Nu 67 EXAM-QUESTIONS AND ANSWERS
-a set of goals and objectives with 10year targets designed to guide national health promotion
and disease prevention efforts to improve the health of all people in the US
healthy people 2020
prevents the onset of disease/condition; e.g. vaccinations/seatbelts
primary prevention
identifies and treats asymptomatic people; e.g. screenings and identifying risk factors
secondary prevention
care of established disease and preventing complications
tertiary prevention
community wide approaches to prevent or reduce several diseases and conditions
HI-5
"EEE" sounds like "AHH" on auscultation; sound is distorted due to no O2 perfusion; consider
pneumonia
egophony
beats have weaker amplitude with respiratory inspiration, stronger with expiration; think COPD,
asthma, or pericardial disease
pulsus paradoxus
typically viral, but can be caused by bacteria such as bord atella pertussis, H. influenza, S.
pneumoniae
bronchitis
sudden onset in 12-24 hours without evidence of COPD, pneumonia, or asthma; cough is initially
dry but then turns productive and is worse at night; afebrile or lowgrade temp; malaise, HA,
chest burning/tightness, dyspnea, wheezing
bronchitis
characterized by purulent nasal excretion, post-nasal drip, sinus tenderness, cervical
lymphadenopathy, wheezes, rales, rhonchi, tahcypnea, injected pharynx, and tachycardia
bronchitis
, treatment methods include rest, fluids, room humidification, inhaler if bronchospasms present,
abx if specific organism identified, NOT mucolytics or antihistamines b/c they dry out airways
and exacerbate symptoms
bronchitis
treated with amoxicillin 500mg q8h OR bactrim BID
bronchitis
complications include MI, CHF of new onset up to 1 year after pt is hospitalized, arrhythmias,
and death
pneumonia
CXR is most definitive diagnosis; sputum culture and sensitivity with gram stain tells you
exactly what abx to prescribe; begin abx presumptively to decrease morbidity and can change
regimen if needed
pneumonia
urine tested to detect pneumococcal or legionella antigen; elevated PCT level indicates likely
bacterial etiology; CRP elevation while treating can indicate worsening or tx failure; PSI and
CURB65 used to identify who needs hospitalization
pneumonia
select empiric abx regimen that targets both typical pathogens and atypical pathogens
pneumonia
for patients without comorbidities and abx use, treat with azithromycin, clarithromycin,
doxycycline, amoxicillin-clavulonate, or cefpodoxime PLUS macrolide, or fluoroquinolone
monotherapy for 5-7 days
pneumonia
for patients with major comorbidities and/or have recently used abx, treat with fluoroquinolone
alone or combination therapy with beta-lactam PLUS macrolide or doxycycline for 5-7 days
pneumonia
empiric tx is mucinex, delsym, robitussin, and dextromethorophan; can move to inhaled
corticosteroids after OTC tx fails
cough/dyspnea
-a set of goals and objectives with 10year targets designed to guide national health promotion
and disease prevention efforts to improve the health of all people in the US
healthy people 2020
prevents the onset of disease/condition; e.g. vaccinations/seatbelts
primary prevention
identifies and treats asymptomatic people; e.g. screenings and identifying risk factors
secondary prevention
care of established disease and preventing complications
tertiary prevention
community wide approaches to prevent or reduce several diseases and conditions
HI-5
"EEE" sounds like "AHH" on auscultation; sound is distorted due to no O2 perfusion; consider
pneumonia
egophony
beats have weaker amplitude with respiratory inspiration, stronger with expiration; think COPD,
asthma, or pericardial disease
pulsus paradoxus
typically viral, but can be caused by bacteria such as bord atella pertussis, H. influenza, S.
pneumoniae
bronchitis
sudden onset in 12-24 hours without evidence of COPD, pneumonia, or asthma; cough is initially
dry but then turns productive and is worse at night; afebrile or lowgrade temp; malaise, HA,
chest burning/tightness, dyspnea, wheezing
bronchitis
characterized by purulent nasal excretion, post-nasal drip, sinus tenderness, cervical
lymphadenopathy, wheezes, rales, rhonchi, tahcypnea, injected pharynx, and tachycardia
bronchitis
, treatment methods include rest, fluids, room humidification, inhaler if bronchospasms present,
abx if specific organism identified, NOT mucolytics or antihistamines b/c they dry out airways
and exacerbate symptoms
bronchitis
treated with amoxicillin 500mg q8h OR bactrim BID
bronchitis
complications include MI, CHF of new onset up to 1 year after pt is hospitalized, arrhythmias,
and death
pneumonia
CXR is most definitive diagnosis; sputum culture and sensitivity with gram stain tells you
exactly what abx to prescribe; begin abx presumptively to decrease morbidity and can change
regimen if needed
pneumonia
urine tested to detect pneumococcal or legionella antigen; elevated PCT level indicates likely
bacterial etiology; CRP elevation while treating can indicate worsening or tx failure; PSI and
CURB65 used to identify who needs hospitalization
pneumonia
select empiric abx regimen that targets both typical pathogens and atypical pathogens
pneumonia
for patients without comorbidities and abx use, treat with azithromycin, clarithromycin,
doxycycline, amoxicillin-clavulonate, or cefpodoxime PLUS macrolide, or fluoroquinolone
monotherapy for 5-7 days
pneumonia
for patients with major comorbidities and/or have recently used abx, treat with fluoroquinolone
alone or combination therapy with beta-lactam PLUS macrolide or doxycycline for 5-7 days
pneumonia
empiric tx is mucinex, delsym, robitussin, and dextromethorophan; can move to inhaled
corticosteroids after OTC tx fails
cough/dyspnea
