Respiratory infections

Question 1

What pathogen causes Community Acquired Pneumonia?

Answer 1

Streptococcus

Question 2

What are symptoms of CAP?

Answer 2

Dysponea, sputum production, pleural pain, sweating, fever, shivers, aches and pains.

Question 3

How do they measure the severity of CAP?

Answer 3

CURB 65 score

Question 4

What is the scoring system of CURB score?

Answer 4

1 point = low severity
2 points = medium severity
3 points = high severity

Question 5

How do you treat low severity CAP?

Answer 5

Amoxicillin
Penicillin allergy: Doxycycline or Clarithromycin (Erythromycin in pregnancy)

Question 6

How do you treat moderate severity CAP?

Answer 6

Amoxicillin PLUS Clarithromycin / Erythromcyin
Penicillin Allergy: Doxycycline

Question 7

How do you treat severe CAP?

Answer 7

Co-Amoxiclav PLUS Clarithromycin / Erythromycin
Alternative in severe cases: Levofloxacin

Question 8

Whats the duration of treatment for CAP?

Answer 8

5 days

Question 9

When would we consider whether it’s CAP or HAP if they have recently been admitted to hospital?

Answer 9

Consider CAP if pneumonia symptoms start less than 48 hours after hospital admission.

Question 10

What is the causative pathogen in Hospital Acquired Pneumonia?

Answer 10

Most cases streptococcus pneumoniae or haemophilus influenzae. Other common causes include gram negative bacteria such as e.coli, Klebsiella pneumoniae.

Question 11

Symptoms of HAP?

Answer 11

Dysponea, sputum production, pleural pain, sweating, fever, shivers, aches, tachycardia, tachypnoea and pains.

Question 12

How do we treat non severe HAP?

Answer 12

1st line: Co-Amoxiclav
Alternatively: Doxycycline, cefalexin, co-trimoxazole or levofloxacin.

Question 13

How do we treat severe HAP?

Answer 13

1st line: Tazosin, Ceftazidime, ceftriaxone or cefuroxime

Question 14

How long do we treat HAP for?

Answer 14

5 days then review

Question 15

What would we use if HAP is MRSA resistant?

Answer 15

Vancomycin, teicoplanin, or linezolid (if advised by micro)

Question 16

What bacteria are acute COPD exacerbations caused by?

Answer 16

Many exacerbations are not caused by bacterial infections so will not respond to antibiotics

Question 17

Symptoms of an Acute COPD exacerbation

Answer 17

Increased breathlessness, cough and sputum production

Question 18

Whats the first line treatment for an acute COPD exacerbation?

Answer 18

Amoxicillin, Clarithromycin or Doxycyline

Question 19

Whats the treatment duration for an acute COPD exacerbation?

Answer 19

5 days

Question 20

What is normally accompanied an antibacterial for a COPD exacerbation?

Answer 20

Prednisolone 30mg OD for 5 days

Question 21

What bacteria causes Strep Throat and Scarlett Fever?

Answer 21

Streptococcus bacteria

Question 22

What is the first and second line treatment for strep throat and scarlett fever?

Answer 22

1st: Phenoxymethypenicillin
2nd: Clarithromcyin or Erythromycin in pregnancy

Question 23

What are the symptoms of Scarlett fever?

Answer 23

Flu like symptoms, high temperature, swollen neck glands, a red rash with small raised bumps, rough feeling like sandpaper, white coating on tongue.