Influenza and Other Emerging Diseases

Chapter 13 Influenza and Other Emerging Diseases




Clinical Case Problem 1 A 73-Year-Old Man with Fever, Headache, and Myalgias


You are called to see a 73-year-old boarding home resident with a 24-hour history of temperature of 103°F, headache, myalgias, cough, rhinorrhea, sore throat, and malaise. Seven other residents in the same boarding home have come down with similar symptoms. It is late winter, and there has been a significant outbreak of respiratory illness in the community. He has received no vaccinations in the previous 5 years. On examination, the patient appears acutely ill with fever, tachypnea, and tachycardia. The patient also has prominent pharyngeal erythema. There are a few expiratory rhonchi heard and intermittent bilateral rales in the lower lung fields.



Select the best answer to the following questions




1. What is the most likely diagnosis in this patient?


a. influenza A

b. bronchiolitis

c. bacterial pneumonia

d. septicemia secondary to an unknown focus of infection

e. peritonsillar abscess

2. Which of the following investigations may be indicated in this patient?


a. complete blood cell count (CBC)

b. blood cultures

c. chest radiograph

d. all of the above

e. none of the above

3. Which of the following statements regarding influenza is (are) true?


a. influenza epidemics occur annually and are of major public health importance worldwide

b. influenza viruses are subclassified as influenza A, influenza B, and influenza C

c. excess morbidity and mortality are reported consistently during influenza epidemics

d. all of the above

e. none of the above

4. Concerning the use of antibiotics in influenza infection in the elderly, which of the following statements most accurately describes a high practice standard?


a. no elderly patients with influenza should receive prophylactic antibiotics

b. all elderly patients with influenza should receive prophylactic antibiotics

c. in most cases of uncomplicated influenza, the risk/benefit ratio favors withholding of antibiotics

d. basically, give the patient antibiotics if he or she asks for them; if the patient does not ask, do not give them

e. nobody really knows for sure

5. What is the most common complication of the illness described in this patient?


a. meningitis

b. pneumonia

c. serum sickness

d. agranulocytosis

e. brain abscess

6. Which of the following types of influenza is responsible for most of the world pandemics?


a. influenza A

b. influenza B

c. influenza C

d. influenza D

e. influenza E

7. Which of the following is the drug of choice to treat the symptoms of the patient described?


a. acetylsalicylic acid

b. acetaminophen

c. oseltamivir

d. meperidine

e. ibuprofen

8. What is the primary mode of transmission of the illness described?


a. by blood and blood products

b. oral-fecal contamination

c. sneezing and coughing

d. fomites

e. kissing

9. What is the most reliable method for prevention of influenza?


a. gamma globulin

b. alfa interferon

c. activated influenza vaccine

d. inactivated influenza vaccine

e. amantadine hydrochloride

10. Regarding influenza vaccine, which of the following statements is true?


a. influenza vaccine is effective only against influenza A

b. the efficacy of influenza vaccine is approximately 95%

c. influenza vaccine should be administered every 2 years

d. the ideal time for administration of influenza vaccine is in the late spring

e. none of the above

11. Regarding influenza vaccination, which of the following statements is (are) true?


a. intramuscular (IM) influenza vaccination typically produces no adverse drug reactions

b. the recommended dosage of the IM influenza vaccine is 0.5   mL for adults

c. influenza vaccination reduces the severity of illness in vaccinated persons who become infected

d. b and c are true

e. a, b, and c

12. Regarding antiretroviral prophylaxis of influenza, which of the following is true?


a. amantadine prophylaxis is effective against both influenza A and influenza B

b. Oseltamivir and zanamivir may be used for chemoprophylaxis for infants younger than 1 year old when indicated

c. More than 99% of currently circulating influenza A virus strains are sensitive to amantadine

d. oseltamivir and zanamivir may be used as prophylaxis in high-risk individuals in whom the influenza vaccine is contraindicated

e. none of the above

13. Which of the following groups should be considered for yearly vaccinations against influenza?


a. healthy adults older than 65 years

b. children and adolescents receiving chronic aspirin therapy

c. health care workers

d. adults and children in chronic care facilities

e. all of the above

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Influenza and Other Emerging Diseases

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