LOW RESPIRATORY TRACT

Question 1

Which of the following inhaled medications is/are (a) short-acting beta agonist(s?
a) Salmeterol
b) Salbutamol
c) Fenoterol
d) Formoterol
e) Terbutaline

Answer 1

B

Question 2

Which of the following local side-effects is most associated with
inhaled beclometasone?
a) Dry mouth
b) Oral candidiasis
c) Metallic taste
d) Dental caries

Answer 2

B

Question 3

what is bronchitis?

Answer 3

inflammation of the bronchi

Question 4

Acute bronchitis

Answer 4

common clinical conditions characterized by an acute onset but persistent cough, with or without sputum production.

Question 5

chronic bronchitis

Answer 5

chronic inflammatory condition, characterized by thickened, oedematous bronchial mucosa with mucous gland and hypertrophy

Question 6

what normally causes chronic bronchitis?

Answer 6

caused by smoking

Question 7

Often co-exists with
emphysema – both what?

Answer 7

airflow limitation and COPD

Question 8

Acute bronchitis vs pneumonia

Answer 8

acute bronchitis: caused by mycoplasma pneumonia. mucus in the airway. inflamed and edematous large airway.

pneumonia: caused by streptococcal pneumonia. inflamed and edematous of small and large airways. pus, mucus and alveoli filled with fluid leading to lung consolidation.

Question 9

symptoms of acute bronchitis

Answer 9

1. acute onset, persistent cough, concurrent upper respiratory tract infection and mild dyspnea.

Question 10

symptoms of pneumonia

Answer 10

dyspnea
lung consolidation
abnormal vitals
high temperature
acute/ subacute onset cough.

Question 11

Acute bronchitis: treatment approach

Answer 11

resolve in about 1-3 weeks.
antibiotics are not recommended.

Question 12

nonpharmacological options for cough relief?

Answer 12

such as throat lozenges,
hot tea, honey, steam inhalation, adequate hydration and/or smoking
cessation or avoidance of second-hand smoke is a reasonable first
step. * Cough preparations
* Paracetamol for pain and fever

Question 13

What are the different types of cough preparations?

Answer 13

• Antitussives
• Mucolytics
• Expectorants

Question 14

What types of cough are they used for?

Answer 14

for Dry cough - for antitussives
wet cough for- mucolytics and expectorants

Question 15

Mechanism of action and examples
* Antitussives
* Mucolytics
* Expectorants

Answer 15

• Antitussives : codeine phosphate, methadone and dihydrocodeine
• Mucolytics: N-acetylcysteine and Bromhexine.
• Expectorants: Guaifenesin (Mucinex, Robitussin Chest Congestion

Question 16

Cautions for cough preparations.

Answer 16

Mucolytics: bronchospasm
GIT irritation
rash
fever
Headache

 Antitussives (Cough Suppressants):
         drowsiness, headache
          constipation, confusion, excitement and sedative

Expectorants: drowsiness, headache
constipation.

Question 17

Part of COPD, and sometimes with emphysema are characterized by:

Answer 17

chronic cough with or without sputum
shortness of breath
wheezing

Question 18

if the symptoms suggest TB it will be ?

Answer 18

weight loss, night sweats and fever

Question 19

what is partially reversible with COPD

Answer 19

bronchospasm.

Question 20

Management of acute exacerbations of chronic bronchitis: an emergency recognition.

Answer 20

wheeze
breathlessness
tightness of chest
respiratory distress
cough.

Question 21

Management of acute exacerbations

Answer 21

short-acting bronchodilators (SABA, SAMA
Supplemental oxygen (24-28%)
* Oral corticosteroids: Prednisone, oral, 3

Question 22

Acute infective exacerbation of chronic bronchitis: drugs used?

Answer 22

Amoxicillin, oral, 8 hourly for 5 days.
Severe penicillin allergy: * Doxycycline, oral, 12 hourly for 5 days

Question 23

Viral structures of pharmacological
importance: of the influenza virus

Answer 23

neuraminidase
hemagglutinin

Question 24

Neuraminidase inhibitor

Answer 24

• Oseltamivir * Zanamivir

they all available as inhalers

Question 25

what is the action of neuraminidase inhibitors?

Answer 25

disrupt the release of influenza virus from the host cell.

Question 26

what does neuraminidase inhibitors mimic?

Answer 26

These neuraminidase inhibitors mimic neuraminidase’s sialic acid binding site. When introduced, they bind neuraminidase on the budding viruses, blocking its enzymatic activity

Question 27

Neuraminidase drug that is taken as an initiative within 24-48 hours of onset symptoms reduce duration by less than 1 day ?

Answer 27

oseltamivir

Question 28

High risk influenza patients:

Answer 28

pregnant, immunosuppressed and children are at risk of influenza.

Question 29

pep for influenza infected people

Answer 29

is given to high risk close contact patient within 48 hours.

Question 30

Oseltamivir MOA and class

Answer 30

is an neuraminidase is a prodrug used as PEP oral Adm.

Question 31

neuraminidase - powder for inhalation

Answer 31

Zanamivir

Question 32

drug treatment key recommendations for COVID

Answer 32

heparin. baricitinib. dexamethasone.

Question 33

drug for patients requiring supplemental oxygen or mechanical ventilation

Answer 33

dexamethasone and baricitinib

Question 34

heparin drug

Answer 34

for venous thromboembolism prophylaxis

Question 35

sign of severe covid -19

Answer 35

dyspnea high RR Bp less than 90/60 confused unable to walk oxygen saturation less than 95% Coughs ≥ 1 tablespoon fresh blood

Question 36

Mild disease management

Answer 36

* Home management * Separate bedroom available for patient to self-isolate in * Able to maintain physical distancing at home * Able to maintain hand hygiene * Patient able to contact, and return to, healthcare facility in case of deterioratio

Question 37

Hospital Level Care for severe disease

Answer 37

Isolate and employ appropriate IPC Supplemental oxygen / ventilator support Respiratory Support Analgesics & Antipyretics Thromboprophylaxis Corticosteroids

Question 38

Analgesic and antipyretics fr pain and fever

Answer 38

paracetamol

Question 39

Corticosteroids given to treat covid -19

Answer 39

* Dexamethasone 6mg daily for 10 days * OR * Betamethasone 6mg (po/iv) for 10 days * OR * Prednisone 40mg PO daily for 10 days * WHO recommended equivalents * OR * Hydrocortisone 50 mg IV TDS * OR * Methylprednisolone 8 mg QID or 16 mg BD PO or I

Question 40

Thromboprophylaxis drug

Answer 40

heparins enoxaparin dalteparin Inactivates thrombin & factor Xa through antithrombin III activation

Question 41

side effects of using thromboprophylaxis

Answer 41

bleeding HIT

Question 42

Janus kinase inhibitor that has anti-inflammatory properties

Answer 42

Baricitinib

Question 43

baricitinib is registered as a drug that treat ?

Answer 43

several dermatological conditions and rheumatoid arthritis.

Question 44

Vaccine: common side-effects

Answer 44

headache muscle sore nausea fatigue fever

Question 45

Vaccine: Caution!!

Answer 45

Thrombocytopenia * Bleeding disorders * On coagulation therapy