Resp infection

Question 1

treatment of epiglottis (H influenza)

Answer 1

cefotaxime (or ceftriaxone)

Hx immediate hypersensitivity reaction: chloramphenicol

Question 2

why is epiglottis a medical emergency

Answer 2

as a swollen epiglottis can restrict the oxygen supply to your lungs.

call 999 if suspected

Question 3

advice if suspected epiglottis

Answer 3

Call 999 for an ambulance if you think you or your child has epiglottitis.

While waiting for an ambulance, you should not attempt to examine your child’s throat, place anything inside their mouth, or lay them on their back. This may make their symptoms worse.

Question 4

epiglottis usually caused by infection with which bacterial

Answer 4

Hib

Question 5

When is the Hip vaccination given in childhood

Answer 5

part of the 6-in-1 vaccine

3 doses of the vaccine: at 8 weeks, 12 weeks and 16 weeks of age.

additional Hib/Men C vaccine at 1 year of age.

Question 6

symptoms of epiglottis

Answer 6

• usually develop quickly and get rapidly worse although they can develop over a few days in older children and adults
• severe sore throat
• pain swallowing
• difficulty breathing, may improve leaning forward
• stridor - high pitched breathing
• high temp
• muffled or hoarse voice
• drooling
• irritability and restlessness

Question 7

what is bronchiectasis

Answer 7

persistent or progressive condition caused by chronic inflammatory damage to the airways and is characterised by thick-walled, dilated bronchi.

Question 8

Bronchiectasis (non-cystic fibrosis), acute exacerbation treatment

Answer 8

Obtain a sputum sample and send for culture and susceptibility testing. Antibacterial therapy should be given to all patients with an acute exacerbation.

1st line amox, clarith, doxy for 7-14 days

if high risk treatment failure (repeated course of abx or previous culture with resistant or atypical bacteria etc): co amox, levoflox

Question 9

COPD exacerbation treatment

Answer 9

5 days amox, clarity or doxy

if high risk of treatment failure co amox of levoflox

Question 10

acute cough is usually self limiting and often resolves within —– without abx.

Answer 10

3-4 weeks

Question 11

choice of abx therapy for acute cough if needed

Answer 11

5 days doxy

alt amox, clarith, eryth

pregnancy amox or eryth

Question 12

what is CURB 65

Answer 12

pneumonia severity

accounts for confusion, urea >7, low RR, low BP, age more than or equal to 65

Question 13

which setting is CRB65 used in

Answer 13

primary care

Question 14

which setting is CURB65 used in

Answer 14

hospital

Question 15

CAP low severity treatment

Answer 15

1. amox

alt: clarith, doxy, eryth (preg)

5 days

Question 16

CAP moderate severity treatment

Answer 16

1. amox
2. atypical pathogens: amox + clarity or eryth (preg)

alt allergy: clarith, doxy

Question 17

CAP high severity treatment

Answer 17

oral or IV 1st line
co amox + clarith or oral eryth (preg)

alt: levofloxacin

Question 18

when is pneumonia defined as HAP

Answer 18

it develops 48 hours or more after hospital admission.

Question 19

oral 1st line for HAP, non severe and not at high risk of resistant

Answer 19

co amox

allergy: doxy, cefalexin, co trim, levoflox

Question 20

HAP IV 1st line if severe signs of symptoms or at higher risk of resistance

Answer 20

IV 1st line

piperacillin with tazobactam, ceftazidime, ceftaziidime + avibactam, ceftriaxone, cefuroxime, levoflox, meropenem

if MRSA suspected of confirmed + vanocmyin or teciplanin or linezolid