ACCP Critical Care Medicine Board Review, 20th Edition - download pdf or read online

March 1, 2018 | Philosophy Critical Thinking | By admin | 0 Comments

By Joshua O. Benditt, et al. American College of Chest Physicians

ISBN-10: 0916609766

ISBN-13: 9780916609764

ISBN-10: 380559366X

ISBN-13: 9783805593663

Instantly from the ACCP serious Care medication Board overview 2009 path, this article covers each subject in a concise, easy-to-use layout. Use as a self-study source to organize for the serious care drugs subspecialty board exam.

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An exception has been use of measles vaccine, a live-virus vaccine, in asymptomatic HIV-infected individuals and potentially in those with symptomatic HIV infection. 83 Even with the overwhelming success of measles immunization programs, this case has prompted reappraisal of recommendations and some have suggested that it may be prudent to withhold measles-containing 31 vaccines from HIV-infected persons with evidence of severe immunosuppression. Emerging Viral Pathogens in Persons With Defects in Cell-Mediated Immunity There have been increasing reports of infections caused by respiratory syncytial virus or parainfluenza virus, particularly in persons who have received bone marrow or solid organ transplantation.

The 23-valent pneumococcal vaccine is recommended for adults with functional or anatomic asplenia, chronic cardiovascular disease, chronic Infections in AIDS Patients and Other Immunocompromised Hosts (Karam) pulmonary disease, diabetes mellitus, alcoholism, chronic liver disease, cerebrospinal fluid (CSF) leaks, and immunocompromised states including malignancy and HIV infection. In the review by the Centers for Disease Control and Prevention (CDC),27 revaccination once was recommended for two groups: (1) persons aged Ն2 years who are at highest risk for serious pneumococcal infection and those who are likely to have a rapid decline in pneumococcal antibody levels (eg, functional or anatomic asplenia, HIV infection, leukemia, lymphoma, Hodgkin disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, other conditions associated with immunosuppression [including transplantation], and those receiving immunosuppressive chemotherapy [including steroids]), provided that 5 years has elapsed since receipt of the first dose of pneumococcal vaccine; and (2) persons aged Ն65 years if they received the vaccine 5 years previously and were Ͻ65 years old at the time of the primary vaccination.

Gram stain of the CSF is positive in only about one fourth of patients. The infection has a predilection for the base of the brain with resultant focal neurologic signs, particularly cranial nerve involvement, in up to 40% of patients. 50 Even though the organism has been rarely reported to cause infection in immunocompetent patients, immunocompromised patients, especially those with HIV infection, are the ones most likely to develop clinical disease due to this pathogen. The most characteristic pattern of infection is described as a progressive pneumonia that may cavitate.

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ACCP Critical Care Medicine Board Review, 20th Edition by Joshua O. Benditt, et al. American College of Chest Physicians

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