AANP board certification exam
how long will a cough last for acute bronchitis?
up to three weeks is completely normal
how do you treat acute bronchitis?
95% cases are viral-- tessalon pearls to help with cough. * prednisone is never
the answer **
explain the following views of chest xrays: AP, PA, PA and lateral
which one do you want for pneumonia patient?
AP- shows the heart predominantly because its from front to back
PA- shows the lungs predominantly because its back to front
lateral shows fluid line
what is the gold standard for diagnosing community acquired pneumonia
chest xray- PA/lateral, repeat post treatment in 6 weeks (repeat not really done
anymore)
treatment guidelines for CAP- healthy adult no comorbidities
MAD LUNG
amoxicillin 1 gram TID (best choice)
doxycycline 100 mg twice daily
macrolide (mycin) in areas with low macrolide resistance so not the best choice
treatment guidelines for CAP- adult with comorbidities
monotherapy: respiratory quinolone (levofloxacin 750 mg daily)
combination therapy: augmentin or cephalosporin PLUS macrolide or doxy
, what are common respiratory fluroquinolones?
Think FLOXACIN-- moxifloxacin, gemifloxacin, levofloxacin
what are common macrolides for CAP
think "MYCIN" -- azithromycin, clarithromycin
what are common tetracyclines for CAP
doxycycline
what are common beta lactams for CAP
amoxicillin, augmentin (amox with clav), cefpodoxime, cefuroxime
how would you treat a pregnant 29 year old with pneumonia?
Amoxicillin 1 g TID-- cant give levaquine (flouroquinolones no in pregnancy due
to fetal ligament destruction, doxycycline no in pregnancy stains tooth bones in
fetus)
how long do you give antibiotics to patient with pneumonia?
5-10 days, you always want to continue antibiotics for 3 more days after clinically
stable (no fever)
When do you get a chest xray for pneumonia?
it is the gold standard for diagnosis, you do not need to do resolution chest xray
unless things are lingering or you suspect something else.
When do you give pneumococcal vaccine?
adults > 65 years old you give PPSV23 or you can give both PCV 13 and
PPSV23 but must be 1 year apart
adults > 65 with immunocompromising condition give both pcv 13 and ppsv23
how long will a cough last for acute bronchitis?
up to three weeks is completely normal
how do you treat acute bronchitis?
95% cases are viral-- tessalon pearls to help with cough. * prednisone is never
the answer **
explain the following views of chest xrays: AP, PA, PA and lateral
which one do you want for pneumonia patient?
AP- shows the heart predominantly because its from front to back
PA- shows the lungs predominantly because its back to front
lateral shows fluid line
what is the gold standard for diagnosing community acquired pneumonia
chest xray- PA/lateral, repeat post treatment in 6 weeks (repeat not really done
anymore)
treatment guidelines for CAP- healthy adult no comorbidities
MAD LUNG
amoxicillin 1 gram TID (best choice)
doxycycline 100 mg twice daily
macrolide (mycin) in areas with low macrolide resistance so not the best choice
treatment guidelines for CAP- adult with comorbidities
monotherapy: respiratory quinolone (levofloxacin 750 mg daily)
combination therapy: augmentin or cephalosporin PLUS macrolide or doxy
, what are common respiratory fluroquinolones?
Think FLOXACIN-- moxifloxacin, gemifloxacin, levofloxacin
what are common macrolides for CAP
think "MYCIN" -- azithromycin, clarithromycin
what are common tetracyclines for CAP
doxycycline
what are common beta lactams for CAP
amoxicillin, augmentin (amox with clav), cefpodoxime, cefuroxime
how would you treat a pregnant 29 year old with pneumonia?
Amoxicillin 1 g TID-- cant give levaquine (flouroquinolones no in pregnancy due
to fetal ligament destruction, doxycycline no in pregnancy stains tooth bones in
fetus)
how long do you give antibiotics to patient with pneumonia?
5-10 days, you always want to continue antibiotics for 3 more days after clinically
stable (no fever)
When do you get a chest xray for pneumonia?
it is the gold standard for diagnosis, you do not need to do resolution chest xray
unless things are lingering or you suspect something else.
When do you give pneumococcal vaccine?
adults > 65 years old you give PPSV23 or you can give both PCV 13 and
PPSV23 but must be 1 year apart
adults > 65 with immunocompromising condition give both pcv 13 and ppsv23
