide 3   A respiratory fluoroquinolone, 1  or an advanced macrolide 3  plus a b-lactam 7   Comorbidities 6       No recent antibiotics       Antibiotic therapy within 3 mo  A respiratory fluoroquinolone, 1  a macrolide, 2  or doxycycline  A respiratory fluoroquinolone 1  alone; an advanced macrolide 3  plus high-dose amoxicillin 4 ; or high-dose amoxicillin-clavulanate 5   Outpatient therapy      Previously healthy      Antibiotic therapy within 3 mo  Preferred Treatment Options   Clinical Variables/Settings
Which of the following does not significantly increase an individual’s risk for developing tuberculosis? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Note: all superscript numbers in table refer to footnotes below: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Th4 Finley Pulm Infections 08 2

  • 1. Pulmonary Infections C. Richard Finley, Ed.D, PA-C Associate Professor Physician Assistant Department College of Allied Health & Nursing Nova Southeastern University
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15. Causes of Pulmonary Infections
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 22.
  • 23.
  • 24.
  • 25.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32. A b-lactam 7 ; vancomycin plus a respiratory fluoroquinolone 1 ; or an advanced macrolide 3 An antipseudomonal agent 10 plus ciprofloxacin; an antipseudomonal agent 8 plus a respiratory fluoroquinolone 1 ; or an advanced macrolide 3 ICU therapy      Pseudomonas not an issue      Pseudomonas a concern A respiratory fluoroquinolone, 1 or an advanced macrolide 3 plus a b-lactam 7 A respiratory fluoroquinolone, 1 or an advanced macrolide 3 plus a b-lactam 7 Inpatient therapy      No recent antibiotics       Antibiotic therapy within 3 mo Amoxicillin-clavulanate 8 or clindamycin 9 A b-lactam 7 or a respiratory fluoroquinolone 1 Suspected aspiration pneumonia       Influenza with suspected bacterial superinfection A respiratory fluoroquinolone 1 or an advanced macrolide 3 A respiratory fluoroquinolone, 1 or an advanced macrolide 3 plus a b-lactam 7 Comorbidities 6      No recent antibiotics       Antibiotic therapy within 3 mo A respiratory fluoroquinolone, 1 a macrolide, 2 or doxycycline A respiratory fluoroquinolone 1 alone; an advanced macrolide 3 plus high-dose amoxicillin 4 ; or high-dose amoxicillin-clavulanate 5 Outpatient therapy      Previously healthy      Antibiotic therapy within 3 mo Preferred Treatment Options Clinical Variables/Settings
  • 33.
  • 34.
  • 35.