Respiratory infections

Question 1

What are 4 distinguishing features of Mycoplasma pneumonia?

Answer 1

Erythema multiforme / Erythema nodosum Cold autoimmune haemolytic anaemia Hyponatraemia GI symptoms

Question 2

How do you distinguish between Legionella and Mycoplasma pneumonia?

Question 3

Is SMART-COP sensitive or specific?

Answer 3

Sensitive

Question 4

Is the CORB score sensitive or specific?

Answer 4

Specific

Question 5

What is in SMART-COP?

Answer 5

Systolic BP <90 - 2 points

Multilobar involvement on CXR

Albumin <35

Resp rate >=25 if under 50, >=30 if over 50

Tachycardia >= 125

Confusion (new)

Oxygen <93% or <70mmHg if under 50, <90% or <60mmHg if over 50 - 2 points

pH <7.35 - 2 points

Question 6

How do you interpret SMART-COP?

Answer 6

Risk of needing intensive respiratory or vasopressor support

0-2 low risk

3-4 moderate risk (1 in 8)

5-6 high risk (1 in 3)

>=7 very high risk (2 in 3)

Question 7

What is in CORB score?

Answer 7

Confusion (new)

Oxygen <92%

Resp rate >=30

BP systolic <90 or diastolic <60

2 or more = severe

Question 8

Pertussis - clinical features?

Answer 8

+/- Catarrhal phase

Paroxysmal phase

Convalescence phase

Generally NO fevers

Question 9

Influenza - what do H and N stand for?

Answer 9

Haemagglutinin

Binds to sialic acid on respiratory epithelium for viral entry

Neuraminidase

Allows daughter virions to be relased from the cell

Question 10

What host factors are associated with severe influenza?

Answer 10

Obesity

Asthma

Immunosuppression

Pregnancy

Low IgG (specifically IgG2) levels