Respiratory Tract Infections

Question 1

List upper respiratory tract infections (3)

Answer 1

1. Sinusitis
2. Tonisilitis
3. Pharyngitis

Question 2

What % of pharyngitis is caused by viruses?

Answer 2

70%

Question 3

List the stages of pathogenesis for the common cold (7)

Answer 3

1. Infection
2. Virus absorbed
3. Viral replication
4. Virus shedding
5. Host defences activated
6. Overgrowth of bacterial commensals
7. Recovery

Question 4

Most efficient mode of rhinovirus transmission?

Answer 4

Direct contact

Question 5

Rhinovirus symptoms (4)

Answer 5

1. Sneezing
2. Sore throat
3. Nasal obstruction
   - Rhinorrhea (nasal cavity filled with significant amount of mucus fluid)
4. Cough

Question 6

What % of sore throats are a result of S. pyogenes (group A)

Answer 6

25%

Question 7

What % of children are asymptomatic carriers of S. pyogenes

Answer 7

15-20%

Question 8

What group of streptococci are the main culprits for sore throats?

Answer 8

Group A (S. pyogenes)

Question 9

What area in the body do ALPHA haemolytic streptococci affect?

Answer 9

Lung + oral

Question 10

What area in the body do BETA haemolytic streptococci affect?

Answer 10

Lungs + throat

Question 11

List virulence factors involved in group A streptococci (2)

Answer 11

1. Pyrogenic exotoxins

2. M protein

Question 12

List the complications that may follow with a streptococcal sore throat

Answer 12

1. Pre-tonsillar abscess
2. Otitis media (middle ear infection)
3. Rheumatic fever
4. Rheumatic heart disease

Question 13

Define bronchitis

Answer 13

Inflammation of the tracheobronchial tree that can lead to bronchoconstriction

Question 14

When does acute bronchitis occur?

Answer 14

Increased frequency during winter

Question 15

Is ACUTE bronchitis mainly viral or bacterial?

Answer 15

Viral

Question 16

List the symptoms of chronic bronchitis

Answer 16

Productive cough during at least 3 months in each 2 years

Question 17

What % of the population is affected by chronic bronchitis

Answer 17

10-25%

Question 18

List predisposing features of chronic bronchitis

Answer 18

1. Smoking
2. Infection
3. Air pollution
4. Allergies

Question 19

Is CHRONIC bronchitis mainly viral or bacterial?

Answer 19

Both

Question 20

What % of bronchitis cases are a result of viruses?

Answer 20

90%

Question 21

List VIRUSES that can cause bronchitis

Answer 21

1. Rhinovirus
2. Influenza
3. Adenovirus

Question 22

What % of bronchitis cases are caused by bacteria?

Answer 22

10%

Question 23

List BACTERIA that cause bronchitis

Answer 23

1. Mycoplasma
2. Pneumoniae
3. Chlamydia pneumoniae

Question 24

Give examples of medications that treat bronchitis (3)

Answer 24

1. Decongestants
2. NSAIDs
3. Antibiotics

Question 25

What proportion of the population are infected with mycobacterium tuberculosis

Answer 25

1/3

Question 26

Is asymptomatic or symptomatic TB more popular?

Answer 26

Asymptomatic | 4 x more likely

Question 27

List the stages involved in producing a caseous necrosis in TB (4)

Answer 27

1. Inhalation of bacteria 2. Bacteria reaches lungs and enters macrophages 3. Bacteria reproduce in macrophages 4. Lesion forms (caseous necrosis)

Question 28

List the effects of the caseous necrosis formed in TB (3)

Answer 28

1. Activated macrophages and bacteria grow 2. Lesion calcifies 3. Lesion liquefies

Question 29

State the effects of a lesion liquefying in TB (3)

Answer 29

1. Bacteria coughed up in sputum 2. Lesion spreads to blood 3. Organ death

Question 30

State the effect of the lesion calcifying in TB (2)

Answer 30

1. Immune suppression and lesion reactivates | 2. This causes more bacteria to reproduce in macrophages

Question 31

State tx options for TB (3)

Answer 31

1. Triple therapy 2. Long term 3. DOTS - directly observed tx short course

Question 32

What drugs are included in the triple therapy tx for TB

Answer 32

1. Streptomycin | 2. Isoniazid

Question 33

List dental aspects that should be considered when managing RTI's (5)

Answer 33

1. Facemasks 2. Ventilation and filtration 3. Control of aerosols 4. Vaccination of staff 5. Universal infection control precautions

Question 34

State high risk factors for TB (4)

Answer 34

1. Close contact with known case/ persons from high prevalence TB countries 2. HIV infection 3. Alcoholism 4. Injection drug abuse

Question 35

List TB symptoms (5)

Answer 35

1. Productive cough over 3 weeks 2. Headache 3. Fever 4. Weight loss 5. Blood in sputum

Question 36

Define pneumonia

Answer 36

Inflammatory lung condition especially affecting the alveoli

Question 37

Causes of pneumonia (5)

Answer 37

1. Infections 2. Bacteria 3. Viruses 4. Fungi 5. Parasites

Question 38

Describe the onset of pneumonia

Answer 38

Can be sudden or insidious

Question 39

Symptoms of pneumonia (3)

Answer 39

1. Fever 2. Shortness of breath 3. Cough producing sputum

Question 40

Name the main causative agent in bacterial pneumonia

Answer 40

Streptococcus pneumonia

Question 41

What groups of people are most susceptible to pneumonia (3)

Answer 41

1. Young 2. Elderly 3. Immunosupressed

Question 42

Tx options for pneumonia (3)

Answer 42

1. Antibiotics 2. Potential hospitalisation 3. Vaccination

Question 43

List an antibiotic for pneumonia

Answer 43

Erythromycin

Question 44

How can pneumonia be orally treated?

Answer 44

Aspiration of microorganisms into the lungs, directly through the endotracheal tube