Respiratory

Question 1

CAP cause by…EXAM!!!!!!!

Answer 1

• S. pneumoniae
• H. influenzae (esp. in existing resp tract infection)
• M. pneumoniae – point outbreaks
• L. pneumophilia – sporadic/outbreaks; v. dangerous
• (C. pneumoniae)

Question 2

Unvestigation of CAP

Answer 2

• confirm Dx (via CXR)
• assess severity (CURB65)
• define pathogen
• identify complications

Question 3

Pneumonia SEVERITY EXAMMMM

Answer 3

• Confusion 8 or luver
• Urea over 7
• Rr over 30
• BP under 90/60
• 65+

1: low oral amox
2: modeate, Add clarithromycin

3+: Co-amoxiclav+clarithromycin IV

Question 4

S. aureus pneumonia sign

Answer 4

• Abscess on CXR
• BADD flucloxacillin

Question 5

Legionallal CAP

Answer 5

• Severe, multi-obe, hyponaetraemia

Question 6

If get TB; check or HIV

Answer 6

If get TB; check or HIV

Question 7

TB latency

Answer 7

• → becomes dormant in macrophages & switch to anaerobic form, very dormant. Kept in these state by IFN-γ and IL-12. Stays in this latent state for ages
• → Switch to aerobic replication & are reactivated and replicate

TB tends to reactivate in the apices of the lungs

Fever, weight loss, cough.

Question 8

EXAMMMM HIV ABs

Answer 8

• Rifampicin R
• Isoniazid H
• Pyrazinamide Z
• Ethambutol E
• Streptomycin S

Two phase:

1. Bactericidal phase: RHZE 2 months
2. RH 4 months

Question 9

Managing MDR TB

Answer 9

Isonizad resistnace common 5%, Rifampicin 2%

• ≥ 4 drugs (that organism likely sensitive to) for 3-6 months until sputum culture -ve
• ≥ 3 drugs for 15-18 months
• surgery may be necessary
• infection control/notify PH
• contact tracing + prophylaxis
• BCG