Urgent Care Urgent Care Respiratory Infections 2 — Questions and Answers
Question 1: Which pathogen is the most common cause of community-acquired pneumonia in adults in the United States?
- Haemophilus influenzae
- Mycoplasma pneumoniae
- Streptococcus pneumoniae (Correct answer)
- Legionella pneumophila
Correct answer: Streptococcus pneumoniae
Streptococcus pneumoniae remains the most common bacterial cause of community-acquired pneumonia in adults in the US.
Question 2: A patient with influenza presents 36 hours after symptom onset. Which antiviral therapy is most appropriate?
- No antiviral — beyond treatment window
- Oseltamivir (Tamiflu) 75 mg twice daily for 5 days (Correct answer)
- Zanamivir inhaled once daily for 3 days
- Amantadine 200 mg once daily for 5 days
Correct answer: Oseltamivir (Tamiflu) 75 mg twice daily for 5 days
Oseltamivir is effective when started within 48 hours of symptom onset and is the first-line antiviral for influenza.
Question 3: Which clinical feature distinguishes croup from epiglottitis in a child with stridor?
- Presence of fever
- Barking cough and gradual onset in croup vs. drooling and toxic appearance in epiglottitis (Correct answer)
- Age of the patient alone
- Stridor only during inspiration
Correct answer: Barking cough and gradual onset in croup vs. drooling and toxic appearance in epiglottitis
Croup typically presents with a barking cough and gradual onset, while epiglottitis presents acutely with drooling, tripod positioning, and a toxic appearance.
Question 4: What is the first-line treatment for mild-to-moderate asthma exacerbation in urgent care?
- Oral corticosteroids alone
- Short-acting beta-2 agonist (SABA) via nebulizer or MDI with spacer (Correct answer)
- Intravenous magnesium sulfate
- Antibiotics for presumed infection
Correct answer: Short-acting beta-2 agonist (SABA) via nebulizer or MDI with spacer
Short-acting beta-2 agonists (albuterol) delivered via nebulizer or MDI with spacer are the cornerstone of acute asthma exacerbation treatment.
Question 5: A patient is diagnosed with community-acquired pneumonia. Which PSI/PORT score would support outpatient management?
- PSI Class IV (score 91–130)
- PSI Class V (score >130)
- PSI Class I or II (low risk) (Correct answer)
- PSI Class III with SpO2 88%
Correct answer: PSI Class I or II (low risk)
PSI Class I and II indicate low mortality risk and support outpatient treatment for community-acquired pneumonia.
Question 6: What is the most common cause of acute bronchitis in adults presenting to urgent care?
- Streptococcus pneumoniae
- Mycoplasma pneumoniae
- Viral pathogens (rhinovirus, influenza, RSV) (Correct answer)
- Haemophilus influenzae
Correct answer: Viral pathogens (rhinovirus, influenza, RSV)
Viral pathogens cause >90% of acute bronchitis cases in adults, which is why antibiotics are not routinely indicated.
Urgent Care Urgent Care Respiratory Infections 2
Which pathogen is the most common cause of community-acquired pneumonia in adults in the United States?