Term
| incidence 1st headache during pregnancy |
|
Definition
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|
Term
| inicidence of headaches in pregnancy |
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Definition
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|
Term
| who has higher risk of headaches, primip or multip |
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Definition
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|
Term
| when to get imaging for a headache - 8 |
|
Definition
| sudden onset without history, >50yo and new, accelerating, worse supine, thunderclap, systemic sx (fever, rash, stiffness), cancer, neuro symptoms |
|
|
Term
| what are concerning neuro symptoms with a headache 4 |
|
Definition
| papilledema, CN palsy, change in senses, weakness |
|
|
Term
| 3 reasons you could consider imaging for a headache but it isn't emergent |
|
Definition
| nausea, vomiting, change in character |
|
|
Term
| CT is best for imaging what in the head - 2 |
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Definition
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|
Term
| MRI is best for imaging what in the head - 4 |
|
Definition
| vascular, temporal lobe, brainstem, spinal cord |
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|
Term
| incidence of migraines in lifetime |
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Definition
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|
Term
| how do migraines change in pregnancy |
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Definition
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|
Term
| characteristics of a common migraine - 5 |
|
Definition
| no aura, 4-72h, pulsing, increased with activity, possible photo/phonophobia |
|
|
Term
| characteristics of a classic migraine - 2 |
|
Definition
| aura up to 60min before, neuro symptoms |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| % of migraines that have trigger |
|
Definition
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|
Term
| % of migraines that have nausea and vomiting |
|
Definition
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|
Term
| criteria for diagnosis of a migraine |
|
Definition
need 1 - unilateral, pulsing, mod-severe, increased with activity.
need 1 - nausea, vomiting, photo, phonophobia |
|
|
Term
| initial treatment of migraine - 2 |
|
Definition
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|
Term
| acute treatment options for migraine - 3 |
|
Definition
| ergot, antiemetic, triptan |
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|
Term
| treatment of an intractable migraine - 1 |
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Definition
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|
Term
| ppx options for migraine - 6 |
|
Definition
| BB, TCA, CCB, anticonvulsant (topomax, gabapentin), breastfeeding for up to 6mo |
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|
Term
|
Definition
| decrease vasoconstriction |
|
|
Term
| contraindications for triptans - 5 |
|
Definition
| CVD, HTN, PVD, CVA, relative pregnancy |
|
|
Term
|
Definition
| flishing, dizziness, paresthesia of chest and jaw |
|
|
Term
| are triptans ok in pregnancy |
|
Definition
| yes studies show no harm, 15% crosses the placenta |
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|
Term
| average age tension headache and gender |
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Definition
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|
Term
| risk factor for tension headache - 2 |
|
Definition
| FHX, cervical spine issues |
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|
Term
| treatment tension headache - 3 |
|
Definition
| NSAID, Tylenol, PT for neck |
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|
Term
| menstural migraines are aka |
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Definition
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|
Term
| cause of menstural migraines |
|
Definition
| decrease in estrogen 2d before to 3d after start of bleeding |
|
|
Term
| incidence of menstrual migraines |
|
Definition
| 50% of women with migraines report this as a trigger |
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|
Term
| treatment of acute menstrual migraines |
|
Definition
| treat like acute regular migraine, ergot, antiemetic, triptan |
|
|
Term
| prevention of menstrual migraines - non-hormonal - 2 |
|
Definition
| naproxen 500mg BID 7 before to 13d after bleeding, triptan 2d before to 6d after bleeding |
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|
Term
| prevention of menstrual migraines - hormonal birth control - 3 |
|
Definition
| extended cycle OCPs, regular OCPs with 0.9mg E3 daily instead of placebo, E2 patch 0.1mg 1d before to 8d after bleeding |
|
|
Term
| prevention of menstrual migraines - hormonal, bigger than birth control - 2 |
|
Definition
| tamoxifen 10-20mg 7-14d before and 5-10mg 3d during period. Lupron rergular dosing |
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|
Term
| percent of brain tumors that cause headache |
|
Definition
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|
Term
| signs of a brain tumor headache- 5 |
|
Definition
| BL frontal, progressive, throbbing, daily, papilledema in 40% |
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|
Term
| cause of a brain tumor headache - 5 |
|
Definition
| lung 65%, breast 15%, melanoma 5%, colorectal 3%, hydronephroma 2% |
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|
Term
| incidence of post-dural headache |
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Definition
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|
Term
| cause of post-dural headache |
|
Definition
| CSF leaks out causing decreased pressure in subarachnoid space |
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|
Term
| signs of a spinal headache - 7 |
|
Definition
| 12-24h after epidural, lasting days to months, worse when standing, nausea, vomiting, frontal/occipital, changes in heading |
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|
Term
|
Definition
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|
Term
| treatments for spinal headache with low but possible success - 4 |
|
Definition
| IVF, caffeine, laying down, analgesics |
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|
Term
| treatment for spinal headache with good success |
|
Definition
| blood patch 30cc 70% success |
|
|
Term
| characteristics of a patient who has pseudotumor cerebri - 3 |
|
Definition
| female 90%, obese 90%, 30yo |
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|
Term
| signs of a pseudotumor cerebri headache - 6 |
|
Definition
| pulsing, daily, 90% papilledema, 70% visual changes, 60% hear noise, 20% VI palsy |
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|
Term
| why get an MRI if pseudotumor cerebri - 2 |
|
Definition
| rule out cortical venous thrombosis and posterior fossa lesion |
|
|
Term
| diagnosis of pseudotumor cerebri |
|
Definition
| elevated opening spinal pressure |
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|
Term
| risk for subarachnoid hemorrhage |
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Definition
|
|
Term
| signs of a subarachnoid hemorrhage - 5 |
|
Definition
| gradually increasing headache, nausea/vomiting, focal neurological symptoms, stiff neck, syncope |
|
|
Term
| diagnosis of subarachnoid hemorrhage - 2 |
|
Definition
| LP with have xanthrocromia, CT with 95% sens in 1d (decreasing each day tho) |
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|
Term
| cause of subdural hematoma |
|
Definition
| 1% from head injury, 50% no injury |
|
|
Term
| signs of subdural hematoma - 3 |
|
Definition
| dull thrombbing, 50% with change in level of consciousness, focal neuro symptoms |
|
|
Term
| diagnosis of subdural hematoma |
|
Definition
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|
Term
| causes of headache that are increased during pregnancy - 3 |
|
Definition
| pseudotumor cerebri, central venous thrombosis, accelerated growth of brain tumors |
|
|
Term
| how long does the common cold last |
|
Definition
| 1-1.5wk, add 2-3d for smokers |
|
|
Term
| how many times does the typical person get a common cold in 1y |
|
Definition
|
|
Term
| what forms of steroids come nasal - 2 |
|
Definition
| fluticasone, beclomethasone |
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|
Term
| what are the 1st generation antihistamines - 2 |
|
Definition
| diphenyhydramine, hydroxyzine, chlorphenirnamine |
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|
Term
| what are the 2nd generation antihistamines - 3 |
|
Definition
| loratadine, certrizine, azelastine |
|
|
Term
| what is the antihistamine that comes in a nasal spray |
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Definition
|
|
Term
| what is the anticholinergic nasal spray |
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Definition
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|
Term
| % of sinusitis that is bacterial |
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Definition
|
|
Term
| bacteria that cause sinisutis - 2 |
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Definition
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|
Term
| sinusitis onset, peak, duration |
|
Definition
| onset in 2-3d, peak 3-5d, duration 7d |
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|
Term
| signs sinusitis is bacterial - 6 |
|
Definition
| fever >101, >10d, pain >3d, worsening, new fever after onset, real purulence |
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|
Term
| indications for a CT in sinusitis - 3 |
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Definition
| recurrent, resistant to antibiotics, concern for malignancy |
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|
Term
| signs of sinusitis on CT - 3 |
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Definition
| mucosal thickening, air fluid levels, complete opacitifcation |
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|
Term
| define acute, subacute, chronic, recurrent sinusitis |
|
Definition
| acute <4d, subacute 4d-12wk, chronic 12wk+, recurrent 3x/y |
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|
Term
| initial treatment for sinusitis, non bacterial - 4 |
|
Definition
| humidification, saline rinse, mucolytics, intranasal steroids (take 1-2wk to work) |
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|
Term
| treatment for bacterial sinusitis - initial, alt, alt |
|
Definition
| amoxicillin-clavulonic acid, doxycycline, fluoroquinolone - 5-7d |
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|
Term
| % of otitis media in adults |
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Definition
|
|
Term
| bugs causing bacterial otitis medial - 3 |
|
Definition
| s. pneumo, H. flu, moraxella |
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|
Term
| risk factors for adult otitis media - 4 |
|
Definition
| GERD, SAR, URI, facial abnormalities |
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|
Term
| complications of adult otitis media - 6 |
|
Definition
| mastoiditis, labrynthitis, hearing loss, meningitis, facial paralysis, brain abscess |
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|
Term
| otitis media treatment, alt, alt, alt |
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Definition
| amoxicillin (10% fail), amoxicillin clavulonic acid, ceftriaxone, clindamycin |
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|
Term
| causes of rhinitis that are not acute/URI stuff - 10 |
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Definition
| afrin/neo-synephrine rebouond, intranasal cocaine, A blockers, BB, risperidone, ACEI, ED drugs, facial abnormalities, atopic, wegners, sarcoid |
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|
Term
|
Definition
| new onset cough (esp PMP smoker), weight loss, dyspnea, chest pain, hemoptysia, dysphagia, hoarsness, SVC syndrome (face and UE swelling) |
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|
Term
| initial work up if concen for lung cancer |
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Definition
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|
Term
|
Definition
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|
Term
| causes of chronic couogh - 6 |
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Definition
| GERD, post-nasal drip, asthma, COPD, SAR, sinusitis, medications |
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|
Term
| work up for chronic cough |
|
Definition
| 1 - stop ACI for 3mo, 2 - CXR and spirometry, 3 - empiric TX for GERD if any symptoms, 4 - bronchoprovication challenge, 5 - empiric TX for GERD |
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|
Term
|
Definition
| airflow limitation due to inflammatory response |
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|
Term
|
Definition
| enlarge airspace distal to terminal bronchioles with wall destruction and fibrosis |
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|
Term
| incidence of asthma in pregnancy |
|
Definition
|
|
Term
| prognosis of asthma in pregnancy |
|
Definition
| 30% worsen, 30% get better |
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|
Term
|
Definition
| testing for asthma, FEV1 <80% with >12% improvement with SABA |
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|
Term
|
Definition
| monitoring symptoms of asthma, not diagnosis |
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|
Term
| what is mild intermittent asthma - 4 |
|
Definition
| <2d/wk, <2night/mo, SABA <2d/wk, FEV1 >80% |
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|
Term
| what is mild persistant asthma - 4 |
|
Definition
| 3-6d/wk, 3-6 night/mo, SABA 2-6d/wk, FEV1 >80% |
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|
Term
| what is moderate persistent asthma - 4 |
|
Definition
| daily symptoms, nightly symptoms, SABA daily, FEV1 >60% |
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|
Term
|
Definition
| moderate persistent with FEV1 <60% |
|
|
Term
| SABA - how long does it work, side effect |
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Definition
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|
Term
| examples of inhaled steroids - 5 |
|
Definition
| beclomethasone, budesonide, triamcinolone, fluticasone, flunislide |
|
|
Term
| complications of inhalted steroids - 3 |
|
Definition
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|
Term
|
Definition
|
|
Term
| steroid regimens for severe asthma - 2 |
|
Definition
| prednisone 40-60m/d PO, IV solumedrol 80mg q8h |
|
|
Term
| what is the asthma yellow zone, management |
|
Definition
| FEV1 50-80%, increase or add a medication |
|
|
Term
| what is the asthma red zone, management |
|
Definition
| FEV1 <50%, O2 if <92%, albuterol q2h, ipratropium vent, CXR/ABX if infection concern |
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|
Term
| what is a sign you need to intubate an asthmatic |
|
Definition
| pCO2 is normal youre almost there, pCO2 is high then intubate |
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|
Term
| when should you hospitalize in asthma - 3 |
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Definition
| pCO2 normal to high, peak flow <40%, not improving in 4-6h |
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|
Term
| what is theophylline used for |
|
Definition
| can be alternative to adding inhaled steroid or LABA in asthma, watch out can be toxic |
|
|
Term
| what asthma medication should be avoided in pregnancy - 3 |
|
Definition
| throphylline, Montelukast, zafirlukast |
|
|
Term
| what asthma medication can you add if someone has allergies |
|
Definition
|
|
Term
| what is the asthma O2 goal in pregnancy |
|
Definition
|
|
Term
| what are the complications of asthma in pregnancy - 4 |
|
Definition
| PTD, pre-e, IUGR, increased MM |
|
|
Term
| what are the signs you need to intubate a pregnant asthmatic - 2 |
|
Definition
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|
Term
| what asthma conditions indicated increased risk of death - 12 |
|
Definition
| history of ICU admission, intubation, sudden onset attack, 2+ admits in 1y, 3+ ER visits in 1y, admit in past 1mo, >2 cans of SABA, recent PO/IV steroids, CVD, COPD, significant psych issues, low SES, illicit drugs |
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|
Term
| clinical signs of pneumonia - 9 |
|
Definition
| tachycardia, tachypnea, rales, fever, crackles, ronchi, dullness to percssion, egophony, whispering perctoriqiuly |
|
|
Term
| work up for pneumonia - 10 |
|
Definition
CXR, CBC, O2, sputum gram stain and culture, blood culure
consider - HIV, TB, legionella, mycoplasma |
|
|
Term
| when to hospitalize someone with pneumonia - 17, what is #1 factor |
|
Definition
| Age #1 factor, pO2 <60, CHF, RR >30, O2 <90%, SBP <90, fever, change in mental status, HR >125, pH <7.35, cancer, BUN >64, Na <130, pleural effusions, glucose >250, HCT <30, SIRS |
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|
Term
| when to intubate someone with pneumonia |
|
Definition
| pO2 <50, pCO2 >50, accessory muscle use |
|
|
Term
| hospital acquired pneumonia - onset |
|
Definition
|
|
Term
| hospital acquired pneumonia - causes - 2 |
|
Definition
|
|
Term
| hospital acquired pneumonia - risk factors - 5 |
|
Definition
| aspiration, COPD, thorax surgery, ICU, ventilator |
|
|
Term
| hospital acquired pneumonia - treatment |
|
Definition
| piperacillin + gent +/- clinda +/- vanc (MRSA) |
|
|
Term
| aspiration pneumonia - risk factors - 3 |
|
Definition
| intubation, intoxication, seizure |
|
|
Term
| aspiration pneumonia - onset |
|
Definition
|
|
Term
| aspiration pneumonia - signs - 2 |
|
Definition
|
|
Term
| aspiration pneumonia - CXR signs |
|
Definition
| will be on one side in 1 or both lobes |
|
|
Term
| aspiration pneumonia - organisms |
|
Definition
| fusobacterium, bacteroides, and lots of other mouth bacteria |
|
|
Term
| aspiration pneumonia - treatment |
|
Definition
|
|
Term
| community acquired pneumonia bacterial - organisms - 2 |
|
Definition
|
|
Term
| community acquired pneumonia bacterial - CXR signs |
|
Definition
|
|
Term
| community acquired pneumonia bacterial - sputum |
|
Definition
|
|
Term
| community acquired pneumonia bacterial - lung sound |
|
Definition
|
|
Term
| community acquired pneumonia bacterial - treatment |
|
Definition
| azithromycin (if hospitalized add 3rd gen cephalospirin) |
|
|
Term
| community acquired pneumonia viral - cause |
|
Definition
|
|
Term
| community acquired pneumonia viral - CXR sign |
|
Definition
| fluffy diffuse infiltrates |
|
|
Term
| community acquired pneumonia viral - exam sound |
|
Definition
|
|
Term
| community acquired pneumonia viral - suptum |
|
Definition
|
|
Term
| community acquired pneumonia viral - treatment - 2 |
|
Definition
|
|
Term
| community acquired pneumonia atypical - organisms - 3 |
|
Definition
| legionella, mycoplasma, chlamydia pneumonia |
|
|
Term
| community acquired pneumonia atypical - lung sound |
|
Definition
| scattered ronchi, localized rales |
|
|
Term
| community acquired pneumonia atypical - suptum |
|
Definition
|
|
Term
| community acquired pneumonia atypical - CXR signs |
|
Definition
| fine patchy interstitial or perihilar infiltrates |
|
|
Term
| community acquired pneumonia atypical - lab test |
|
Definition
| cold agglutins/complement fixation titers |
|
|
Term
| community acquired pneumonia atypical - treatment azithromycin |
|
Definition
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|
