43: Respiratory Tract Infections - Kanis

Question 1

upper respiratory infections URI aka

Answer 1

acute infective rhinitis
acute rhinopharyngitis
nasopharyngitis
acute coryza
common cold

Question 2

URI are usually caused by…

Answer 2

viruses (rhinovirus 40%0

Question 3

leading diagnosis for which antibiotics are prescribed on an outpatient basis

Answer 3

URI

Question 4

antibiotics have _____ role in uncomplicated and non-specific URI

Answer 4

NO **

treatment for URI should be symptom based

Question 5

suppresses medullary cough center

Answer 5

dextromethorphan

Question 6

increases volume and decreases viscosity of mucous

Answer 6

guaifenisen

Question 7

true or false: zinc, vitamin C, echinacea have been shown to help colds

Answer 7

false

no consistent benefit shown

Question 8

most commonly involved sinus in sinusitis

Answer 8

maxillary

Question 9

what lines the sinuses?

Answer 9

respiratory epithelium

• produces mucus
• ciliary action
• should remain sterile

Question 10

acute sinusitis

Answer 10

• less than 4 weeks

- often with preceding viral URI

Question 11

______ rhinosinusitis is more common than ______

Answer 11

viral

bacterial

Question 12

common sinusitis pathogens

Answer 12

strep. pneumonia
haemophilus influenza

*bacterial causes are better described

Question 13

diabetic patient with a sinusitis infection

Answer 13

could be rhinocerebral mucormycosis ** needs urgent evaluation

Question 14

sinusitis diagnosis is based on

Answer 14

illness duration

7d with facial or toot pain –> bacterial sinusitis

Question 15

sinusitis treatment

Answer 15

decongestants

saline lavage

Question 16

> 7d or severe sinusitis treatment

Answer 16

amoxicillin or bactrim

for 3 weeks

Question 17

what might cause chronic sinusitis?

Answer 17

> 12 wks

due to impairment of mucociliary clearance from repeated infection rather than to persistent bacterial infection

Question 18

nosocomial =

Answer 18

hospital acquired pneumonia

Question 19

common bacterial pathogens in pneumonia

Answer 19

strep pneumonia

staph aureus

Question 20

COPD pneumonia - what pathogen?

Answer 20

haemophilus influenzae

Question 21

alchoholism pneumonia - what pathogen?

Answer 21

kelbsiella

Question 22

nosocomial pneumonia

Answer 22

pseudomonas

Question 23

treat nosocomial?

Answer 23

aminoglycosides, 3rd gen ceph, anit-pseudomonal PCNs

Question 24

symptoms of pneumonia

Answer 24

cough
dyspnea
sputum
pleuritic chest pain

Question 25

where does aspiration usually end up?

Answer 25

right lower lobe

Question 26

outpatient pneumonia with no cardiopulmonary disease or other modifying risk factor --> tx

Answer 26

azithromycin or clarithromycin or doxycycline

Question 27

outpatient pneumonia, with cardiopulmonary disease and or modifying factors --> tx

Answer 27

quinolone or beta-lactam plus or macrolide or doxycycline

Question 28

hospitalized pneumonia tx

Answer 28

IV beta lactam or macroloide or doxycycline or quinoone

Question 29

hospitalized, severe pneumonia tx

Answer 29

IV beta lactam and either macrolide or quinolone

Question 30

define flu

Answer 30

fever 100F with cough or sore throat in the absence of known cause other than influenza

Question 31

when do you need to give tamiflu

Answer 31

best w/i 48 hrs

Question 32

high risk flu pts

Answer 32

less than n5 more than 65 pregnant high risk comorbid (obesity)

Question 33

diabetic pt with proptosis, ptosis, orbital swelling, cellulitis -->

Answer 33

rhinocerebral mucormycosis **urgent treatment

Question 34

the decision regarding hospitalization should be based on...

Answer 34

stability of pts clinical condition, risk of death and complication, presence or absence of other active medical problems, and psychosocial issues