Respiratory Illness Intro

Question 1

T/F A cold is an upper respiratory tract infection that is typically caused by Rhinoviruses

Answer 1

T

Question 2

Which of the following statements is true regarding the common cold? (Select All)

A. Must be treated using antibiotics only

B. Self-limiting for 7-14 days

C. Can be transmitted by air and by touching nasal mucosa after contacting the virus (by touch)

D. Children commonly catch it through self-inoculation

Answer 2

B, C, D

Question 3

Which of these factors can increase susceptibility of catching any cold viruses?

A. High population densities

B. Allergic disorders (allergies)

C. Smoking and lack of physical activity

D. Sleep deprivation or poor quality of sleep (<7 hours/day)

E. All of the above

Question 4

What is the incubation period for the common cold?

A. 1-3 days

B. 4-7 days

C. 8-10 days

D. 16-18 days

Answer 4

A.

Question 5

List the following signs/symptoms of the common cold in order of occurance:

I: Sore throat

II: Low grade fever <100 ºF

III: Cough

IV: Nasal Symptoms

A. I, II, IV, III

B. II, IV, III, II

C. I, IV, III, II

D. IV, III, II, I

Answer 5

C.

Question 6

When observing cold symptoms the Day 1 is usually dominated by:

A. Cough

B. Fever

C. Sore throat

D. Nasal symptoms

Answer 6

C

Question 7

What day(s) do nasal symptoms of the cold become dominant?

A. Day 1

B. Day 2-3

C. Day 4-5

D. Symptom does not correspond to the cold

Answer 7

B

Question 8

What symptom is commonly seen in days 4-5 of the common cold?

A. Sore throat

B. Cough

D. Low grade fever

E. Nasal symptoms

Answer 8

B.

It can be argued however that nasal symptoms and fever can be seen in these days as well but according to the powerpoint day 4 or 5 is when coughing primarily begins.

Question 9

As the cold Progresses mucus will appear (______) and as the cold Resolves mucus will appear _____.

A. (Thicker, Yellow/Green), (Thinner,Clear, Watery)

B. (Thinner, Clear, Watery), (Thicker, Yellow/Green)

Answer 9

A

In the first 2-3 days of the cold nasal symptoms and mucus will appear clear and thin/watery but as it progresses it gets thicker and more discolored. Once the cold begins resolving it goes back to clear and thin/watery.

Question 10

Which of these signs are found in a physical assessment of a patient that is suspected to have the cold?

A. Slightly reddening of throat

B. Evidence of postnasal draining in throat

C. Nasal congestion

D. Tender sinus upon palpatation

E. All of the above

Answer 10

E

Question 11

Acute cough lasts approximately _____:

A. < 3 weeks

B. > 8 weeks

C. 3-8 weeks

Answer 11

A

Question 12

How long does a cough last in order to be categorized as subacute?

A. 3-8 weeks

B. > 8 weeks

C. < 3 weeks

Answer 12

A

Question 13

Cough that lasts longer than 8 weeks is defined as a(n)_____

A. Acute cough

B. Subactue cough

C. Chronic cough

D. Whooping Cough

Answer 13

C

Question 14

A Productive cough is associated with which of these characteristics? (Select All)

A Secretions

B. Dry

C. Wet

D. Phlegm

E. Hacking

Answer 14

A, C, D

Question 15

A Non Productive cough is associated with which of these characteristics? (Select All)

A. Wet

B. Dry

C. Hacking

D. Secretions

E. Phlegm

Answer 15

B, C

Question 16

Which of these is NOT an exclusions of self-care from Upper Respiratory Viral Illnesses (cold/influenza)?

A. Patients with underlying COPD or Asthma

B. Fever > 101.5 ºF

C. Cough and/or Phlegm

D. Chest pain and Shortness of breath

E. Frail patients or patients with AIDS or on Immunosuppresants

F. Infants <9 months of age

Answer 16

C

Question 17

Which of the following is NOT an exclusion for self-treatment of acute cough?

A. Chest Pain & Shortness of Breath

B. Fever >103 ºF

C. Underlying COPD or Asthma

D. Cough lasting > 7 days/ or with thick yellow/green sputum

E. Worstening Symptoms

F. Sore throat

Answer 17

E.

Other criteria include:

• Unintended weight loss
• Drenching nightime sweats
• Hemoptysis
• Forgein object aspiration (breathing in solid matter)
• Suspected drug associated cough (ACE inhibitors for example)

Question 18

Inflammation of the mucous membranes of the nose is known as:

A. COPD

B. Asthma

C. Rhinitis

D. Cold/ Influenza

Answer 18

C

Question 19

Rhinitis can be categorized as Allergic Rhinitis or Non-Allergic Rhinitis. Which of these causes is categoriezed as Non-Allergic Rhinitis? (Select All)

A. Infections

B. Vasomotor

C. Intermittent (Seasonal)

D. Hormonal and Anatomical

E. Rhinitis Medicamentosa

Answer 19

A, B, D, E

Question 20

Allergic rhinitis pertains to prominent ___ symptoms and Allergic Conjunctivitis pertains to prominant ___ symptoms

A. Nasal, Oral

B. Ocular, Nasal

C. Nasal, Ocular

D. Ocular, Oral

Answer 20

C

Question 21

Which of the following are risk factors associated with Allergic Rhinitis?

A. Family of history or allergic rhinitis

B. Atopic Dermatitis

C. Higher socioeconomic status

D. Positive reaction to skin tests

E. All of the above

Answer 21

E.

Higher socioeconomic status is a risk factor because people of higher socioeconomic status have great healthcare and benefits and as a result they rarely get sick. This leaves their eosinophils without any natural enemies and bacteria to target and as a result they begin targeting simple allergens in the air instead. This leads to allergies.

Question 22

What are some of the common symptoms of allergic rhinitis? (select all)

A. Rhinorrhea and Nasal congestion

B. Pruritus of the nose, eyes and throat

C. Unilateral symptoms (only appearing in one eye)

D. Worse upon awakening, improve during the day and worsen again at night.

E. Pain

Answer 22

A, B, D

Question 23

Which of these symptoms is not associated with Alelrgic Rhinitis? (Select All)

A. Watery eyes and sneezing

B. Bilateral presentation

C. Pain

D. Purulent (pus) rhinorrhea

E. Epistaxis (nose bleed)

Answer 23

C, D, E

Question 24

A patient presents with nasal congestion, sneezing and runny nose that has lasted for the past 3 days. The patient reports that they are an annoyance but is able to function relavitvely well with the symptoms. The patient most likely has:

A. Intermittent, moderate-severe allergic rhinitis

B. Persistent, Mild allergic rhinitis

C. Intermittent, Mild allergic rhinitis

D. Persistent, moderate-severe allergic rhinitis

Answer 24

C

Question 25

A patient presents to the pharmacy complaining of an itchy and runny nose for the past 2 weeks. Upon further questioning the patient reveals that the symptoms are worst upon awakening and have woken him up at random hours of the night. He said he normally experiences these symptoms less than 4 days per week. What does this patient most likely have?

A. Persistent, Moderate-Sever Allergic Rhinitis

B. Persistent, Mild Allergic Rhinitis

C. Intermittent, Mild Allergic Rhinitis

D. Intermittent Moderate-Sever Allergic Rhinitis

Answer 25

D.

The patient has had at least one impairment of daily activity (Sleep) so it is categorized as moderate-severe. It has also lasted for less than 4 days per week for the past 2 weeks so it is intermittent. In order for it to be classified as persistent it needs to last greater than or equal to 4 days per week for greater than 4 weeks.

Question 26

A patient presents with symptoms of rhinnorea, nasal and ocular itching (pruritus) and frequent sneezing. Upon examining the patient he shows physical signs of a nasal crease (allergic salute) and pale blue turbinates. The patient reveals that sometimes when he sneezes he feels slight chest pain and difficulty breathing. These symptoms have been present daily for the past 6 weeks. What can you deduce from this information given by the patient?

A. Patient has Persistent, Severe Allergic Rhinitis

B. Patient has Intermittent, Mild Allergic Rhinitis

C. Patient has Persistent, Mild Allergic Rhinitis

D. Patient may have another underlying condition and should be referred to hospital

Answer 26

D

Due to the chest pain and difficulty breathing the patient could possibly have another underlying condition such as Asthma or COPD that has not yet been clinically diagnosed by a physician (exclusion criteria for allergic rhinitis)

Question 27

An 11 year old child is brought to the pharmacy with symptoms of watery eyes, itchy nose and congestion. Upon further questioning of the mother it is revealed that the child has experienced these symptoms before but they seem to be getting worse during this season (summer). She wants to know if there is any particular medication that can be recommended for her child?

A. The child is most likely experiencing seasonal allergic rhinitis and can be started safely on an intranasal corticosteroid.

B. The child is most likely experiencing a cold and should be treated using nonpharmacolgic remedies.

C. The child could possibly have seasonal allergic rhinitis that is developing with age but should be referred to a physician.

D. The child is most likely experiencing seasonal allergic rhinitis and can be started safely on benadryl to be taken in the morning upon awakening.

Answer 27

C.

The child could very well have seasonal allergic rhinitis that is developing but since the child is under the age of 12 and hasn’t been clinically diagnosed with allergic rhinitis by a physician he is not a candidate for self-care (Exclusion criteria)

Question 28

A woman presents to the pharmacy to drop off two prescriptions from her PCP. In addition to dropping off her prescription she presents with watery eyes, and an itchy throat and states that she has been experiencing these symptoms on and off for roughly 5 days/week during the past 2 months. She reveals that during a visit with her family doctor a week ago she was diagnosed with allergic rhinitis. As you the process the prescriptions from her PCP you notice one is written for prescription-strength prenatal vitamins and the other is for cromolyn sodium. Is it ok for this patient to recieve medicinal treatment with cromolyn sodium?

A. Yes

B. No

Answer 28

A. Yes

The patient is pregnant (exclusion criteria) however she has also visited with her PCP and was clinicallly diagnosed with allergic rhinitis and the PCP has approved treatment with medication (OTC or prescription).