Management Of Reapiratory Infections

Question 0

What antibiotics are used in bacterial pharyngitis (indicated by pus)?

Answer 0

Penicillin, amoxicillin

Question 1

What can cause pharyngitis?

Answer 1

Bacterial - gp A streps sore throat, white pus
Corynebacterium diptheriae - grows membrane
Viruses - EBV, adenovirus, enterovirus, HSV

Question 2

What is epiglottitis caused by?

Answer 2

Haemophilus influenza B

Question 3

What are the symptoms of epiglottitis?

Answer 3

Drooling, dysphonia, dysphagia, drawn faces, medical emergency, need to secure airway

Question 4

How is epiglottitis treated?

Answer 4

IV cefuroxime (a broad spectrum, second generation cephalosporin) active against gram negatives such as Haem influenzae

Question 5

First line treatment for bronchitis?

Answer 5

Amoxicillin

Question 6

Causes of bronchitis?

Answer 6

Acute caused by viral or bacterial, chronic by smoking

Question 7

Mnemonic for diagnosing pneumonia?

Answer 7

Definitely in a surgeons gown a physician might make some progress.
‘Definition, incidence, aetiology, sex, geography, age, presentation, microscopic/ macroscopic appearance, spread, prognosis

Question 8

Who invented the stethoscope?

Answer 8

R. Leannec 1838

Question 9

What’s the definition of pneumonia?

Answer 9

Inflammation and consolidation (uniting) of the lung tissue

Question 10

What pathogens are associated with foreign travel?

Answer 10

Legionella Mediterranean, TB, pseudomonas SE Asia, N Australia, histioplasmosis USA

Question 11

What’s pathogens are associated with aspiration?

Answer 11

Klebsiella, TB, E Coli

Question 12

What drugs are a risk factor for pneumonia?

Answer 12

Magnesium salicylate and atropine (decrease mucociliary action), sedatives (decrease cough), steroids and salicylates decrease phagocytic function

Question 13

Other risk factors of pneumonia

Answer 13

Institutions, comorbidity, alcohol, smoking, nutrition

Question 14

Why do we test urine output in pneumonia?

Answer 14

To check for sepsis, BP drops so urine output drops, urea is a marker for kidney failure

Question 15

What investigations must be done in pneumonia?

Answer 15

Sputum, urine, blood cultures, ECG, Xray

Question 16

What sputum tests should be done?

Answer 16

Acid fast bacilli, general culture, gram stain

Question 17

How is legionella tested for?

Answer 17

Legionella antigen in urine

Question 18

Investigations in HAP

Answer 18

Sputum, tracheal aspirate, blood culture

Question 19

What to do in a severely ill patient

Answer 19

Take samples of sputum, blood, urine and give empiric antibiotics

Question 20

What is CURB65?

Answer 20

Confusion mms below 8, urea higher than 7 ml/l, resp rate above 30, BP lower than 90/60, age 65 or over

Question 21

What indicates massive sepsis?

Answer 21

WBC above 20

Question 22

What is a normal urine output?

Answer 22

1 ml/kg per hour

Question 23

CURB65 scoring

Answer 23

1 send home, 2 IV antibiotics, 3 bad news

Question 24

Treatment of uncomplicated pneumonia

Answer 24

Po amoxicillin and Clarithromycin (macrolide£ or po cephalosporin ie cefuroxime

Question 25

Treatment of complicated pneumonia

Answer 25

IV cefuroxime and po Clarithromycin OR IV augmentin and po Clarithromycin

Question 26

Treatment of cavitation pneumonia

Answer 26

IV cefuroxime, IV metronidazole, IV flucloxacillin

Question 27

Treatment of aspiration pneumonia

Answer 27

IV cefuroxime or metronidazole

Question 28

What is bronchiectasis?

Answer 28

Abnormal widening of the airways?

Question 29

What are the complications of pneumonia? 5

Answer 29

Bronchiectasis, empyema, ARDS, abscess, pulmonary emboli

Question 30

What are the risk factors for pneumonia?

Answer 30

Bacterial load and reduced cough