43 - Infectious Diseases of the Respiratory Tract

Question 1

Does bacteria cause most upper respiratory tract infections?

Answer 1

NO

Question 2

Should you give antibiotics to most patients with an upper respiratory tract infections?

Answer 2

NO

Question 3

What do you need to know about the use of antibiotics in patients with upper respiratory tract infections?

Answer 3

Antibiotics have no role in uncomplicated and non-specific URI

When you have a young, healthy patient with a cold, do NOT give them antibiotics

Let the virus (most likely) run its course and have them come back if they have any complications

Question 4

When would you give antibiotics for an upper respiratory tract infection?

Answer 4

When the patient is old, has multiple comorbidities and is not likely to clear the infection on their own, so they will likely develop or already have developed a bacterial infection

Question 5

What is the rule of thumb that you need to know for the exam?

Answer 5

Antibiotics have no role in uncomplicated and non-specific URI

Question 6

What is sinusitis?

Answer 6

Inflammatory condition involving the sinuses surrounding the nasal cavities

Question 7

In which patients do you need to take sinusitis very seriously?

Answer 7

Diabetic patients

Question 8

What is rhinocerebral mucormycosis

Answer 8

• ## A pathogen-caused condition typically seen in sinus infections in diabetic patients

Question 9

In what patients will you suspect rhinocerebral mucormycosis?

Answer 9

• Diabetics with ketoacidosis
• Diabetics with pressure in the face
• Diabetics with nasopharyngeal ulcers
• Diabetics with proptosis, ptosis, orbital swelling, cellulitis
• Diabetic patients who do NOT appear seriously ill

Just remember DIABETIC ***

Question 10

In this case, what do you need to do?

Answer 10

When you see a diabetic with potential rhinocerebral mucormycosis, it needs URGENT EVALUATION ***

There is concern for the spread of this infection into the CNS

Question 11

What is the key to diagnosing pneumonia?

Answer 11

Chest x-ray

Question 12

Why do you need to get a chest x-ray before you are able to diagnose pneumonia?

Answer 12

Because you need to see the shadow of fluid in the lungs to rule out any other causes of the symptoms

Question 13

What is the gold standard for a pneumonia diagnosis?

Answer 13

Chest x-ray

Question 14

How do you decide which patients with pneumonia you admit or don’t admit to the hospital for treatment?

Answer 14

The decision regarding hospitalization should be based on…

• Stability of patient’s clinical condition
• Risk of death and complication
• Presence or absence of other active medical problems
• Psychosocial issues