Respiratory

Question 1

Croup

Answer 1

Usually mild URTI causing barking cough, hoarse voice and rasping breathing. Often lasts 5 days, peaking on day 3 and being worse at night

Question 2

CURB-65 score

Answer 2

Scoring system for CA pneumonia.

Points for:

• confusion
• blood urea nitrogen >19mg/dl
• RR >30
• BP <90/60
• age >65

1 point = outpatient care
2-3 points - outpatient care with close f/u
4-5 = inpatient care

Question 3

Legionnaire’s disease

Answer 3

Caused by the intracellular bacterium Legionella pneumophilia. It typically colonizes water tanks and hence questions may hint at air-conditioning systems or foreign holidays. Person-to-person transmission is not seen.
sx:
flu-like symptoms including fever (present in > 95% of patients)
dry cough
relative bradycardia
confusion
lymphopaenia
hyponatraemia
deranged liver function tests
pleural effusion: seen in around 30% of patients

Ix: urinary antigen

Tx - clarithromycin/erithromycin