Respiratory diseases

Question 1

What is the primary cause of the common cold?

Answer 1

The most common cause is viral infections, spread from person to person.

Viruses include Rhinovirus, Parainfluenza, Respiratory Syncytial Virus (RSV), Adenovirus, and Coronavirus. Associated conditions are Rhinitis, Sinusitis, and Pharyngitis.

Question 2

Which viruses are associated with the common cold?

Answer 2

Rhinovirus, Parainfluenza, Respiratory Syncytial Virus (RSV), Adenovirus, and Coronavirus.

These viruses cause upper respiratory symptoms like nasal congestion and sore throat.

Question 3

What are the symptoms of influenza?

Answer 3

Symptoms include fever, chills, muscle aches, headache, nasal discharge, unproductive cough, and sore throat.

Influenza is characterized by systemic symptoms, unlike the common cold’s primarily local symptoms.

Question 4

How does fever differ between a cold and influenza according to the comparison table?

Answer 4

Fever is rare in a cold but typically high (39–40°C) in influenza.

High fever is a hallmark of influenza’s systemic impact.

Question 5

What is the difference in headache prevalence between a cold and influenza?

Answer 5

Headache is rare in a cold but usual in influenza.

Headaches in influenza are often severe due to systemic inflammation.

Question 6

How do body aches compare between a cold and influenza?

Answer 6

Body aches are mild in a cold but severe in influenza.

Severe body aches contribute to influenza’s debilitating nature.

Question 7

How does weakness differ between a cold and influenza?

Answer 7

Weakness is mild in a cold but may last up to 3 weeks in influenza.

Prolonged weakness is common during influenza recovery.

Question 8

What is the difference in extreme fatigue between a cold and influenza?

Answer 8

Extreme fatigue is unusual in a cold but usual in influenza.

Fatigue in influenza significantly impacts daily functioning.

Question 9

How do nasal congestion and sneezing compare between a cold and influenza?

Answer 9

Nasal congestion and sneezing are common in a cold but only sometimes present in influenza.

Upper respiratory symptoms are more prominent in colds.

Question 10

How does chest discomfort/cough differ between a cold and influenza?

Answer 10

Chest discomfort/cough is mild in a cold but moderate to severe in influenza.

Influenza’s cough is often unproductive and persistent.

Question 11

What is pharyngitis, and what are its potential causes?

Answer 11

Pharyngitis is severe throat inflammation caused by bacterial or viral infections.

It commonly presents with sore throat and difficulty swallowing.

Question 12

What are the symptoms of bacterial pharyngitis?

Answer 12

Symptoms include sudden severe sore throat, dysphagia, fever over 38°C, swollen tonsils and lymph nodes, white or yellow spots on the back of the throat, headache, and abdominal pain.

Group A Streptococcus is the most common bacterial cause.

Question 13

What is the general treatment approach for respiratory infections?

Answer 13

90% are viral, so treat symptoms only. If bacterial (e.g., Streptococcus), and the patient worsens or doesn’t improve, perform a culture + antibiogram and give specific antibiotics. Consider fungal infections if indicated.

Avoid antibiotics for viral infections to prevent resistance.

Question 14

What is asthma, and what causes its breathing difficulties?

Answer 14

Asthma is a chronic condition causing difficulty breathing due to inflammation, mucus in airways, and tightening of muscles around the airways.

It involves reversible airway obstruction.

Question 15

What are the symptoms of asthma?

Answer 15

Symptoms include coughing, wheezing (whistling sound), shortness of breath, chest tightness, sneezing, runny nose, and itchy/inflamed eyes.

Wheezing is a hallmark sign, often worse at night or with triggers.

Question 16

What are common asthma triggers?

Answer 16

Triggers include air pollutants (e.g., diesel exhaust, tobacco smoke, cleaning chemicals, solvents, paints), pollens, mites, molds, animal dander (e.g., birds, cats, dogs), medications (e.g., aspirin, anti-inflammatory drugs), and foods (e.g., eggs, wheat, nuts).

Trigger avoidance is critical for asthma control.

Question 17

What is laryngitis, and what is its primary symptom?

Answer 17

Laryngitis causes hoarse voice or complete voice loss due to vocal fold irritation.

Causes include viral infections, vocal overuse, or irritants like smoke.

Question 18

What is bronchitis, and when is it most prevalent?

Answer 18

Bronchitis is inflammation of the main air passages to the lungs, most prevalent in winter, often following a common cold or viral infection of the nasopharynx, throat, or bronchi, with secondary bacterial infection.

It is typically part of an acute upper respiratory infection (URI).

Question 19

What are the symptoms of bronchitis?

Answer 19

Symptoms include malaise, chilliness, slight fever, back and muscle pain, sore throat, and a distressing cough (starts dry, later produces mucus).

Cough onset signals the start of bronchitis.

Question 20

Why is pneumonia considered a serious condition?

Answer 20

Pneumonia is the most deadly infectious disease, especially for high-risk groups: elderly, those with viral infections, chronically ill, immunosuppressed, and smokers.

Prompt diagnosis and treatment are critical to prevent complications.

Question 21

What are the symptoms of pneumonia?

Answer 21

Symptoms include fever, general malaise, difficulty breathing, increased pulse, and mucous cough.

Symptoms vary by typical vs. atypical pneumonia.

Question 22

What are the typical symptoms and physical signs of pneumonia?

Answer 22

Typical symptoms include general malaise and fever. Physical signs include tachycardia and fever.

Tachycardia reflects systemic infection and potential hypoxia.

Question 23

What is community-acquired pneumonia (CAP)?

Answer 23

Community-acquired pneumonia is pneumonia contracted outside healthcare settings, commonly caused by bacteria like Streptococcus pneumoniae.

It is a leading cause of hospitalization.

Question 24

What are the outpatient treatment options for community-acquired pneumonia?

Answer 24

For healthy patients with no risk factors, use a macrolide. For patients with comorbidities, use a fluoroquinolone.

Antibiotic choice depends on local resistance patterns and patient factors.

Question 25

What are the symptoms of active tuberculosis (TB) disease?

Answer 25

Symptoms include weakness, weight loss, fever, night sweats, bad cough lasting longer than 2 weeks, chest pain, and shortness of breath. ## Footnote A cough persisting beyond 2 weeks is a red flag for TB.

Question 26

What is the difference between TB infection and TB disease?

Answer 26

TB infection (latent TB) is asymptomatic with no active disease, while TB disease involves active Mycobacterium tuberculosis replication, causing symptoms like cough and fever. ## Footnote Latent TB is treated to prevent progression to active disease.

Question 27

What is the primary risk factor for lung cancer?

Answer 27

90% of lung cancer cases are caused by smoking, with additional contributions from occupational and environmental exposures. ## Footnote Asbestos, radon, and industrial chemicals are key environmental risks.

Question 28

What are the symptoms of lung cancer?

Answer 28

Symptoms include cough, shortness of breath, loss of appetite, fatigue, chest pain, hemoptysis, and weight loss. ## Footnote Hemoptysis is a concerning symptom requiring urgent evaluation.

Question 29

What is included in the diagnostic workup for suspected lung cancer?

Answer 29

The workup includes assessing risk factors, clinical symptoms, timing, blood work, chest X-ray, sputum culture, thoracic CT (TAC), and PET scan. ## Footnote Imaging and sputum analysis are critical for diagnosis and staging.

Question 30

What are the high-risk groups for pneumonia?

Answer 30

High-risk groups include the elderly, those with viral infections, chronically ill, immunosuppressed, and smokers. ## Footnote These groups require vigilant monitoring and early intervention.

Question 31

How does the cough in bronchitis evolve over time?

Answer 31

The cough starts dry and later produces mucus, reflecting progression of airway inflammation. ## Footnote Persistent cough may indicate secondary bacterial infection.

Question 32

What is the most common bacterial cause of community-acquired pneumonia?

Answer 32

Streptococcus pneumoniae is the most common bacterial cause of community-acquired pneumonia. ## Footnote It is often treated with macrolides or fluoroquinolones in outpatient settings.

Question 33

How is Group A Streptococcus pharyngitis diagnosed?

Answer 33

Diagnosis is confirmed with a rapid antigen detection test (RADT) or throat culture. ## Footnote Positive results warrant antibiotics (e.g., penicillin) to prevent complications like rheumatic fever.

Question 34

What is the first-line treatment for acute asthma exacerbations?

Answer 34

Short-acting beta-agonists (SABA) like albuterol are used for acute relief, often with inhaled corticosteroids for inflammation control. ## Footnote Long-term management includes inhaled corticosteroids and long-acting beta-agonists (LABA).

Question 35

What are the diagnostic criteria for active tuberculosis?

Answer 35

Active TB is diagnosed with a positive sputum culture for Mycobacterium tuberculosis, often supported by chest X-ray showing cavitary lesions. ## Footnote Treatment involves a multi-drug regimen (RIPE: Rifampin, Isoniazid, Pyrazinamide, Ethambutol) for 6–9 months.

Question 36

What is the CURB-65 score, and how is it used in pneumonia?

Answer 36

CURB-65 assesses pneumonia severity to guide hospitalization. It includes Confusion, Urea >7 mmol/L, Respiratory rate ≥30/min, Blood pressure (systolic <90 or diastolic ≤60 mmHg), and age ≥65 years. ## Footnote Score ≥2 suggests hospitalization; ≥3 indicates ICU care.

Question 37

What is the hallmark radiologic finding in bacterial pneumonia?

Answer 37

Consolidation on chest X-ray, appearing as a white opacity, is the hallmark finding. ## Footnote Lobar consolidation is typical for Streptococcus pneumoniae.

Question 38

What is the role of inhaled corticosteroids in asthma management?

Answer 38

Inhaled corticosteroids (e.g., budesonide) reduce airway inflammation and are the cornerstone of long-term asthma control. ## Footnote They are used daily to prevent exacerbations, not for acute relief.

Question 39

What is the most common cause of viral pneumonia in adults?

Answer 39

Influenza virus is the most common cause of viral pneumonia in adults. ## Footnote Antiviral therapy (e.g., oseltamivir) is effective if started within 48 hours of symptom onset.

Question 40

Why is hemoptysis significant in lung cancer?

Answer 40

Hemoptysis suggests tumor invasion into blood vessels or bronchial tissue, warranting urgent imaging and bronchoscopy. ## Footnote It’s a red flag, especially in smokers over 40.

Question 41

What is the Mantoux test, and how is it used in TB diagnosis?

Answer 41

The Mantoux tuberculin skin test detects latent TB infection by measuring induration after intradermal injection of purified protein derivative (PPD). ## Footnote Induration ≥10 mm (in most cases) requires further evaluation for active TB.

Question 42

Why are smokers at higher risk for pneumonia?

Answer 42

Smokers have impaired ciliary function and chronic airway inflammation, increasing susceptibility to infections like pneumonia. ## Footnote Smoking cessation reduces pneumonia risk.

Question 43

What is the significance of night sweats in TB?

Answer 43

Night sweats are a systemic symptom caused by the immune response to Mycobacterium tuberculosis, often with fever and weight loss. ## Footnote They are a classic feature of active TB.

Question 44

What is the role of sputum culture in respiratory disease diagnosis?

Answer 44

Sputum culture identifies pathogens (e.g., Mycobacterium tuberculosis, Streptococcus pneumoniae) in diseases like TB and pneumonia, guiding targeted therapy. ## Footnote It’s critical for confirming bacterial or mycobacterial infections.

Question 45

What is the significance of a PET scan in lung cancer workup?

Answer 45

A PET scan detects metabolically active cancer cells, aiding in staging and identifying metastases. ## Footnote It complements CT for comprehensive lung cancer evaluation.

Question 46

What are the occupational and environmental risk factors for lung cancer?

Answer 46

Besides smoking (90%), occupational and environmental risks include asbestos, radon, and industrial chemicals. ## Footnote Workplace exposure to carcinogens significantly increases risk.

Question 47

What is the first-line antibiotic for bacterial pharyngitis caused by Group A Streptococcus?

Answer 47

Penicillin or amoxicillin is the first-line treatment for Group A Streptococcus pharyngitis. ## Footnote A 10-day course is standard to eradicate the infection and prevent complications.

Question 48

What is the role of bronchodilators in bronchitis management?

Answer 48

Bronchodilators (e.g., albuterol) relieve bronchospasm and improve airflow in acute bronchitis with wheezing. ## Footnote They are used symptomatically, not routinely, in bronchitis.

Question 49

What is the significance of a cough lasting longer than 2 weeks in TB?

Answer 49

A cough persisting beyond 2 weeks is a red flag for active TB, prompting sputum analysis and chest imaging. ## Footnote It’s often productive and accompanied by systemic symptoms.

Question 50

What is the role of chest CT in pneumonia diagnosis?

Answer 50

Chest CT identifies complications (e.g., abscess, empyema) and atypical findings not visible on X-ray, aiding in severe or unclear cases. ## Footnote It’s used when X-ray is inconclusive or for high-risk patients.