Respiratory infections

Question 1

Mode of spread of influenza?

Answer 1

droplet

Question 2

Three complications of influenza?

Answer 2

  Bronchitis 
  Pneumonia: esp. Staph 
  Sinusitis 
  Encephalitis 
  Pericarditis

Question 3

Two drugs used for severe influenza treatment?

Answer 3

oseltamivir
zanamivir
amantidine= M2 inhibitor

Question 4

List two viral infections that can result in pneumonia

Answer 4

influenza
SARS
COVID

Question 5

Two complications of the common cold

Answer 5

otitits media, sinusitis

Question 6

Which virus accounts for 50% of the causes of the common cold?

Answer 6

rhinovirus

Question 7

What are the two variants of influenza B?

Answer 7

Victoria and Yamagata

Question 8

What are the symptoms of influenza based on body system?

Answer 8

1. Neurological- fever, headache 2. Respiratory 3. GI 4. Musculoskeletal

Question 9

Name two neuraminidase inhibitors that are frequently used in the UK

Answer 9

oseltamivir (tamiflu), zanamivir

Question 10

Which coronavirus emerged in 2002 that had a fatality rate of 9.5%?

Answer 10

SARS-CoV

Question 11

Which coronavirus emerged in 2012 with 34.5% fatality rate?

Answer 11

MERS-COV

Question 12

Which is the most common bacterial infection that causes pneumonia?

Answer 12

streptococcus pneumoniae

Question 13

Two agents which cause typical pneumonia?

Answer 13

streptococcus pneumoniae, haemophilus influenzae, moraxella catharralis

Question 14

Two agents which cause atypical pneumonia?

Answer 14

mycoplasma pneuomoniae, legionella pneumoniae, chlamydophila pneumoniae (rare), chlmydophila psittaci (Rare)

Question 15

Three risk factors for strep pneumoniae?

Answer 15

HIV (T cell defect)

alcohol (affects immune system)

preexisting airway disease

smoking (Destroys epithelium)

influenza (results in post-flu pneumonia)

Question 16

Two signs of classical pneumonia?

Answer 16

dull percussion, coarse crackles/crepitations, increased vocal resonance

Question 17

What is the treatment for H.influenzae pneumonia?

Answer 17

amox

Question 18

Two symptoms of atypical pneumonia?

Answer 18

Headache, myalgia (muscle pain), fatigue

Question 19

Name two scoring systems are available to determine severity of pneumonia?

Answer 19

1. Curb65 score 2. Multilobar consolidation on CXR and/or hypoxia on room air 3. Sepsis- qSOFA

Question 20

What are the features of the CURB65 score?

Answer 20

Confusion
Urea>7
Resp rate >30
BP <90/60
65- age over 65

Question 21

What score is obtained on CURB65 score to determine severe pneumonia?

Answer 21

> 2

Question 22

What are the issues with CURB65 and qSOFA?

Answer 22

do not factor hypoxia and consolidation!

Question 23

Two examples of CAP?

Answer 23

strep.pneumoniae
haemophilus influenza
mycoplasma
legionella

Question 24

Two examples of hospital acquired pneumonia?

Answer 24

MRSA
E.coli
Klebsiella pneumoniae

Question 25

Treatment for CAP?

Answer 25

amoxicillin

Question 26

If patient has CAP but has penicillin allergy, which abx could you give them?

Answer 26

clarithromycin

Question 27

Oral antibiotic for hospital acquired pneumonia?

Answer 27

co-amoxiclav

Question 28

A 65-year-old woman with COPD attends surgery with a 2-day history of worsening dyspnoea, productive cough, and fever. On examination, she has basal crackles on the right side. What is the most likely causative organism?

Answer 28

This is an infective exacerbation of COPD, with the fever and basal crackles indicating a bacterial cause. The most common cause in COPD is Haemophilus influenzae.

Question 29

An 8-year-old boy is brought in by his mother with a history of shortness of breath and fever over the last few hours. On examination, he has a toxic appearance, has inspiratory stridor, and is drooling. What is the most likely organism?

Answer 29

The history indicates acute epiglottitis, and this child would obviously need an ambulance to transfer him to the emergency department urgently. The most common cause of acute epiglottitis in children is Haemophilus influenzae type B, and the incidence of acute epiglottitis has fallen since the introduction of the Hib vaccine.

Question 30

A 27-year-old man attends with a 2-day history of right-sided otalgia and discharge. He is a keen swimmer. On examination, the external auditory canal is swollen and erythematous, with purulent material on the walls. Organism?

Answer 30

Bacterial causes of otitis externa are most common, with Pseudomonas aeruginosa being most prevalent. Other causes include Staphylococcus aureus