respi microbiology

Question 1

which of the following is correct about glandular fever?
a. caused by EBV and stays latent in T cells
b. unlikely to develop fever
c. likely to recover within a week
d. could be diagnosed by atypical monocytes

Answer 1

d. could be diagnosed by atypical monocytes (glandular fever aka infectious mononucleosis)

a. EBV stays latent in B cells
b. will develop fever
c. recover in a few weeks to months

Question 2

what is pharyngitis best treated with?

Answer 2

penicillins

Question 3

what bacteria causes pharyngitis?

Answer 3

group A haemolytic/streptococci and group B streptococci

Question 4

what is the most common causative agent of CF in early childhood?

Answer 4

S. aureus

Question 5

what is the common cold also known as and what is common causative agent?

Answer 5

viral rhinitis
commonly caused by rhinovirus

Question 6

what is quinsy (peritonsillar abscess) a complication of?

Answer 6

suppurative complication of pharyngitis/tonsilitis

Question 7

what is the bacteria causing pharyngitis and tonsilitis?

Answer 7

streptococcus pyogenes

Question 8

what is the common cause of pharyngitis?

Answer 8

viral

Question 9

what antibiotics can be given to a patient with pharyngitis/tonsilitis?

Answer 9

amoxicillin (penicillin)
cephalexin (cephalosporin)
azithromycin (macrolide)

Question 10

which URTI involves the formation of a pseudomembrane over the pharynx/larynx?

Answer 10

diphteria

Question 11

what URTI does a patient presenting with a bull neck have?

Answer 11

diphteria

enlarged cervical lymph nodes cause bull neck

Question 12

what URTI does Epstein-Barr Virus (EBV) cause?

Answer 12

glandular fever/infectious mononucleosis

Question 13

which URTI causes hoarseness of voice?

Answer 13

acute laryngitis

Question 14

which group of patients usually affected with acute laryngotracheobronchitis (croup)?

Answer 14

in the very young (3 months to 3 years old)

Question 15

what is the common causative agent of croup?

Answer 15

parainfluenza virus (type 1)
other possibles: parainfluenza virus types 2 and 3, influenza virus, adenovirus, RSV

Question 16

what is the causative agent of acute epiglottitis?

Answer 16

Haemophilus influenzae type B

Question 17

what drugs can be given to treat rhinosinusitis/acute sinusitis?

Answer 17

amoxicillin
cefuroxime
doxycycline

Question 18

what drugs can be given to treat otitis media?

Answer 18

amoxicillin
cefuroxime

Question 19

why is otitis media more common in infants/young children?

Answer 19

their eustachian tube is more horizontal –> harder for nasal secretions to drain out –> fluid build up leading to inflammation of middle ear

Question 20

what is a crowded pharynx indicative of?

Answer 20

obstructive sleep apnea

Question 21

at which phase should antibiotics most ideally be administered in pertussis and why?

Answer 21

catarrhal phase
most infectious period with URTI symptoms

Question 22

what is the most common causative agent of acute bronchiolitis?

Answer 22

respiratory syncytial virus

Question 23

what is the most common causative agent of typical pneumonia in general?

Answer 23

S. pneumoniae

Question 24

what is the most common causative agent of typical pneumonia among COPD patients?

Answer 24

H. influenzae, Klebsiella pneumoniae

Question 25

what is the most common causative agent of typical pneumonia among CF patients?

Answer 25

P. aeruginosa

Question 26

what is the most common causative agent of typical pneumonia among IVDU and elderly?

Answer 26

S. aureus

Question 27

what is the main causative agent of atypical pneumonia?

Answer 27

mycoplasma pneumoniae

Question 28

which micro-organism is most likely to cause pneumonia in patients with AIDS/HIV?

Answer 28

pneumocystis jiroveci

Question 29

which test confirms that patient has active TB infection?

Answer 29

presence of acid-fast bacilli in sputum sample

Question 30

which two viruses cause more than half of the common colds?

Answer 30

rhinovirus and coronavirus

Question 31

which of the following symptoms is most likely to be absent in a patient with streptococcus pharyngitis?
a) cough
b) pus
c) inflammation
d) high fever

Answer 31

no cough in bacterial pharyngitis

Question 32

what is nasopharyngeal aspirate diagnostic procedure used for?

Answer 32

acute bronchiolitis

Question 33

Which of the following is a symptom of both typical pneumonia and atypical
pneumonia?
a. Dry cough
b. Fever
c. Purulent sputum
d. Dyspnoea

Answer 33

b) Fever
dry cough: atypical pneumonia
purulent sputum: typical pneumonia
dyspnoea: typical pneumonia

Question 34

what drugs are used to treat severe community-acquired pneumonia?

Answer 34

Ceftriaxone + azithromycin (broad spectrum)

Question 35

compare streptococcal pharyngitis and viral pharyngitis in terms of onset

Answer 35

streptococcal pharyngitis: sudden onset

Question 36

high fever, enlarged painful tonsils with white pus-filled lesions, tender cervical lymphadenopathy, no cough

what infection is this?

Answer 36

streptococcal pharyngitis

Question 37

which statement is correct about otitis externa?
a. spreads only superficially and can be treated with a topical antibiotic
b. this is a minor infection and usually self-limiting
c. invades inner ear components
d. invades tissue deeply, causing necrosis as it goes

Answer 37

d. invades tissue deeply, causing necrosis as it goes –> invasive otitis externa

a. infection invades deep tissue
b. quite serious infection
c. referring to otitis interna

Question 38

what are the 3 types of otitis externa?

Answer 38

1. localised (hair follicle furnucles/pustules, boil in ear)
2. diffuse (‘swimmer’s ear, whole ear canal inflamed)
3. invasive (severe necrotising infection that spreads to adjacent soft tissue and bone)

Question 39

should throat swab be used in acute epiglottitis?

Answer 39

AVOID!! can aggravate airway obstruction

Question 40

what drugs are used to treat low severity pneumonia?

Answer 40

amoxicillin + doxycycline

Question 41

what drugs are used to treat moderate severity pneumonia?

Answer 41

benzylpenicillin + doxycycline