COMMUNITY ACQUIRED PNEUMONIA

Question 1

rhinitis

Answer 1

= common cold
- excess mucus
- viruses: rhinovirus + coronavirus
- natural immunity is short-lived
- spread by hands and close contact

Question 2

what is acute rhinosinusitis?

Answer 2

• caused by a viral infection associated with common cold
  -symptoms: nasal congestion, purulent nasal discharge, maxillary tooth pain, facial pain , fever and ear pain
• acute bacterial rhinosinusitis can develop secondary to a viral upper respiratory infection, however, fewer than 2% of viral URIs are complicated by rhinosinusitis

Question 3

what is otitis media

Answer 3

• painful ear - middle ear infection
• 1/3 caused by by viral infections
• many cases resolve spontaneously
• antibiotics can be deferred for 48 hours in mild cases
• AMOXICILLIN: appropriate for initial treatment. improvement should occur within 48-72 hours

Question 4

Laryngitis (URT) and Tracheitis (LRTI)

Answer 4

• cough
• hoarseness/loss in voice
• otherwise patients look healthy
• mostly viral

Question 5

Pharyngitis

Answer 5

= sore throat
- 70% viral
-30% bacterial
- mostly self-limited
-throat culture: 10 day penicillin

Question 6

the 4 components of Centor criteria

Answer 6

• Tonsillar exudates
• Tender anterior cervical adenopathy/ lymphadenopathy
• fever
• absence of a cough

0-1 : no testing, no treatment
2-3: rapid step test
4: treat empirically

Question 7

Acute sinusitis

Answer 7

• mostly due to allergy or viral, antibiotics are ineffective
• green or yellow nasal discharge
• antibiotics only if severe symptoms:
  1. fever > 39 degrees
  2. facial pain and or swelling
  3. cough with purulent rhinorrhea for more than 7 to 10 days
• intranasal decongestants/antihistamines esp if its allergic rhinitis

Question 8

acute bronchitis

Answer 8

• mostly viral etiology and self limiting
• cough often persists for up to months

Question 9

symptoms of whooping cough

Answer 9

• coughing fits
• lightheadedness
• vomiting
• fainting

Question 10

whooping cough treatment?prevention?

Answer 10

• Azithromycin: 500mg stat then 250mg x3 - 5 days
  -Tdp vaccine