respiratory infections

Question 1

causative organism of otitis media

Answer 1

RSV
rhinovirus

pneumococcus
HiB
moraxella catarhalis
pseudomonas aeruginosa

Question 2

causative organism of epiglottitis

Answer 2

HiB

Question 3

treatment for sinusitis

Answer 3

antibiotics

surgical drainage

Question 4

symptoms of sinusitis

Answer 4

fever
headache
facial pain
rhinorrhea

Question 5

possible complications of sinusitis

Answer 5

menigitis
cavernous sinus thrombosis
chronic sinusitis

Question 6

what URTIs have sudden onset obstruction

Answer 6

croup
epiglottitis
neck abscess

Question 7

definition of pneumonia

Answer 7

LRTI causing inflammation and consolidation of alveoli, bronchioles

Question 8

4 ways to classify pneumonias

Answer 8

causative organism
anatomical location
predisposition
typical VS atypical

Question 9

4 types of “predisposition” pneumonias

Answer 9

Community acquired
hospital acquired
aspiration
opportunistic

Question 10

causative organism of typical pneumonia

Answer 10

streptococcus pneumoniae
klebsiella
Haemophilus influenza

Question 11

causative organisms of atypical pneumonia

Answer 11

legionella
mycoplasma pneumonia
chlamydia pneumoniae

Question 12

symptoms of typical pneumonia

Answer 12

fever
cough
chest pain
rusty sputum
tachycardia

Question 13

symptoms of atypical pneumonia

Answer 13

lower grade fever
relative bradycardia
late cough, little sputum

Question 14

what hospital interventions can predispose you to pneumonia

Answer 14

IV cannulas, catheters, NG tubes, ventilators

Question 15

what can predispose you to aspiration pneumonia

Answer 15

stroke patient
PEG feeding
alcoholics

Question 16

how to diagnose pneumonia

Answer 16

cough, fever and any other LRTI symptom
consolidation on CXR
no other explanation for illness

Question 17

atypical pneumonia organisms will not grow on petri dish, T or F

Answer 17

T

Question 18

what is CURB 65

Answer 18

confusion
urea >7
Respiratory rate ≥30
blood pressure <60 diastolic or 90 systolic

age over 65

Question 19

treatment for pneumonia

Answer 19

oxygen

antibiotics - amoxicillin, clarithromycin

Question 20

symptoms in infective exacerbation of COPD

Answer 20

increased coughing
change in sputum colour
increased SoB
no chance in CXR

Question 21

what are 2 LRTI complications

Answer 21

lung abscess

empyema

Question 22

definition of exudate

Answer 22

> 30g/L protein and pH <7.2

Question 23

how to treat empyema

Answer 23

chest drain + antibiotics

Question 24

definition of pyrexia of unknown origin

Answer 24

38.3 >3 weeks AND no identifiable cause after 3x hospital/3 days hospital stay

Question 25

approach to PuO history taking

Answer 25

``` normal hx PLUS travel hx sexual hx animal contacts occupation/hobby ```

Question 26

what are the possible outcomes of someone in contact with mycobacterium tuberculosis

Answer 26

1. not infected 2. infection infection -> latent tuberculosis -> +/- reactivation infection -> primary tuberculosis -> resolution/death

Question 27

what is the pathophysiology of latent TB

Answer 27

MTB inhaled in droplets, deposited in lungs, ingested by macrophages. macrophages go to hilar lymph nodes, immune reaction causes necrosis and caseation. lumph nodes heal with fibrosis and calcify forming a granuloma granulomas contain TB which can reactive many years later

Question 28

which part of the lung is TB most likely to reactive

Answer 28

apices

Question 29

what are some possible outcomes of an immunocompromised patient infected with pulmonary TB

Answer 29

``` parenchymal infection pleural effusion TB empyema bronchiectasis haemoptysis lung collapse ```

Question 30

extrapulmonary tuberculosis is limited to only hollow body organs - T or F?

Answer 30

False, can occur anywhere

Question 31

what is miliary TB

Answer 31

dessiminated TB foci throughout the body

Question 32

systemic clinical features of TB

Answer 32

``` fever malaise anorexia weight loss sweats rigors ```

Question 33

features of pulmonary TB

Answer 33

cough haemoptysis SoB chest pain

Question 34

what are features of genitourinary TB

Answer 34

dysuria | haematuria

Question 35

most common site of extrapulmonary TB

Answer 35

ileocaecal region

Question 36

features of gastrointestinal TB

Answer 36

abdo pain

Question 37

what is a TB lesion on the skin called

Answer 37

lupus vulgaris

Question 38

risk factors of TB

Answer 38

no BCG vaccine homelessness prison population immunosuppressed inc HIV

Question 39

investigation of TB

Answer 39

sputum/bronchoalveolar lavage microscopy and culture CXR

Question 40

what 2 stains can be used for mycobacterium tuberculosis

Answer 40

ziehl nielsen stain | auramine

Question 41

what test is done for screening of contacts of TB exposure

Answer 41

mantoux test

Question 42

what does the quadruple therapy for TB treatment consist of

Answer 42

isoniazid rifampicin ethambutol pyrazinamide

Question 43

what skin condition can you get after a bout of pneumonia?

Answer 43

erythema multiform

Question 44

what antibiotic to use in pneumonia if patient has true penicillin allergy?

Answer 44

doxicylin

Question 45

clarithromycin should not be prescribed with statins - t or f?

Answer 45

true