Urgent Care Urgent Care Respiratory Infections 1 — Questions and Answers
Question 1: Which clinical feature best distinguishes bacterial sinusitis from viral upper respiratory infection in urgent care?
- Runny nose lasting 3 days
- Symptoms persisting beyond 10 days or worsening after initial improvement (Correct answer)
- Mild facial pressure for 5 days
- Sneezing and clear nasal discharge
Correct answer: Symptoms persisting beyond 10 days or worsening after initial improvement
Bacterial sinusitis is diagnosed clinically when URI symptoms persist beyond 10 days without improvement or worsen after initial improvement (double-sickening pattern).
Question 2: What is the first-line antibiotic for adult community-acquired pneumonia treated outpatient without comorbidities?
- Amoxicillin-clavulanate
- Azithromycin or doxycycline (Correct answer)
- Levofloxacin
- Trimethoprim-sulfamethoxazole
Correct answer: Azithromycin or doxycycline
For healthy adults with community-acquired pneumonia managed outpatient, azithromycin or doxycycline is recommended per IDSA/ATS guidelines.
Question 3: A 35-year-old presents with sore throat, fever 38.9°C, tonsillar exudate, and anterior cervical lymphadenopathy. No cough. What is the Centor score?
- 1
- 2
- 3
- 4 (Correct answer)
Correct answer: 4
This patient scores 4 on the Centor criteria: fever >38°C, tonsillar exudate, anterior cervical lymphadenopathy, and absence of cough.
Question 4: Which finding on chest X-ray is most consistent with typical bacterial pneumonia?
- Bilateral diffuse interstitial infiltrates
- Lobar or segmental consolidation with air bronchograms (Correct answer)
- Hyperinflation with flattened diaphragms
- Pleural effusion without parenchymal infiltrate
Correct answer: Lobar or segmental consolidation with air bronchograms
Lobar or segmental consolidation with air bronchograms is the classic radiographic finding of typical bacterial pneumonia.
Question 5: What is the recommended duration of antibiotic therapy for uncomplicated acute bacterial sinusitis in adults?
- 3 days
- 5–7 days (Correct answer)
- 10–14 days
- 21 days
Correct answer: 5–7 days
Current guidelines recommend 5–7 days of antibiotics for uncomplicated acute bacterial sinusitis in adults.
Question 6: Streptococcal pharyngitis is treated to prevent which serious complication?
- Viral myocarditis
- Acute rheumatic fever and glomerulonephritis (Correct answer)
- Bacterial meningitis
- Ludwig's angina
Correct answer: Acute rheumatic fever and glomerulonephritis
Treatment of streptococcal pharyngitis with penicillin prevents acute rheumatic fever and its associated cardiac sequelae.
Urgent Care Urgent Care Respiratory Infections 1
Which clinical feature best distinguishes bacterial sinusitis from viral upper respiratory infection in urgent care?