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Cheatography

Pulmon Cheat Sheet (DRAFT) by

pulmonology FNP quick review for boards

This is a draft cheat sheet. It is a work in progress and is not finished yet.

COMMUNITY - ACQUIRED PNEUMONIA (CAP)

strep pneumoniae
HEALTHY OUTPATIENT ADULTS NO COMORBIDITIES:
Amoxicillin 1 g TID - BEST EVIDENCE
Penicillin ALRG:
Doxycy­cline 100 mg BID
Clarit­hro­mycin 500 mg BID
Azithr­omycin 500 mg x1 then 250 mg QD
OUTPATIENT ADULTS W COMORBIDITIES:
Augmentin & Macrolide (azithromycin; calrithromycin)
OR Doxycycline
Pneumonia Preven­tion: Vaccinate
Pneumo­coccal - 65y; 19-64ycomorb­idities
General rule: you want to give the abx for at least 48h after you have achieved symptom resolu­tion. So minimum CAP TX is 5d if symptoms mod-severe 7 days!

DIFFER­ENTIAL DX: COUGH

CLUES TO DX
"­chest tightn­ess­"
asthma, cardiac ischemia
"­suf­foc­ati­ng"
pulmonary edema
"­inc­rease work to breath­"
COPD, asthma myopathy
"air hungry­"
HF, PE, asthma, COPD
"­win­ded­" OR "­bre­athing heavy"
decond­iti­oning
 

COPD

Differ­ential DX
Chronic Bronchitis
NML spirometry
Asthma
Bronch­iec­tasis
CT bronchial wall thickening
Heart Failure
Dilated heart on CXR
PE
Tuberc­ulosis

I will confirm COPD w Spir­ome­try

FEV1/FVC post-b­ron­cho­dil­ation less than 0.7 confirms COPD
 

COPD Prescr­ibing "­ABE­"

Group A
LAMA or LABA + SABA prn
Tiotropium qd + Albuterol prn
Formoterol qd + Albuterol prn
Group B
LAMA &/or LABA + SABA prn
Group A & B do not have to be hospit­alized