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L18 Acute Respiratory Tract Infections

Deleted user 10 questions Updated 26 May 2019

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Questions in this quiz (10)

  1. 1The common cold is a self [blank_start]limiting[blank_end] illness (2 days - 2 weeks), characterised by nasal [blank_start]discharge[blank_end] and a sore [blank_start]throat[blank_end]. It is caused by [blank_start]viruses[blank_end], predominantly rhinoviruses. No treatment is required, but [blank_start]symptomatic[blank_end] relief is available. Complications in the elderly, young, and immunocompromised could be [blank_start]pneumonia and asthma attacks[blank_end].
    1. Alimiting
    2. Bdischarge
    3. Cthroat
    4. Dviruses
    5. Esymptomatic
    6. Fpneumonia and asthma attacks
  2. 2A sore throat may be pharyngitis/tonsillitis. This can be viral or bacterial.
    1. Viral: 80-90% of cases attribute to [blank_start]adenoviruses[blank_end]. A mild, self-limiting infection presenting with a [blank_start]sore[blank_end] throat, and [blank_start]slight[blank_end] fever. No treatment required except for [blank_start]symptom[blank_end] relief.
    2. Bacterial: A more [blank_start]severe[blank_end] infection. The most common cause of bacterial throat infection is Group A [blank_start]Streptococcus pyogenes[blank_end] (GAS). Presents with a sore throat, [blank_start]fever[blank_end], and aching, swollen [blank_start]lymph[blank_end] nodes. Diagnosis is by throat [blank_start]culture[blank_end] and treatment is [blank_start]antibiotics[blank_end]. Common complications: abscess and [blank_start]rheumatic[blank_end] fever.
    1. Aadenoviruses
    2. Bslight
    3. Csore
    4. Dsymptom
    5. Esevere
    6. FStreptococcus pyogenes
    7. Glymph
    8. Hfever
    9. Iculture
    10. Jantibiotics
    11. Krheumatic
  3. 3Diphtheria is a serious throat infection caused by [blank_start]Corynebacterium diphtheriae[blank_end]. It presents with a sore throat, headache, greatly [blank_start]enlarged[blank_end] cervical lymph nodes, low grade [blank_start]fever[blank_end], and [blank_start]grey[blank_end] mucus on tonsils.
    There is a gradual onset over [blank_start]2-5[blank_end] days, and it is transmissible for up to [blank_start]4[blank_end] weeks. It is [blank_start]toxin[blank_end] producing which causes heart & kidney [blank_start]failure[blank_end]. Prompt treatment with diphtheria [blank_start]anti-toxin[blank_end] is required & [blank_start]antibiotics[blank_end] are given even before confirmation by culture. 1 in [blank_start]10[blank_end] will still die from it. The last case in NZ was in 1998.
    There has been a vaccine available since 1926, which has been on the NZ immunisation schedule since 1941. It is a [blank_start]toxoid[blank_end] vaccine given as an intramuscular injection, between 87-98% effective in generating anti-toxin [blank_start]IgG[blank_end], though it declines with time, and boosters necessary & recommended at [blank_start]45 and 65[blank_end]. The vaccine is [blank_start]funded[blank_end] but not the administration. [blank_start]Pregnant[blank_end] women are funded.
    1. ACorynebacterium diphtheriae
    2. Benlarged
    3. Cfever
    4. Dgrey
    5. E2-5
    6. F4
    7. Gtoxin
    8. Hfailure
    9. Ianti-toxin
    10. Jantibiotics
    11. K10
    12. Ltoxoid
    13. MIgG
    14. N45 and 65
    15. Ofunded
    16. PPregnant
  4. 4Whooping cough, also known as [blank_start]pertussis[blank_end], is caused by a highly infectious (via [blank_start]droplets[blank_end]), and [blank_start]toxin[blank_end] producing bacteria, the gram negative bacilli Bordetella pertussis. It causes airway [blank_start]inflammation & oedema[blank_end], and airway [blank_start]cell[blank_end] death. The most at risk are [blank_start]infants[blank_end] too young to be immunised; Complications – pneumonia, convulsions, brain damage, death. 1 in 6 infants will [blank_start]die[blank_end] or have [blank_start]brain or lung[blank_end] damage.
    For adults and children, [blank_start]12-37[blank_end]% of persistent coughs are pertussis.

    There are [blank_start]2-5[blank_end] yearly epidemics. The highest rates are in Pacific and Māori
    infants, with [blank_start]51[blank_end]% hospitalized. There is a 4-fold increased risk of hospitalizations for children living in in [blank_start]deprived[blank_end] conditions.
    1. Apertussis
    2. Bdroplets
    3. Ctoxin
    4. Dinflammation & oedema
    5. Ecell
    6. Finfants
    7. Gdie
    8. Hbrain or lung
    9. I12-37
    10. J2-5
    11. K51
    12. Ldeprived
  5. 5Stages of Whooping Cough:
    After a [blank_start]7-10[blank_end] day incubation -
    • Stage 1 - ([blank_start]1[blank_end] week) malaise, low grade [blank_start]fever[blank_end], sneezing, runny [blank_start]nose[blank_end],
    dry [blank_start]cough[blank_end]. The [blank_start]most[blank_end] infectious stage. Antibiotic treatment at this stage
    can [blank_start]decrease[blank_end] severity of stage 2. Contacts should also be [blank_start]treated[blank_end].
    • Stage 2 - ([blank_start]4[blank_end] weeks) short burst of extreme paroxysmal coughing
    (accumulation of [blank_start]mucus[blank_end]), vomiting, feeling of [blank_start]choking[blank_end], “whooping”
    between coughing fits. Still infectious, and [blank_start]few[blank_end] symptoms between
    paroxysms. Treatment here will not effect the disease but reduces [blank_start]transmission[blank_end].
    • Stage 3 - ([blank_start]6[blank_end] weeks - months) recovery, cough less often.

    Prevention:
    - Vaccine available since 1945, on NZ immunisation schedule since 1960, i.m. injection
    - Moved from a cell-based vaccine to an [blank_start]acellular[blank_end] pertussis vaccine in
    the 1990s – less [blank_start]reactogenic[blank_end] but less effective. Boosters are required & funded.
    - It is recommended, but not funded that contacts & carers of [blank_start]newborns[blank_end] get boosters.
    1. A7-10
    2. B1
    3. C4
    4. D6
    5. Efever
    6. Fnose
    7. Gcough
    8. Hmost
    9. Idecrease
    10. Jtreated
    11. Kmucus
    12. Lchoking
    13. Mfew
    14. Ntransmission
    15. Oacellular
    16. Preactogenic
    17. Qnewborns
  6. 6Influenza is an acute, self-limiting infection of the respiratory tract, causing fever, malaise, a sore throat, [blank_start]dry[blank_end] cough, and [blank_start]headache[blank_end].
    It is caused by [blank_start]orthomyxovirus[blank_end] which has an RNA genome and 2 major surface [blank_start]glycoproteins[blank_end]; [blank_start]Haemagglutinin[blank_end] (H) and [blank_start]neuraminidase[blank_end] (N).
    There are 3 types of influenza viruses - A, B and C:
    A - evolves [blank_start]quickly[blank_end], causes [blank_start]human[blank_end] epidemics & pandemics, [blank_start]severe[blank_end] disease, H/N subtypes
    B - no H/N [blank_start]subtypes[blank_end], evolves more [blank_start]slowly[blank_end] than A, causes disease in humans, usually [blank_start]less[blank_end] severe
    C - no H/N subtypes, no disease in [blank_start]humans[blank_end]
    1. Aheadache
    2. Bdry
    3. Corthomyxovirus
    4. Dglycoproteins
    5. EHaemagglutinin
    6. Fneuraminidase
    7. Gquickly
    8. Hhuman
    9. Isevere
    10. Jsubtypes
    11. Kslowly
    12. Lless
    13. Mhumans
  7. 7Individuals can get influenza many times during life because the virus is continuously mutating.
    1. ATrue
    2. BFalse
  8. 8Antigenic [blank_start]drift[blank_end] of the influenza virus causes seasonal variants.
    It occurs to overcome the [blank_start]antibodies[blank_end] blocking the H glycoproteins ability to bind to [blank_start]cells[blank_end]. It is a [blank_start]mutation[blank_end] of the H epitopes so that the antibody [blank_start]cannot[blank_end] bind and the virus may bind to the cell instead.

    Antigenic [blank_start]shift[blank_end] of the influenza virus causes epidemic/pandemic variants.
    It occurs when two viral strains exchange [blank_start]RNA[blank_end] segments in a [blank_start]secondary[blank_end] host and a [blank_start]novel[blank_end] H is formed.
    1. Adrift
    2. Bshift
    3. Cantibodies
    4. Dantigens
    5. Ecells
    6. Fviruses
    7. Gmutation
    8. Hcopy
    9. Icannot
    10. Jcan
    11. Kshift
    12. Ldrift
    13. MRNA
    14. NDNA
    15. Osecondary
    16. Pprimary
    17. Qnovel/new
    18. Rdefective
  9. 9Treatment for influenza is typically [blank_start]symptomatic[blank_end] relief of fever and pain with [blank_start]OTC[blank_end] meds.

    We can also use:
    1. [blank_start]M2 Ion Channel[blank_end] Inhibitors (Cyclic Amines or Adamantanes) - amantadine, rimantadine: Inhibit viral [blank_start]uncoating[blank_end], which is symptomatic relief. Does not stop viral [blank_start]shedding[blank_end]. Has systemic [blank_start]toxicities[blank_end] and is associated with rapid induction of [blank_start]resistant[blank_end] viruses.
    2. [blank_start]Neuraminidase[blank_end] inhibitors eg oseltamivir (Tamiflu) & zanamivir (Relenza): [blank_start]Pharmacist only[blank_end] medicine in NZ. Symptomatic relief via [blank_start]decrease[blank_end] of viral shedding, which reduces the [blank_start]rate of complications[blank_end]. May stop protective [blank_start]immune[blank_end] response developing. Has toxicities (especially [blank_start]zanamivir[blank_end]), and will induce viral resistance (especially [blank_start]oseltamivir[blank_end]). There is [blank_start]weak[blank_end] evidence that it may reduce mortality, hospitalisation and duration of symptoms, compared with no treatment.
    1. Asymptomatic
    2. BOTC
    3. CM2 Ion Channel
    4. DNeuraminidase
    5. Euncoating
    6. Fshedding
    7. Gtoxicities
    8. Hresistant
    9. IPharmacist only
    10. Jdecrease
    11. Krate of complications
    12. Limmune
    13. Mzanamivir
    14. Noseltamivir
    15. Oweak
  10. 10Seasonal influenza prevention:
    - [blank_start]Inactivated[blank_end] vaccines against 3 or 4 circulating strains available – the supplier varies from year to year
    - Usually an intramuscular vaccine, which is [blank_start]funded[blank_end], effectiveness is [blank_start]~50[blank_end]%?
    - Funded in pharmacy for over [blank_start]65[blank_end]’s

    Pandemic influenza prevention:
    - H1N1 pandemic strain – now included in [blank_start]seasonal[blank_end] vaccine
    - H5N1 vaccine – Focetria® (Novartis), etc
    - H7N9 – pre-pandemic vaccines have been made by reverse genetics,
    not publicly available but [blank_start]stockpiles[blank_end] exist
    1. AInactivated
    2. Bfunded
    3. C~50
    4. D65
    5. Eseasonal
    6. Fstockpiles

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User has deleted their subject information Quiz on L18 Acute Respiratory Tract Infections, created by Deleted user on 14/04/2019.
Author
Deleted user
Language
English
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Created on 14 Apr 2019 · updated on 26 May 2019
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