Acute resp infection

Question 1

Oliguria

Answer 1

<0.5ml/kg/hr

Question 2

Anuria

Answer 2

<100ml in 24 hrs

Question 3

Influenza virus drugs

Answer 3

Oseltamivir

Zanamivir

Question 4

When to use influenza virus drugs

Answer 4

Critical care pts or those headed that way
Immunocompromised

(tho debated)

Question 5

Flu virus mutates in two ways:

Answer 5

Antigenic drift

Antigenic shift

Question 6

Antigenic drift

Answer 6

Gradual accumulations of mutations of surface antigens

Virus less susceptible to antibodies produced during prev infections

Question 7

Antigenic shift

Answer 7

Two or more strains combine to form a new subtype with surface antigens humans haven’t encountered yet

Question 8

Complicated influenza

Answer 8

Hospital admission
LRTI signs eg hypoxaemia, dyspnoea, lung infiltrates
CNS involvement
Significant exacerbation of an underlying medical condition

Question 9

Risk factors for complicated influenza

Answer 9

Neuro/hepatic/renal/pulm/chronic cardiac disease
DM
Immunosuppression
Age >65
Pregnancy (including up to 2 weeks post partum)
Morbid obesity (BMI >= 40)

Question 10

Superimposed bacterial pneumonia (after influenza) bugs

Answer 10

Strep pneumoniae
Staph aureus
Haemophilus influenzae

Question 11

Complications of influenza

Answer 11

Pneumonia
Myositis
Rhabdomyolysis
CNS complications

Question 12

Myositis/rhabdomyolysis features

Answer 12

Common in children, but overall rare
Rise in creatinine kinase
Myoglobuinuria
Occasionally swollen muscles

Question 13

CNS complications of influenza

Answer 13

Encephalitis
Transverse myelitis
Guillain-Barre syndrome
Aseptic meningitis

Question 14

Risk factors for severe influenza

Answer 14

HIV infection (cd4 <200)
Severe primary immunodeficiency
Leukaemia/lymphoma/multiple myeloma
Splenectomy
Recent chemo (6 months)
many more, check notes

Question 15

Serious vs mild influenza

Answer 15

Serious: A and B (A usually more severe)
Mild: C