URTI's

Question 1

Droplet sizes?

Answer 1

Large= >100 microns 
Medium= 5-100 microns 
Small= <5 microns

Question 2

Difference between common cold and influenza symptoms?

Answer 2

Common cold symptoms: Cough, Rhinitis, sore throat.

Influenza symptoms: Rhinitis, sore throat, systemic symptoms, viral pneumonia.

Question 3

Common causes of the common cold?

Answer 3

Rhinovirus, Coronavirus and RSV.

Question 4

Common causes of influenza?

Answer 4

Influenza virus

Question 5

Main treatment for the common cold?

Answer 5

Symptomatic (e.g rest, fluids etc.)

Question 6

Non-infective causes of sinusitis?

Answer 6

Tumours
Allergy
GPA
Foreign body

Question 7

Common viral causes of sinusitis?

Answer 7

Rhinovirus, influenza virus, parainfluenza virus.

Question 8

What investigations may be carried out in sinusitis?

Answer 8

X-ray or CT.
- X-ray more common. Shows air-fluid level and thickening of soft tissue.

Sinus aspirate if fluid present.

Question 9

Treatment of sinusitis?

Answer 9

Viral= Resolves spontaneously.

Bacterial= Amoxicillin or clarithromycin. Decongestants. Analgesia. Sinus puncture and lavage.

Fungal= Surgical debridement. Anti-fungals.

Question 10

Investigations/ diagnosis of otitis media?

Answer 10

Otoscopy

Tympanocentesis.

Question 11

Treatment for otitis media?

Answer 11

Amoxicillin, clarithromycin, co-amoxiclav x5days

Question 12

Investigations for sore throats?

Answer 12

Throat swab- culture and susceptibility.
Blood culture if epiglottitis.
Monospot test for EBV.
Point of care test for GAS.

Question 13

When to prescribe antibiotics for sore throat patients?

Answer 13

If culture implies.
3 of 4 of CENTOR criteria. (CAFE)
If GAS= Penicillin x 10 days.
If diptheria= Penicillin G or erythromycin. (Also diptheria antitoxin and airway management etc.)

Most patients don’t respond to antibiotics.

Question 14

IPC for diptheria?

Answer 14

Droplet precautions. Vaccination. Notify contacts.

Question 15

Main cause and treatment of laryngitis?

Answer 15

Viral

Symptomatic treatment= Voice rest, humidification.

Question 16

Commonest cause of epiglottitis?

Answer 16

HiB.

Question 17

Clinical features of epiglottits?

Answer 17

Dysphagia 
Stridor 
Dyspnoea 
Fever 
Lethargy 
Drooling

Question 18

Management of epiglottits?

Answer 18

Secure airway
Blood cultures
Antibiotics= Cefotaxime. (IV)

Question 19

Difference between croup and epiglottitis?

Answer 19

Epiglottitis is more rapid and doesnt have the croup like/seal-like cough.

Question 20

Treatment of croup?

Answer 20

Corticosteroids and humidified oxygen

Question 21

Antibiotic treatment of acute bronchitis?

Answer 21

Symptomatic.
Amoxicillin, clarithromycin, tetracycline.
Ventilation if severe.

Question 22

When to give antibiotics for infective exacerbation of COPD?

Answer 22

If requires mech ventilation

If increased sputum purulence and volume or dyspnoea.

Question 23

How to treat Inf exacerbation of COPD?

Answer 23

Amoxicillin or clarithromycin or doxycycline for 5-7 days.
Corticosteroids
Bronchodilators.

Question 24

Prevention of inf exacerbation of COPD?

Answer 24

Stop smoking
Annual influenza vaccine
Pneumococcal vaccine every 5 yrs.