Respiratory Infections

Recovery while receiving antibiotic syrup is the correct answer. This patient has otitis media. Treatment with antibiotics is effective and no additional intervention is needed.

A 3-year-old girl is brought to the clinic with fever, sleeplessness, and pulling on her right ear. There is bulging and erythema of the right tympanic membrane. This is the 3rd episode of these symptoms in the past 2 years. Which of the following is the most likely outcome of this illness? Insertion of tympanostomy tubes to prevent recurrences Recovery while receiving antibiotic syrup Perforation of her tympanic membrane Recovery while receiving decongestants and anti-histamines Permanent hearing loss detected by audiometry

Inhibition of bacterial cell wall synthesis is the correct answer. Inhibition of bacterial cell wall synthesis: This choice describes the action of amoxicillin, which inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins.

Question 10 1 / 1 pts A 35-year-old man presents to his primary care physician complaining of facial pain, nasal congestion, and purulent nasal discharge lasting for 10 days. He reports that his symptoms began as a common cold but progressively worsened. Physical examination reveals tenderness over the maxillary sinuses and erythema of the nasal mucosa. The patient's medical history is unremarkable, and he has no known drug allergies. The physician prescribes amoxicillin-clavulanate for the treatment of this patient's acute bacterial sinusitis. Which of the following best describes the mechanism of action of this medication? Disruption of bacterial cell membrane integrity Inhibition of protein synthesis at the 50S ribosomal subunit Inhibition of bacterial cell wall synthesis Inhibition of bacterial DNA gyrase Inhibition of protein synthesis at the 30S ribosomal subunit

Penicillin is the correct answer. Penicillin. For most patients, preferred antibiotics are penicillin or erythromycin If there is resistance to penicillin or macrolides and one of the following agents is being considered: clindamycin, quinolones, tetracyclines, trimethoprim-sulfamethoxazole, vancomycin and linezolid.

Question 11 1 / 1 pts A 7-year-old boy presents to the emergency department with a sore throat, low-grade fever, and difficulty breathing that have progressively worsened over the past three days. His mother mentions that he has not been vaccinated due to personal beliefs. On examination, the physician notes a thick, grayish membrane covering the child's tonsils and pharynx. There is noticeable neck swelling and hoarseness. The child appears anxious and has a barking cough. A rapid antigen detection test confirms the presence of Corynebacterium diphtheriae. What is the most preferred antibiotic treatment for this patient? Monobactam Penicillin Cephalosporin Aminoglycoside Chloramphenicol

Ceftriaxone and vancomycin is the correct answer. Ceftriaxone and vancomycin. Ceftriaxone provides broad coverage, including effective treatment against most strains of Streptococcus pneumoniae and Haemophilus influenzae. Adding vancomycin covers resistant gram-positive cocci, including methicillin-resistant Staphylococcus aureus (MRSA), which is crucial given the severity and rapid progression of epiglottitis and the potential for airway obstruction.

Question 12 1 / 1 pts A 5-year-old girl is brought to the emergency department by her parents due to a sudden onset of high fever, severe sore throat, and difficulty breathing. Her symptoms started about 6 hours ago and have progressively worsened. On examination, the child appears anxious, is drooling, and has a muffled voice. She is sitting upright, leaning forward, and breathing heavily. There is no cough, and her vaccination history is up-to-date, including Haemophilus influenzae type b (Hib) vaccination. Considering the suspected diagnosis of acute epiglottitis, what is the most appropriate initial empiric antibiotic therapy for this patient? Azithromycin Clindamycin Amoxicillin-clavulanate Chloramphenicol Ceftriaxone and vancomycin

Piperacillin-tazobactam is the correct answer. Piperacillin-tazobactam. Piperacillin-tazobactam is a potent broad-spectrum combination antibiotic that includes a beta-lactam and a beta-lactamase inhibitor. This combination is effective against Pseudomonas aeruginosa and is appropriate for severe exacerbations of chronic bronchitis in patients with a known history of Pseudomonas infections, especially in a hospital setting.

Question 13 1 / 1 pts A 68-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with increased shortness of breath, productive cough with green sputum, and a low-grade fever. He mentions that his symptoms have progressively worsened over the past three days. His medical history includes frequent hospitalizations for respiratory issues, and he is a current smoker with a 40-pack-year history. A sputum sample reveals the presence of Pseudomonas aeruginosa. What is the most appropriate antibiotic therapy for this patient's acute exacerbation of chronic bronchitis? Piperacillin-tazobactam Azithromycin Ceftriaxone Amoxicillin Ciprofloxacin

Inhibition of DNA gyrase and topoisomerase IV is the correct answer. Inhibition of DNA gyrase and topoisomerase IV. Fluoroquinolones act by inhibiting these two critical enzymes in bacteria, which are necessary for DNA replication and cell division. This action results in the death of the bacterial cells, making fluoroquinolones effective against a wide range of bacteria, including those that cause sinusitis.

Question 14 1 / 1 pts A 45-year-old man presents to his primary care physician with a two-week history of facial pain, nasal congestion, and yellow nasal discharge. He reports that his symptoms started with a cold, which seemed to improve initially but then worsened. He has a history of recurrent sinusitis and allergies to penicillin and cephalosporins. His last episode of sinusitis was treated with a macrolide, but symptoms persisted. Given his history and current presentation, the physician decides to prescribe a fluoroquinolone. What is the mechanism of action of the fluoroquinolone prescribed for this patient's bacterial sinusitis? Inhibition of protein synthesis by binding to the 30S ribosomal subunit Inhibition of bacterial cell wall synthesis Disruption of bacterial membrane integrity Inhibition of folic acid synthesis Inhibition of DNA gyrase and topoisomerase IV

Inhibition of protein synthesis by binding to the 30S ribosomal subunit is the correct answer. Inhibition of protein synthesis by binding to the 30S ribosomal subunit. Doxycycline is a tetracycline antibiotic that binds to the 30S ribosomal subunit of bacteria, preventing the attachment of aminoacyl-tRNA to the RNA-ribosome complex. This action inhibits bacterial protein synthesis, which is essential for bacterial growth and replication.

Question 15 1 / 1 pts A 25-year-old woman presents to the clinic with a 4-day history of right ear pain, decreased hearing, and a sensation of fullness in the ear. She also reports a low-grade fever and has a recent history of upper respiratory infection. Examination reveals a reddened, bulging tympanic membrane on the affected side, and the patient is uncomfortable during pneumatic otoscopy. Given her age and clinical presentation, the physician decides to prescribe doxycycline due to the patient's allergy to penicillin. What is the mechanism of action of doxycycline, the antibiotic prescribed for this patient's otitis media? Inhibition of DNA gyrase Inhibition of bacterial cell wall synthesis Disruption of bacterial membrane integrity Inhibition of folic acid synthesis Inhibition of protein synthesis by binding to the 30S ribosomal subunit

Do a throat culture for Streptococcus pyogenes is the correct answer. It is important to determine if the patient has a streptococcal infection so that treatment can be initiated to lessen the chance of post-infectious sequelae.

Question 2 1 / 1 pts A 12-year-old boy noticed painful swallowing, fever, and swellings in his neck. In the clinic, you see enlarged tonsils with white exudates, but the rapid antigen detection test for Group A Streptococcus was negative. What is the best next step to take in the care of this patient? Do a throat culture for Streptococcus pyogenes Treat with Tylenol and a decongestant Do a nasopharyngeal culture for respiratory viruses Treat with penicillin Do a Monospot test for mononucleosis

A leathery gray membrane in the pharynx is the correct answer. The presence of this membrane is indicative of diphtheria.

Question 3 1 / 1 pts A 12-year-old unimmunized boy in Tanzania, Africa presented to the clinic with a recent onset of fever, sore throat, and noisy labored breathing. The doctor made a presumptive diagnosis of diphtheria. Which of the following most likely allowed him to arrive at this diagnosis rather than streptococcal pharyngitis? A negative rapid antigen detection test for group A streptococcus A leathery gray membrane in the pharynx Enlarged tonsils with white exudates A low ASO antibody titer An irregular pulse indicating exotoxin effect on heart

He had an effective immune response to a causative virus is the correct answer. Treatment is often initiated to lessen symptoms and speed recovery, but immune clearance is likely in most circumstances.

Question 4 1 / 1 pts A one-year-old boy with fever and earache has a red bulging tympanic membrane on the left, and a pediatrician prescribed antibiotic. However, his mother did not fill the prescription for financial reasons. Nevertheless, the patient recovered fully about 4 days later. He had antibodies from vaccinations He had an effective immune response to a causative virus y did this illness resolve without treatment? It was caused by a respiratory virus He had antibodies from previous exposure to causative viruses He had an effective immune response to a causative bacterium

Rhinovirus is the correct answer. This patient has a common cold.

Question 5 1 / 1 pts In November, an 8-year-old school boy is brought to his pediatrician because he got sick and stayed home the day before with runny nose, fever, tiredness, nasal voice, and puffiness under his eyes. His temperature was 38 C , his nasal membranes were red, and his face was tender under the eyes. Which of the following is the most likely cause of this illness? Haemophilus influenzae Viridans streptococci Metapneumonovirus Rhinovirus Chlamydophila pneumoniae

Untreated, the bacteria can persist for weeks is the correct answer. Symptoms will abate over time and the patient may appear to be fully healthy, but Streptococcus pyogenes carriage occurs in patients of all ages.

Question 6 1 / 1 pts A 10-year-old girl develops a sore throat with fever, painful swallowing, and swollen lymph nodes in her neck. The rapid antigen test for group A streptococcus is positive. What is true about this infection? Penicillin is needed to shorten the illness Untreated, the bacteria can persist for weeks Always acquired from another person with pharyngitis Incubation period of 7-14 days Occurs mostly in children of 1-5 years

Haemophilus influenzae is the correct answer. This patient has otitis media for which H. influenzae is a leading cause.

Question 7 1 / 1 pts A one-year-old baby girl is brought to the clinic because of 2 days of fever, rhinorrhea, and cough. Her tonsils and breathing are normal. The right tympanic membrane is observed as shown (right). Which of the following causes is most likely? respiratory_infections-q7.jpg Mycoplasma pneumoniae Adenovirus Haemophilus influenzae Moraxella catarrhalis Rhinovirus

To relieve symptoms as early as possible is the correct answer. Otitis media is very uncomfortable, so treatment is directed at relief rather than concerns about complications.

Question 8 1 / 1 pts A one-year-old boy was brought by his mother to a pediatrician with a 1-day history of fever, irritability, and drainage from the right ear. He had a red, bulging tympanic membrane on the right side. The pediatrician prescribed an antibiotic syrup. Why was the antibiotic prescribed? To prevent bacterial infection during a viral illness To soothe his mother's nerves To relieve symptoms as early as possible To prevent permanent hearing loss To prevent perforation of the tympanic membrane

Amoxicillin-clavulanate is the correct answer. Oral amoxicillin-clavulanate. This combination is particularly effective in treating otitis media that might involve beta-lactamase producing bacteria, making it suitable for cases where there is severe infection, treatment failure with amoxicillin alone, or when antibiotic resistance is a concern.

Question 9 1 / 1 pts A 2-year-old girl is brought to the pediatrician by her parents due to a 3-day history of irritability and pulling at her right ear. She also had a fever of 38.9 C (102 F) yesterday. Otoscopic examination reveals a bulging, opaque right tympanic membrane with limited mobility. The diagnosis of otitis media is made. The child has no known drug allergies and has not received antibiotics in the past six months. Her vaccinations are up to date. Which of the following is the most appropriate pharmacological treatment for this patient's condition? Ceftriaxone Azithromycin Amoxicillin Ofloxacin Amoxicillin-clavulanate