Deck 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)

Question 1

Which of the following patients is least likely to experience a severe RSV infection?

A) A 6-month-old recently diagnosed with cystic fibrosis
B) A 3-month-old who was born prematurely
C) A 2-year-old undergoing chemotherapy for leukemia
D) A 3-year-old with no siblings

Answer 1

A 3-year-old with no siblings

Question 2

Infants with RSV do NOT benefit from which of the following?

A) Chest percussion and drainage (CPT & D)
B) High-flow nasal cannula therapy (HFNC)
C) Bulb suctioning of the nares
D) Nebulized hypertonic saline

Answer 2

Chest percussion and drainage (CPT & D)

Question 3

A respiratory syncytial virus (RSV) infection will cause which of the following anatomic alterations of the lungs?
1) Chemical pneumonitis of the small airways
2) Peribronchiolar mononuclear infiltration
3) Small airway epithelial necrosis
4) Edema of the epiglottis and upper airway

A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 2, 3, 4

Answer 3

2, 3

Question 4

Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema

A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4

Question 5

An infant with RSV will show what clinical manifestations associated with the more negative intrapleural pressures needed during inspiration?
1) Seesaw breathing movement
2) Breath sounds reveal pleural friction rub
3) Inspiratory stridor
4) Cyanosis of the dependent abdominal areas

A) 2, 4
B) 1, 4
C) 1, 3, 4
D) 1, 2, 3, 4

Question 6

Several small children who attend the same day care facility have become sick with RSV. The owner of the day care can expect them to recover within:

A) 4 to 6 days.
B) 3 to 8 days.
C) 1 to 2 weeks.
D) greater than 3 weeks.

Question 7

Which of the following characteristics would put an adult at increased risk for a severe case of RSV?
1) Compromised immune system
2) History of asthma
3) Under 30 years of age
4) More than 65 years of age

A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 1, 2, 4

Question 8

Anatomic alterations related to an RSV infection can lead to all of the following EXCEPT:

A) pneumomediastinum.
B) partial airway obstruction.
C) decreased airway lumen.
D) complete airway obstruction.

Question 9

The physical examination of a neonate with RSV will often reveal all of the following EXCEPT:

A) change in point of maximum impulse (PMI).
B) excessive secretions.
C) expiratory grunting.
D) cyanosis.

Question 10

What can be given to a premature baby in order to prevent an RSV infection?

A) An inhaled corticosteroid agent
B) Ribavirin (Virazole)
C) Palivizumab (Synagis)
D) A sympathomimetic agent

Question 11

The diagnosis of RSV is most often confirmed with a sample obtained by:

A) tracheal suctioning.
B) venipuncture.
C) arterial blood sampling.
D) urine specimen.
E) nasopharyngeal aspirate.

Question 12

Outbreaks of RSV are usually found in all of the following seasons of the year EXCEPT:

A) spring.
B) summer.
C) fall.
D) winter.

Question 13

Which of the following is no longer recommended in the management of a patient with RSV infection?

A) Palivizumab (Synagis)
B) Bulb suctioning of the nares
C) Nebulized hypertonic saline
D) Ribavirin (Virazole)

Question 14

A patient with an RSV is hypoxemic. What could cause this?
1) Atelectasis
2) Excessive airway fluid
3) Persistent pulmonary hypertension of the newborn (PPHN)
4) Consolidation

A) 1, 2
B) 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4

Question 15

A chest radiograph was taken of a patient with RSV. What finding can be expected?

A) Elevated diaphragms
B) "Steeple point" sign
C) Lobar atelectasis
D) Pneumothorax