Infection

Question 1

define coryza and its causes

Answer 1

common cold caused by adenovirus, rhinovirus or RSV

Question 2

define rhinitis

Answer 2

inflammation of the nasal mucosa, can be allergic, non-allergic or mixed

Question 3

presentation of rhinitis

Answer 3

• rhinorrhoea (watery mucus accumulation in the nasal cavity)
• sneezing
• itching

Question 4

diagnosis for rhinitis

Answer 4

skin prick unless active eczema then do IgE antibodies

Question 5

management of rhinitis

Answer 5

• avoid trigger
• antihistamines e.g. loratadine or cetirizine
• glucocorticoids e.g. beclomethasone
• vasoconstrictors
• sodium cromoglicate

Question 6

define diphtheria

Answer 6

infection with corynebacterium diphtheriae which produces the characteristic pseudomembrane

Question 7

gram stain of corynebacterium diphtheriae

Answer 7

gram +ve bacillus

Question 8

is there a vaccine for diphtheria?

Answer 8

yes

Question 9

define whooping cough

Answer 9

infection with bordetella pertussis

Question 10

gram stain of bordetella pertussis

Answer 10

gram -ve coccobacillus

Question 11

presentation of bordetella pertussis

Answer 11

• violent cough with inspiratory whoop

- vomiting common

Question 12

diagnosis of bordetella pertussis

Answer 12

culture and PCR of nasal swab

Question 13

management of bordetella pertussis

Answer 13

• younger than 1= clarithromycin
• older than 1= clarithromycin/azithromycin
• pregnant= erythromycin

Question 14

define pneumonia

Answer 14

infection of the alveoli in the lungs

Question 15

presentation of pneumonia

Answer 15

• cough
• malaise
• fever
• haemoptysis
• pleural rub (crackles)

Question 16

which bacteria in pneumonia presents with extra pulmonary symptoms?

Answer 16

mycoplasma

• headaches
• malaise
• myalgia

Question 17

diagnosis of pneumonia

Answer 17

• CURB65
• serology and blood culture
• PCR swabs for mycoplasma
• CXR PA
• urinary antigen for legionella
• pulse oximetry for severity

Question 18

management of pneumocystis jirovecii

Answer 18

co-trimoxazole and prednisolone

Question 19

management for mycoplasma, coxiella and psittaci

Answer 19

tetracyclines (doxycycline) ad macrocodes (clarithromycin)

Question 20

management of legionella

Answer 20

clarithromycin, erythromycin and levofloxacin

Question 21

klebsiella associations

Answer 21

• alcoholics

- poor dental hygiene

Question 22

haemophilus influenza association

Answer 22

pre-existing lung condition

Question 23

mucoid sputum

Answer 23

chlamydia psittaci

Question 24

red jelly sputum

Answer 24

klebsiella

Question 25

rusty sputum

Answer 25

pneumococcal pneumonia

Question 26

define influenza

Answer 26

infection with influenza A, B, haemophilus influenza or parainfluenza

Question 27

presentation of influenza

Answer 27

- fever - malaise - headache - prostration (extreme weakness)

Question 28

influenza diagnosis

Answer 28

PCR of nasopharyngeal or throat swabs

Question 29

management of influenza

Answer 29

- bed rest, fluids - immunisations - antivirals e.g. oseltamivir or zanamivir

Question 30

define bronchiolitis

Answer 30

infection in childhood with RSV, rhinovirus, adenovirus, etc.

Question 31

presentation of bronchiolitis

Answer 31

- below 2 years - fever - coryza - poor feeding

Question 32

diagnosis of bronchiolitis

Answer 32

- pulse oximetry (severity) | - ELISA for antigen detection

Question 33

management of bronchiolitis

Answer 33

- supportive - infection control e.g. cohort nursing - palivizumab

Question 34

define croup

Answer 34

viral infection of the upper airway in children

Question 35

presentation of croup

Answer 35

- barking cough - fever - stridor - hoarse voice - laboured breathing

Question 36

diagnosis of croup

Answer 36

- CXR (steeple sign)

Question 37

management of croup

Answer 37

steroids e.g. dexamethasone

Question 38

define epiglottitis

Answer 38

inflammation of the epiglottis cause by H. influenza B

Question 39

presentation of epiglottitis

Answer 39

fever airway obstruction children under 5

Question 40

diagnosis of epiglottitis

Answer 40

- CXR or lateral neck radiograph shows thumbprint sign

Question 41

management of epiglottitis

Answer 41

ET intubation | antibiotics e.g. ceftazidine