Respiratory Tract Infections

Question 1

Viruses that cause coryza

Answer 1

Adenovirus
Rhinovirus
Respiratory Syncytial Virus

Question 2

Complications of coryza

Answer 2

Sinusitis, Acute Bronchitis

Question 3

Clinical presentation of coryza

Answer 3

Mild fever, sore throat, malaise chills. Symptoms subside over few days without treatment.

Question 4

What is quinsy?

Answer 4

Tonsillar abcess of pus. Rare.

Question 5

Why is diphtheria life-threatening?

Answer 5

Bacteria creates pseudo-membrane visible on pharynx that can block airway.

Question 6

Symptom characteristic of partially blocked airway?

Answer 6

Stridor - high pitched grating sound on inspiration. Heard diphtheria and acute epiglottitis

Question 7

Acute bronchitis clinical presentation

Answer 7

Productive cough, normal chest X ray and examination, fever and wheeze may be seen.

Question 8

Acute bronchitis prognosis is

Answer 8

Usually self limiting and antibiotics are not indicated. Can lead to morbidiity in patients with chronic lung disease.

Question 9

Respiratory syncytial virus incubation time is

Answer 9

7 days

Question 10

Acute exacerbation of COPD clinical presentation

Answer 10

Usually preceded by upper respiratory tract infection
Increased sputum production
Increased sputum purulence
More wheezy
Breathless

Question 11

Acute exacerbation of COPD on examination?

Answer 11

Respiratory Distress
Wheeze
Coarse crackles
May be cyanosed
In advanced disease – ankle oedema

Question 12

Management exacerbation COPD

Answer 12

Antibiotic. e.g. doxycycline or amoxicillin
Bronchodilator inhalers
Short course of steroids in some cases
Evidence of respiratory failure- oxygen

Question 13

What is alveoli infiltrate?

Answer 13

Opacification of alevoli due to them filling with blood, pus or fluid, usually around seen around the bronchi in film. It is a sign for pneumonia

Question 14

What is consolidation?

Answer 14

When the lung tissue is filled with blood, pus or fluid resulting in the swelling or hardening of lung tissue. It is a sign of pneumonia

Question 15

Clinical presentation of pneumonia?

Answer 15

Malaise
Sweats
Rigors
Myalgia
Arthralgia
Headache
Cough
Pleuritic Pain
Haemoptysis
Dyspnea

Question 16

Signs of pneumonia

Answer 16

Tachypnoea- rapid breathing
Crackles
Pleural Rub
Cyanosis
Hypotension
Consolidationon CXR
Pleural effusion on CXR
Alveolar Infiltrate on CXR

Question 17

What is a common complication of pneumococcal disease?

Answer 17

Reactivation of herpes labialis

Question 18

How do you assess the severity of pneumonia?

Answer 18

C  	New onset of confusion
U  	Urea >7
R  	Respiratory rate >30/min
B  	Blood pressure Systolic <90  OR  Diastolic <61
65 	age 65 years or older

Question 19

What is empyema?

Answer 19

Pus in pleural space. Complication of pneumonia. CXR dulling of costophrenic angles. Excess can impair breathing and cause orthopnea.

Question 20

What is pleural effusion?

Answer 20

Fluid in pleural space, can be serous fluid, pus or blood. Complication of pneumonia. CXR dulling of costophrenic angles. Excess can impair breathing and cause orthopnea.

Question 21

Investigations for suspected pneumonia would be?

Answer 21

Blood culture
Serology
Arterial gases
Full blood count
Urea
Liver function
Chest X-ray

Question 22

Treatment for community aquired pneumonia?

Answer 22

Antibiotics
Amoxicillin
Doxycycline
Oxygen Maintain SaO2 94-98 % or 88-92 %
Fluids
Bed rest
No smoking