13. RTI-4

Question 1

It is February and an 8 year old boy comes into your office with complaints of headache, fever and general malaise as well as diarrhea. What medication is contraindicated in this patient?

A. Amantadine
B. Aspirin
C. Zanamivir 
D.Oseltamivir
E. Rimantadine 

RFA

Answer 1

Ans. Aspirin- is contraindicated in children with the flu because it can cause liver damage

Question 2

It is February and an 18 year old boy comes into your office with complaints of headache, fever and general malaise. Testing is done and found his illness is not due a flu strain of H1N1 or H3N2. What mechanism of action would most likely be most effective against this infection?

A. Targets M2 proteins 
B. Inhibits Cox 
C.Inhibits uncoating of virus 
D.  Causes virus to bind to its own sialic acid
E. Passive immunization 

RFA

Answer 2

Ans. D. Causes virus to bind to own sialic acid- this describes Zanamivir & Oseltamivir. These drugs inhibit neuraminidase causing to bind to its own sialic acid. This is the DOC since the strain is not H1N1 or H3N2 hence not Influenza A so B or C

A. & C both describe the action of Amantadine or Rimantadine which only work on Influenza A

B. Inhibits COX- describes Aprin which isn’t a DOC for Flu but is contraindicated in children which flu

E. Passive immunization- describes the flu vaccine but since the patient is already infected this won’t be helpful.

Question 3

Which of the following symptoms could help differentiate a cold from the flu?

A. Fever
B. Headache
C. General malaise
D. Vomiting
E. Sore throat

SZ

Answer 3

Ans. E Sore throat

The remaining symptoms are for flu

Question 4

A 4 y/o girl presents to the pediatrician. Her mother complains that the pt has been pulling her ears, complaining if ear pain, fever of 101.1F and difficulty hearing. The bacteria is cultured on chocolate agar and growth are round opaque colonies. Which of the following characteristic may also be present?

A. Positive Elek test
B. Growth with hemin and NAD
C. Quellung reaction
D. DNAase (+) and Nitrate reduction (+)
E. Sensitive to Bacitracin

SZ

Answer 4

Ans. D. DNAase (+) and Nitrate reduction (+)

The child has otitis media caused by Moraxella catarrhalis. DNAase (+) and Nitrate reduction (+) is the distinguishing factor between Moraxella and Neisseria

A. Positive Elek test- Corynebacterium diphtheriae
B. Growth with hemin and NAD- H. influenza
C. Quellung reaction- S. pneumoniae
E. Sensitive to bacitracin - S. pyogenes