Leik Condensed Part 2 latest update | verified

Step 4 Severe persistent asthma (FEV1 60% predicted): Symptoms of asthma throughout the day; nocturnal awakenings nightly Preferred treatment: Medium-dose ICS plus LABA Community-Acquired Bacterial Pneumonia (CAP) “rust-colored sputum” fever and cough think Streptococcus pneumoniae. The top two bacteria in CAP are: • S. pneumoniae • H. influenzae Case study: An older adult presents with sudden onset of a high fever (100.4°F) with chills that is accompanied by a productive cough with purulent sputum (rust-colored sputum seen with streptococcal pneumonia). The patient complains of pleuritic chest pain with coughing and dyspnea. Chest xray is the GOLD STANDARD Tx: Macrolides are preferred. • Azithromycin (Z-Pack) daily × 5 days • Clarithromycin (Biaxin) BID × 7 days -If patient had an antibiotic in previous 3 months or macrolide-resistance (25%): • Doxycycline 100 mg BID × 5 to 7 days • Levofloxacin (Levaquin) 750 mg × 5 days • Azithromycin or clarithromycin plus amoxicillin or Augmentin *****Elderly are high risk for due to comorbidities, BUT they must meet the “CURB-65” criterion for hospital admission (know what components is the CURB 65 FOR EXAM!!!!!) C (confusion) U (blood urea nitrogen 19.6 mg/dL) R (respiration 30 breaths/min) B (blood pressure 90/60 mmHg) AND • 65 years of age or older (each factor is worth 1 point). If score 1, patient should be hospitalized!!!