Respiratory

Question 1

What type of Virus is Influenza

Answer 1

RNA Virus

Question 2

What percentage of the worlds population is infected by influenza yearly?

Answer 2

10-20%

Question 3

Similaries of flu with common cold

Answer 3

Spread in winter months
Direct contact or via droplets
Child (5-7 per yr)
Adult (1-2 per year)

Question 4

Influenza A viruses

Answer 4

Found in humans, birds, pigs & horses
causes epidemics and occasionally pandemics, and there is an animal reservoir, notably in birds

Question 5

Influenza B viruses

Answer 5

Found in humans only
Only causes epidemics and do not involve animal hosts.

Question 6

Influenza C viruses

Answer 6

Found in humans only
Only cause minor respiratory illness.

Question 7

What type of viruses is mainly responsible for pandemics?

Answer 7

Type A Viruses

Question 8

What are the subdivisions of type A viruses?

Answer 8

HA types
NA types

Question 9

What does a seasonal flu vaccine contain?

Answer 9

Each seasonal vaccine contains 3 influenza viruses:

One A(H3N2) virus

One A(H1N1) virus – not the 2009 pandemic virus

One B virus

Question 10

Treatment (drugs) for human flu

Answer 10

Zanamivir (Relenza)
Neuraminidase inhibitor (important for the budding out of virus from the host cell)
Influenza A and B

Oseltamivir (Tamiflu)
Neuraminidase inhibitor
Influenza A and B

Amantadine
Inhibitor of viral M2 protein

Question 11

What percentage of protection do current vaccines give?

Answer 11

70-80%
prevention purposes

Question 12

Swine flu pandemic - Year, strain and spread

Answer 12

2009
H1NI
Spread: It is derived originally from a strain that lived in pigs. It spreads by droplets and touch from person to person and not from swine to people.
The virus, contains a combination of genes from swine, avian (bird), and human influenza viruses.

Question 13

Vaccine and treatment for swine flu

Answer 13

Preventive vaccine: Pandemrix – killed/inactivated vaccine
Treatment: Antivirals – Relenza or tamiflu

Question 14

How does SARS-CoV-2 infect cells?

Answer 14

by droplets
in epithelial of the respiratory tract

Question 15

What is the virus that caused COVID-19?

Answer 15

SARS-CoV-2

Question 16

Infections that affect the lower respiratory tract?

Answer 16

Cough
Sputum (+ presence of blood)
Wheezing
Breathlessness
Chest pain
Others, e.g. fever
Cyanosis
Clubbing of fingers

Question 17

Normal blood o2 saturation range + meaning

Answer 17

95% to 100%, = almost all of your blood’s hemoglobin is carrying oxygen

Question 18

What is Pneumonia?

Answer 18

acute inflammation of lung parenchyma

Question 19

Risk factors of pneumonia

Answer 19

Age (infants, young children and elderly)
Stroke, multiple sclerosis, Alzheimer’s disease
Immunocompromised individuals
Alcoholism and smoking
Asthma
Congestive cardiac failure
Cystic fibrosis
Chronic obstructive lung diseases

Question 20

Aetiology of Pneumonia

Answer 20

Bacteria, viruses, fungi, mycoplasma, chlamydia

Question 21

What opportunistic infections cause pneumonia?

Answer 21

Pneumocystis carinii
Fungal infections
Cytomegalovirus (CMV)
Mycobacterium Avium

Question 22

Risk factors for opportunistic pneumonia

Answer 22

Bone marrow transplants
Cancer (including lymphoma and leukemia)
Long-term corticosteroid medication
Organ transplants
Stem cell transplants
Use of immunosuppressant medication.

Question 23

Community acquired pneumonia

Answer 23

one of the most common infectious diseases
Most commonly caused by a bacterial infection
Communityacquiredis when a person who has little contact with the healthcare system contracts the condition

Question 24

Hospital acquired pneumonia

Answer 24

AKA nosocomial pneumonia
any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted.
It is usually caused by a bacterial infection, rather than a virus.

Question 25

Morphological classes of pneumonia

Answer 25

Bronchopneumonia, Lobar & interstitial pneumonia

Question 26

Lobar Pneumonia

Answer 26

right side of lung is affected - collection of fluid Streptococcus pneumoniae, Klebsiella Symptoms: Stabbing chest pain when breathing in Cough and fever Shortness of breath Diagnosis: X-ray Bacteria in blood or sputum Increase in neutrophil count in blood Treatment: Antibiotics: ampicillin, clarithromycin for 5-7 days Prophylactic vaccine against pneumococcus

Question 27

What are the complications of lobar pneumonia?

Answer 27

Abscess formation Failure of resolution stage: - intra-alveolar fibrosis - permanent loss of ventilatory function Bacteremia: - endocarditis - cerebral abscess/meningitis Pleural effusion: fluid collection in pleural cavity Empyema: Pus collection in pleural cavity

Question 28

What is Bronchopneumonia caused by?

Answer 28

Staphylococcus aureus, H.influenza symptoms + treament same as lobar pneuomonia

Question 29

What is Interstitial Pneumonia caused by?

Answer 29

Most frequently caused by viruses – influenza A and adenovirus

Question 30

Treatment for interstitial pneumonia

Answer 30

Bed rest (oxygen may be needed in severe cases) Antibiotics will have no effect – unless there is a secondary bacterial infection. Most cases resolve completely. The rare complication is interstitial fibrosis.

Question 31

Symptoms of interstitial pneumonia

Answer 31

Fever Chill Dry Cough Shortness of breath

Question 32

Causes of lung cancer

Answer 32

Smoking (90% of cases) Asbestos Radon (radioactive gas) Chromium, nickel, arsenic and coal tar Radiation Passive smoking Mutation in: EGFR, BRAF, KRAS, MET, LKB1 and P53

Question 33

Primary lung cancer

Answer 33

Small cell lung cancer (SCLC) Non-small cell lung cancer (NSCLC)

Question 34

Secondary lung cancer

Answer 34

Any type of cancer that can spread to the lung

Question 35

Small cell lung cancer

Answer 35

15-20% of lung cancers Tends to be very aggressive

Question 36

Non-small cell lung cancer

Answer 36

80-85% of lung cancers Squamous cell carcinoma: 30% Adenocarcinoma: 35-40% Large cell lung cancer: 10-15%

Question 37

Squamous cell carcinoma

Answer 37

smoking for a long period of time

Question 38

Adenocarcinoma

Answer 38

Occurs more in smokers who have quit and non-smokers

Question 39

small cell carcinoma

Answer 39

Most common type seen in asbestos workers

Question 40

Lung cancer diagnosis

Answer 40

Patient history and physical examination Diagnostic tests - Chest x-ray - Biopsy - CT scan of chest/abdomen - PET Scan - Bone scan

Question 41

Lung cancer screening

Answer 41

No proven effective screening tool Chest x-ray commonly used

Question 42

Metastasis of primary lung cancer

Answer 42

Lymph nodes, brain, liver, adrenal gland, bones

Question 43

Lung cancer treatment Non-small cell lung carcinoma (NSCLC)

Answer 43

Surgical removal (T1, N0, M0) – 5-10% cases 70% survival for 5 years 85% unresectable cases Radiotherapy Chemotherapy (cisplatin, carboplatin, paclitaxel, gemcitabine

Question 44

Lung cancer treatment Small cell lung carcinoma (SCLC)

Answer 44

Limited disease: Chemotherapy Concomitant radiotherapy Prophylactic cranial irradiation 18-20 months median survival 10% 5-year survival chance Extensive disease: Chemotherapy Palliative radiation 10-12 months median survival 1-2% 5-year survival