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PATHOGEN CHARACTERISTICS FOR PNEUMONIA PULMONARY NEOPLASMS INTERSTITIAL LUNG DISEASE OCCUPATIONAL LUNG DISEASES 100% VERIFIED!!
Most common cause of bacterial pneumoniaRust-colored sputum Streptococcus Pneumoniae Purulent sputum, sometimes greenHib vaccination available for children Haemophilus Influenzae High risk of complications - necrotizing pneumonia, abscess, sepsis, shock, bacteremia.Most common in long term care residents and IV drug users Can be caused from MRSAStaphylococcus Aureus
Bulging fissure sign on CXRCurrent jelly sputum High rate of ABX resistanceMost commonly seen in alcohol use disorders Klebsiella Pneumoniae
GI symptoms and confusion History of contact with contaminated water suppliesUrine antigen testing available Legionella Pneumophilia Most common cause of atypical pneumoniaCold agglutinins may be positive Often midler in severityMycoplasma Pneumoniae
Often starts with flu-like symptoms: pharyngitis, laryngitis, sinusitis.Cough with inspiration between each single breath = staccato cough Chlamydia Pneumoniae Purulent sputum, sometimes green or aquamarine.Most common in hospitalized pts or those with structural lung abnormalities like cystic fibrosis/bronchiectasis/COPDPseudomonas Aeruginosa
What is the most common pneumonia-causing virus seen in kidsRespiratory Syncytial virus (RSV)
What are the three categories of people for which the Pneumococcal vaccination isrecommended for?
- All healthy children
- All adults 65 or older
- Adults 19-64 with increased risk of disease
This pneumococcal vaccine stimulates a weaker immune response and is less effectivein young children and eldery. It is 23-valent formulations. What is it commonly referredto as?
Polysaccharide VaccinePneumovax
This pneumococcal vaccine stimulates a stronger immune response and is effective ininfants, young children, and elderly. It is 13,15, and 20-valent formulations. What is itcommonly referred to as?
Conjugate VaccinePrevnar
For the pneumococcal adult vaccine schedule which vaccine is preferredPCV-20 alone
For the pneumococcal adult vaccine schedule, if the patient received the PCV15vaccine, what would they get next? PPSV23 1 year later Which carcinoma is mainly associated with smoking and asbestos is the most commonoccupational risk factor Bronchogenic Carcinoma Which carcinoma is the most common type of lung cancer in non-smokers. it is oftenseen in the upper lobe and in the peripheral lung Adenocarcinoma (NSCLC) Which carcinoma is strongly associated with smoking and is usually central located andis the most common type of lung cancer is cavitate Squamous Cell Carcinoma (NSCLC) Which carcinoma is almost always in smokers and is related to to neuroendocrinecarcinoma and generally begins centrally and spreads submucosally Small Cell Carcinoma (SCLC)
Surgery +/- chemo and radiation in selective patients - Lobectomy For most patients with advanced NSCLC that can't be treated with a targeted therapy(i.e. without driver mutations), what is often the preferred initial treatment? Immunotherapy +/- chemotherapy What is first line treatment for certain patients with stage III or stage IV (metastatic)NSCLC Immunotherapy What is the treatment for SCLC?Chemotherapy - usually cisplatin/etoposide NO SURGERY!!!!!
What is organ dysfunction related to immune-mediated or secretory effects ofneoplasms (hormone production). Seen much more with SCLC Paraneoplastic Syndromes What is referred to as a "coin lesion" sitting in the middle of the lung and is a roundedopacity often <3cm in diameter
Solitary Pulmonary Nodule To determine the probability of malignancy you often look at the rate of progression ordoubling time. What are the parameters that make a malignancy unlikely? <30 days or >465 days of a solid nodule
What type of malignancy risk is there for: Young Age Less or no smoking Small nodule Regular margins Location not in upper lobe Low Risk What type of malignancy risk is there for: Older Age
What type of cancer is associated with asbestos exposure and is NOT associated withsmoking. Arises from malignancy in the pleural cavity Mesothelioma What is the main source of asbestos exposureShipyard Work
What is usually the definitive diagnosis procedure for mesothelioma?VATS - video assisted thoracoscopic surgery
What is the first line treatment for mesotheliomaChemotherapy - cisplatin and pemetrexed
What refers to a pattern of disease, not a diagnosis. It can be associated withautoimmune/connective tissue disease? If no cause is identified, its termed idiopathicpulmonary fibrosis (IPF)
Usual Interstitial Pneumonia (UIP) This lung issue will normally present with a gradual onset of dyspnea and dry cough; onexam clubbing could be seen; on HRCT you will see honeycombing
UIP/IPF (Usual Interstitial Pneumonia/Idiopathic pulmonary fibrosis) What is the treatment for UIP/IPFAntifibrotic agents - nintedanib (Ofev) and pirfenidone (Esbriet)
What type of lung disease is characterized by rapid onset and rapid progression torespiratory failure and ARD Acute Interstitial Pneumonia (AIP) What type of lung disease is characterized by subacute dyspnea and cough over months(gradual onset) and often idiopathic etiology Non-specific interstitial pneumonia (NSIP) What type of lung disease is smoking-related and often asymptomatic. Treatment issmoking cessation and steroids if no improvement Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) What type of lung disease has a presentation of flu-like illness, dyspnea, dry cough,fever, malaise, wt loss Cryptogenic Organizing Pneumonia
"Ferruginous body" What occupational lung disease is a form of pulmonary fibrosis caused by inhalation ofcrystalline silica; stonecutting, sandblasting, mining at risk Silicosis What is the main clinical feature of silicosis on HRCT? Where in the lung does silicosispresent normally? Eggshell pattern (calcified hilar nodes)Upper Lobes
What can provide symptomatic relief for pts with silicosis?Whole-lung lavage
What is an associated risk with Silicosis? Tuberculosis - all pts should get TB test and CXR
What type of occupational lung disease is seen in anthracite miners and has potential toprogress to progressive massive fibrosis (PMF)? Where in the lung is this located? Coal Worker's Pneumoconiosis (CWP)
Upper lung zone What is a rare condition in coal workers with rheumatoid arthritisCaplan Syndrome
What type of occupational lung disease presents with small, nodular densities sparingthe apices and bases (in the mid lung) and exposure comes from inhaled organicantigens? On lab findings there will be an increased WBC count with a left shift Hypersensitivity Pneumonitis (farmer's lung)
