Pharyngitis and Bronchitis

Question 1

Bronchitis is the inflammation of the:

Answer 1

Bronchial tubes (lower respiratory tract infection)

Question 2

Acute bronchitis (chest cold) is an acute respiratory infection with a normal chest radiograph manifested by cough with or without phlegm production that lasts for up to __________

Answer 2

3 weeks

Question 3

Acute pharyngitis is the inflammation of the:

Answer 3

pharynx, usually caused by virus, bacteria, or fungi

Question 4

If pharyngitis is bacterial it is most likely _________

Answer 4

Group A Streptococcus (GAS)

Question 5

Most cases of acute bronchitis are ____

Answer 5

Viral, thus antibiotics are not recommended

Question 6

Bacterial sources of acute bronchitis include
1.
2.
3.
etc

Answer 6

1. S. pneumoniae
2. H. influenzae
3. Mortaxella catarrhalis

Bordetella parapertussus, Bordatella pertussis, Chlamydophila pneumoniae, Mycoplasma pneumoniae

Question 7

Acute bronchitis clinical presentation involves cough up to __ to __ weeks +/- sputum production

Answer 7

3-4 weeks, suspect bronchitis if cough > 5 days

Question 8

True or False: majority of adult acute pharyngitis is viral and self limiting

Answer 8

True

Question 9

The _______________ determines if the probability that a patient has a streptococcal pharyngitis and should be tested or empirically treated with antibiotics

Answer 9

Modified Centror Score

Question 10

Bacterial pharyngitis caused by GAS, aka STREP throat, must be diagnosed and treated in children due to the risk of complications such as _______ and _______

Answer 10

rheumatic fever and glomerulonephritis

Question 11

______ or ______ is the best way to diagnose GAS

Answer 11

Rapid antigen test (RAT) or throat Culture (gold standard)

Question 12

Some non drug options for the management of acute bronchitis:
1.
2.
3.

Answer 12

1. Humidifier
2. Hydration
3. Honey (children > 1 years old)
   Education
   Comfot

Question 13

Some non drug options for the management of pharyngitis:
1.
2.
3.

Answer 13

1. Warm liquids
2. Mouth rinses
3. Lozenges to alleviate throat pain

Question 14

There is some evidence that zinc shortens the duration and severity of a cold. Intranasal zinc should not be used due to the side effect of _______

Answer 14

permanent anosmia

Question 15

The following are not routinely recommend for symptom management of acute bronchitis
1.
2.
3.

Answer 15

1. oral or inhaled corticosteroids (unless ashtma)
2. expectorants
3. antihistamines (cause drying of mucus secretions, prevent draining)

Question 16

Routine antibiotic treatment is not recommended for acute bronchitis since > ___ % of bronchitis is viral

Answer 16

90%, no benefit and increase risk of adverse events

Consider further investigations if:
- symptoms last >14 days without improvement or worsen, if links to pertussis case or if IMMUNOCOMPROMISED

Question 17

Antibiotic therapy directed at ____ is recommended for the treatment of confirmed bacterial pharyngitis backed by ______ or _______

Answer 17

GAS , backed by culture or antigen test

Question 18

First line treatment for the majority of GAS cases ?

Answer 18

Penicillin V (narrow spectrum, no documented resistance, max absorption when given on empty stomach)
Amoxicillin (broader, as effective, liquid for kids)

Question 19

2nd line treatment for treatment of bacterial pharyngitis due to GAS?

Answer 19

Cephalexin, also used if type IV hypersensitivity reaction to penicillins

Question 20

Treatment of bacterial pharyngitis due to GAS in patient with Type I penicillin allergy ?

Answer 20

Macrolide - azithromycin, clarithormcyin