A.) Arterio-tracheobronchial fistula
D.) Catamenial haemoptysis
E.) Cystic fibrosis
F.) Foreign body aspiration
G.) Goodpastures syndrome
H.) Lung malignancy
I.) Systemic lupus erythrematosus
For each clinical scenario select the most likely diagnosis.
- A 29 year old man presents with 1 week of streaky haemoptysis and cough. He has also noticed pink urine and swelling of his hands and feet.
- A 52 year old man presents with chronic cough, months of daily purulent mucous production and now episodes of haemoptysis
- A 23 year old female presents with 3 days of cough, fevers, wheeze and streaky haemoptysis. She has no past medical history.
- A 27 year old Iranian man presents with 2 weeks of night sweats, fevers, weight loss and haemoptysis.
- A 64 year old man presents with 1 month of haemoptysis, chronic cough and weight loss.
- A 27 year old woman presents with weeks of intermittent fevers, sore joints and now 1 week of cough with intermittent streaky haemoptysis. She has had 4 miscarriages in the last 18 months.
Author: J Haire
Ref: Tintinalli p. 474
A.) Amoxycillin 25mg/kg PO tds 3 days
B.) Amoxycillin 1g tds PO for 5 days
C.) Amoxycillin 875mg + clavulanate 125mg bd PO 5 days
D.) Benzylpenicillin 60 mg/kg IV bd and gentamicin 5mg/kg od for 7 days
E.) Benzylpenicillin 1.2g IV qid and metronidazole 500mg IV bd
F.) Clindamycin 450 mg tds PO for 21 days
G.) Ceftriaxone 1g IV od
H.) Roxithromycin 4mg/kg bd PO for 5 days
I.) Roxithromycin 150 mg bd 10 days
J.) Trimethoprim 5mg/kg + sulfamethoxazole 25 mg/kg IV tds for 21 days
For each clinical scenario select the most appropriate antibiotic treatment.
- A 78 year old woman who was discharged 1 week ago after having a dynamic hip screw for a fractured neck of femur presents with fever, cough and pleuritic chest pain. Her vitals are HR 124 bpm, BP 112/78, RR 20, O2 sats 92% RA, GCS 15, temp 38.2° Her CXR shows left lower lobe consolidation. She has no allergies.
- A 46 year old man with HIV presents with fever, cough and shortness of breath. His last CD4+ count was 167 cells/mm3. His vitals are HR 136 bpm, RR 32 bpm, Ox sats 88% Ra, GCS 14, temp 38.8°C. His CXR shows bilateral diffuse interstitial changes.
- A 46 year old woman who presents with 1 week of fever, cough, pleuritic chest pain and no past medical history. Her vitals are HR 88 bpm, BP 124/88, O2, RR 14 bpm, sats 97% RA, temp 37.8°C, GCS 15. CXR shows left lower lobe consolidation. She has no allergies.
- A 2 year old girl presents with coryzal symptoms, fevers and cough. Her vitals are HR 120 bpm, RR 26 bpm, sats 96% Ra, GCS 15, temp 38.2° A CXR shows increased opacity in the left lower lobe.
- A 76 year old man who had a severe stroke 3 months ago and is fed via a percutaneous endoscopic gastrostomy tube presents with 3 days of cough and now fever. His vitals are HR 105, BP 110/75, O2 sats 92% RA, RR 20 bpm, temp 38.6° His CXR shows a right middle lobe consolidation
- A 6 year old boy presents with 3 days of fever and cough. His vitals are HR 90 bpm, RR 22, O2 sats 96% RA, GCS 15, temp 37.8° A CXR shows diffuse peri-hilar increased opacity.
Author: J Haire
Ref: Therapeutic Guidelines