Respiratory Infections and Atrial Fibrillation Quiz
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Questions and Answers

What is the recommended antibiotic treatment for adults with acute bacterial rhinosinusitis who have no penicillin allergy?

  • Ciprofloxacin 500 mg PO TID
  • Amoxicillin-Clavulanate 875/125 mg PO BID (correct)
  • Azithromycin 500 mg PO QD
  • Doxycycline 100 mg PO BID

In case of a slow response to the initial treatment for acute bacterial rhinosinusitis, what is the recommended action?

  • Consult a specialist immediately
  • Prescribe an antihistamine
  • Increase the dosage of the current antibiotic
  • Change to a different class of antibiotics (correct)

What is a common supportive management recommendation for acute bacterial rhinosinusitis?

  • Administering oral steroids
  • Staying indoors during the acute period
  • Using decongestants regularly
  • Saline irrigation (correct)

Which of the following symptoms is NOT typical in acute otitis media?

<p>Nasal congestion (C)</p> Signup and view all the answers

What should patients avoid during the acute period of a respiratory infection?

<p>Smoking and exposure to secondhand smoke (B)</p> Signup and view all the answers

What is a characteristic feature of Atrial Fibrillation as noted in the content?

<p>Uncoordinated and disorganized atrial activation (C)</p> Signup and view all the answers

Which condition is indicated by 'almost mirror RBBB'?

<p>Brugada Pattern (A)</p> Signup and view all the answers

What is the required duration for Atrial Fibrillation to be classified as persistent?

<p>Sustained over 7 days (D)</p> Signup and view all the answers

What is a major consideration when prescribing antithrombotic therapy?

<p>Risk of bleeding (A)</p> Signup and view all the answers

Which of the following correctly describes the dosing of Eliquis?

<p>5 mg twice daily with renal adjustments if necessary (B)</p> Signup and view all the answers

What characterizes the management of asthma according to evidence-based practice?

<p>Inhaled corticosteroids for all patients. (A)</p> Signup and view all the answers

What is a clinical sign that may indicate a severe asthma exacerbation?

<p>Absent lung sounds. (A)</p> Signup and view all the answers

Which of the following vaccinations is recommended for the prevention of pneumonia?

<p>PCV. (C)</p> Signup and view all the answers

What distinguishes COPD from asthma?

<p>COPD is classified under obstructive lung diseases. (C)</p> Signup and view all the answers

Which of the following does NOT describe a full thickness (3rd degree) burn?

<p>Blisters develop rapidly. (D)</p> Signup and view all the answers

What factor is a common predisposing condition for impetigo?

<p>Poor hygiene. (C)</p> Signup and view all the answers

Which symptom is typically NOT associated with a COPD exacerbation?

<p>Higher than normal oxygen saturation. (D)</p> Signup and view all the answers

What is the primary goal of managing asthma?

<p>To understand and manage triggers. (D)</p> Signup and view all the answers

What distinguishes bullous from nonbullous lesions in Staphylococcus aureus infections?

<p>Bullous lesions are large, fragile, and ooze fluid. (D)</p> Signup and view all the answers

Which of the following is a characteristic of the clinical presentation of nonbullous lesions?

<p>They begin with maculopapular lesions. (C)</p> Signup and view all the answers

Which type of bacterial skin infection is classified as a secondary infection?

<p>Infection at the site of minor trauma. (C)</p> Signup and view all the answers

During which seasons is the greatest risk of tick-borne disease bites present?

<p>Spring, summer, and fall. (A)</p> Signup and view all the answers

What is the primary form of pharmacologic treatment for Staphylococcus aureus infections?

<p>Topical antibiotics. (D)</p> Signup and view all the answers

Which of the following is NOT part of the typical clinical presentation for these skin infections?

<p>High fevers. (C)</p> Signup and view all the answers

What is the appearance of the crust formed after ruptured bullae in bullous Staphylococcus aureus infections?

<p>Thin and brown. (C)</p> Signup and view all the answers

What is the recommended initial approach for diagnosing skin infections caused by Staphylococcus aureus?

<p>Diagnosing based on typical clinical presentation. (B)</p> Signup and view all the answers

What is a common early sign of appendicitis?

<p>Pain in the epigastrium area (D)</p> Signup and view all the answers

Which of the following is NOT typically a symptom of gastroesophageal reflux disease (GERD)?

<p>Chest pain after exercise (D)</p> Signup and view all the answers

What imaging technique is often utilized for diagnosing appendicitis?

<p>Abdominal ultrasound (B)</p> Signup and view all the answers

Which sign involves pain in the right lower quadrant when the left lower quadrant is palpated?

<p>Rovsing Sign (D)</p> Signup and view all the answers

What is the first-line management approach for GERD?

<p>Lifestyle changes and dietary modifications (C)</p> Signup and view all the answers

Which of the following is a complication associated with untreated GERD?

<p>Esophageal stricture (C)</p> Signup and view all the answers

What is the correct duration of PPI therapy recommended for symptom relief in GERD?

<p>8 weeks (A)</p> Signup and view all the answers

Which of the following agents lowers esophageal sphincter tone?

<p>Nitrates (D)</p> Signup and view all the answers

Which physical examination technique is used to assess for appendicitis by extending the right leg?

<p>Psoas Sign (D)</p> Signup and view all the answers

In pediatric patients, which group demonstrates a higher prevalence of appendicitis?

<p>Children aged 5 and older (B)</p> Signup and view all the answers

Which symptom is typically seen in older patients with GERD that may be atypical?

<p>Chest pain (D)</p> Signup and view all the answers

What is the common issue affecting the diagnosis of GERD?

<p>Chronic cough and sore throat (B)</p> Signup and view all the answers

Which treatment is typically avoided in GERD management due to its potential to exacerbate symptoms?

<p>Anticholinergics (B)</p> Signup and view all the answers

What is a common cause of peptic ulcer disease?

<p>H. Pylori (D)</p> Signup and view all the answers

Which symptom is typically relieved after a meal in duodenal ulcers?

<p>Gnawing or dull ache (B)</p> Signup and view all the answers

What clinical finding might be present on an abdominal exam for a peptic ulcer?

<p>No significant findings (A)</p> Signup and view all the answers

Which factor is a risk for macrolide resistance when treating H. pylori?

<p>Prior antibiotic treatments (C)</p> Signup and view all the answers

In the context of diarrhea, what alteration indicates inflammatory diarrhea?

<p>Fever with blood or pus in the stool (A)</p> Signup and view all the answers

What would be considered a red flag in the history of a patient with diarrhea?

<p>Diarrhea that awakens from sleep (A)</p> Signup and view all the answers

What is the first-line treatment for C. diff or CDI?

<p>Fidaxomicin (D)</p> Signup and view all the answers

In the management of NSAID-induced ulcers, which option is recommended if NSAID discontinuation is not possible?

<p>Add a continuous PPI or misoprostol (A)</p> Signup and view all the answers

Which factor is NOT commonly associated with acute diarrhea?

<p>Chronic gastrointestinal conditions (A)</p> Signup and view all the answers

Which type of diarrhea is characterized by watery, non-bloody stools?

<p>Acute non-inflammatory diarrhea (A)</p> Signup and view all the answers

What is one of the primary goals in differentiating between acute and chronic diarrhea?

<p>To identify the underlying cause (D)</p> Signup and view all the answers

What condition is characterized by fecal retention, often leading to constipation?

<p>Peristaltic movement disorder (B)</p> Signup and view all the answers

Which medication is commonly used for nausea relief associated with diarrhea?

<p>Zofran (A)</p> Signup and view all the answers

Which demographic group is noted to experience a significant decrease in quality of life due to diarrhea?

<p>Older adults (D)</p> Signup and view all the answers

Flashcards

Acute Bacterial Rhinosinusitis

An infection of the sinuses caused by bacteria.

Amoxicillin-Clavulanate

A common treatment for adults with acute bacterial rhinosinusitis, typically given for 5-7 days.

Earache

A common symptom of acute otitis media (AOM), often accompanied by a fever.

Streptococcus Pneumoniae

One of the main bacterial culprits behind acute otitis media (AOM).

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Saline Irrigation

A key recommendation for managing AOM, helping to clear the middle ear.

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Atrial Fibrillation (AFib)

A type of heart rhythm abnormality characterized by a rapid and irregular heart rate. It occurs when the upper chambers of the heart (atria) beat chaotically.

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Bundle Branch Block (BBB)

A type of heart rhythm abnormality where the electrical signal in the heart is delayed or blocked in one of the ventricles, causing a characteristic wide QRS complex on an electrocardiogram (ECG).

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Brugada Pattern

A specific ECG pattern that may indicate an increased risk of sudden cardiac death. It often shows an abnormally shaped QRS complex, particularly in leads V1 and V2.

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Anticoagulation

A medication used to prevent blood clots from forming in the heart, reducing the risk of stroke in patients with atrial fibrillation.

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Direct Factor Xa Inhibitors

A type of blood thinner medication that directly inhibits the factor Xa enzyme involved in blood clotting.

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Pneumonia: What is it?

A serious lung infection that can be caused by bacteria, viruses, or fungi. It can be identified by symptoms like coughing, shortness of breath, fever, wheezing, and chest pain. It can be prevented by regular vaccination and managed with antibiotics in some cases.

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Asthma: What is it?

A chronic lung disease characterized by inflammation and narrowing of the airways. It causes difficulty breathing, wheezing, and coughing. It can be triggered by allergies, infections, or environmental factors.

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COPD: What is it?

An umbrella term for a group of lung diseases that cause airflow obstruction and damage to the lungs. It's often caused by smoking and can lead to shortness of breath, wheezing, and chronic cough.

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Full Thickness Burn (3rd Degree): What is it?

A severe burn that involves all layers of the skin, often causing a white, leathery, or charred appearance. It can be extremely painful and requires immediate medical attention.

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Impetigo: What is it?

A common skin infection that can spread easily. It's often caused by bacteria called staphylococcus aureus or streptococcus pyogenes. It usually presents as itchy blisters filled with pus.

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Acute Otitis Media (AOM): What is it?

A condition that occurs when the space between the eardrum and the middle ear fills with fluid. It can cause ear pain, fever, and hearing loss, particularly in young children.

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Amoxicillin-Clavulanate: What is it?

A type of antibiotic commonly used to treat bacterial infections. It's often used to treat ear infections, respiratory infections, and skin infections.

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Saline Irrigation: What is it?

A key recommendation for managing acute otitis media (AOM). It involves flushing the middle ear with a saltwater solution to help clear the fluid and reduce pressure.

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Impetigo

A skin infection caused by Staphylococcus aureus or Streptococcus A, often manifesting as red, crusting rash with pus-filled blisters.

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Bullous Impetigo

A type of impetigo characterized by large, fluid-filled blisters that burst and leave behind thin brown crusts.

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Nonbullous Impetigo

A type of impetigo with smaller, pus-filled blisters and red, crusting rash.

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Primary Impetigo

Impetigo that develops on normal skin, without any prior injury.

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Secondary Impetigo

Impetigo that occurs at a site of minor trauma, like a scratch or insect bite.

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Impetigo Clinical Presentation

Impetigo is typically self-limited, meaning it resolves on its own within 2-3 weeks, but may cause itching or burning.

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Impetigo Treatment

Topical antibiotics, such as mupirocin ointment, are often used to treat impetigo.

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Tick Bite Season

The greatest risk of being bitten by a tick occurs during the spring, summer, and fall months.

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Appendicitis Pain Pattern

Pain that starts in the upper abdomen or around the belly button and then moves to the lower right abdomen.

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McBurney's Point

A point on the abdomen that's tender to touch in appendicitis.

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Rovsing's Sign

A sign of appendicitis tested by pressing on the left side of the abdomen and feeling pain on the right side.

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Obturator Sign

A test for appendicitis where you rotate the hip of a person lying on their back, and pain indicates a positive result.

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Psoas Sign

A test for appendicitis where you have the person lie on their side and extend their top leg backwards, causing pain if positive.

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GERD

A condition where stomach acid flows back up into the esophagus, causing heartburn.

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Heartburn

A common symptom of GERD, described as a burning sensation in the chest.

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PPIs

Medications that reduce acid production in the stomach, but can also decrease bone density.

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GERD Triggers

Foods, drinks, or substances that can worsen GERD symptoms.

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Dysphagia

A symptom of GERD where it feels like food is stuck in the throat.

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pH Monitoring

A diagnostic test for GERD that measures the acidity of the esophagus.

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Barrett's Esophagus

A condition where the lining of the esophagus is damaged from acid reflux, increasing the risk of cancer.

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Esophageal Stricture

A complication of GERD where the esophagus narrows due to inflammation and scarring.

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Antacid

A medication that helps neutralize stomach acid.

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H2 Receptor Antagonists (H2RAs)

A type of medication that reduces acid secretion in the stomach.

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Peptic Ulcer Disease

A common gastrointestinal condition marked by pain in the upper abdomen, often described as sharp, burning, aching, or gnawing.

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H. pylori

A bacterial infection that frequently contributes to peptic ulcer disease.

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NSAIDS

Medications like ibuprofen or naproxen that can increase the risk of developing peptic ulcers.

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Acute Diarrhea

A type of diarrhea characterized by frequent, watery stools that last less than four weeks.

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Inflammatory Diarrhea

A type of diarrhea resulting from inflammation in the digestive tract.

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Osmotic Diarrhea

A type of diarrhea linked to water retention in the digestive system.

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Secretory Diarrhea

A type of diarrhea caused by an overproduction of fluids in the intestines, often due to specific toxins or bacteria.

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Inflammatory Diarrhea

A type of diarrhea that can be caused by conditions like Crohn's disease or ulcerative colitis.

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Medication-induced Diarrhea

A type of diarrhea caused by medications such as antibiotics, antacids, or proton pump inhibitors (PPIs).

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Malabsorption Diarrhea

A type of diarrhea that can be caused by a lack of enzymes needed to digest certain foods, such as lactose (milk sugar).

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Motility Disorder Diarrhea

A type of diarrhea that can be caused by issues with the rhythm and movement of the intestines.

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Clostridium difficile Infection (CDI)

A serious type of diarrhea that can occur after hospitalization and antibiotic use.

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Diarrhea in Older Adults

A condition that can worsen diarrhea in older adults, leading to significant quality of life decline and even death.

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Bristol Stool Chart

A medical chart known as the 'Bristol Stool Chart' is used to assess and categorize the consistency of stools.

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Childhood Constipation

A type of constipation that is characterized by having fewer than two bowel movements per week.

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Study Notes

Allergic Rhinitis

  • Types: Seasonal (intermittent), year-round (chronic), mixed rhinitis (combined allergic and non-allergic).
  • History: Allergies, family history, triggers, known allergens (e.g., asthma, atopic dermatitis).
  • Symptoms: Nasal congestion, clear rhinorrhea, sneezing, nasal pruritus, post-nasal drip, non-productive cough.
  • Chronic sinusitis can be a complication.
  • Clinical Presentation: Periorbital edema, allergic shiners, Dennies lines.
  • Physical Exam: Examine nose for mucosal edema, clear secretions, palpate sinuses (tenderness), examine mouth (breathing, erythema), eyes (allergic conjunctivitis), ears (eustachian tube dysfunction), assess skin (dermatitis), neck lymph nodes.
  • Diagnostic Testing: Skin allergy testing, serum testing.
  • UpToDate Information: Mild or episodic symptoms → minimally sedating oral antihistamine or olopatadine(antihist. nasal spray), azelastine or olopatadine (antihist. nasal spray), glucocorticoid nasal spray, cromolyn nasal spray(ideally 30 min before exposure). Persistent or moderate-to-severe symptoms → glucocorticoid nasal spray + an antihistamine spray, possibly add an minimally sedating oral antihistamine/decongestant, injection immunotherapy.

Pharyngitis

  • Pathogens: Viral (adenovirus, parainfluenza, coronavirus), bacterial (group A strep). Coxsackie virus, EVB and CMV. Group A, Gonorrhea, Fusobacterium.
  • Clinical Presentation: Gradual onset, URI, cough, conjunctivitis (particularly in kids), low-grade or absent fever.
  • Viral Pharyngitis: Coryza (nasal & Lacrima edema and congestion), pharyngeal erythema, tonsillar edema, low-grade or absent fever; presence of exudate, oral ulcers, and exanthema.
  • Streptococcus Pharyngitis: Tender, swollen anterior cervical lymph nodes (unilateral or bilateral), patchy tonsillar exudates, pharyngeal erythema and tonsillar edema, fever, and exudates.
  • Other Findings: Palatal petechiae (small red spots), scarlatiniform rash, strawberry tongue.
  • Management: Antibiotic treatment if bacterial infection suspected (e.g., penicillin).
  • Viral pharyngitis usually self-limiting and managed supportively.

Pharyngitis - Bacterial (GABHS)

  • Most common bacterial cause of acute pharyngitis.
  • Clinical presentation: Sudden onset, fever (>101°F), sore throat with dysphagia. abdominal pain and vomiting could also be present
  • Diagnostic tests: RADT, CBC, mono.
  • Treatment: Penicillin VK 500mg PO BID for 10 days; Cephalexin 500mg BID×10 days if allergic to penicillin; Azithromycin for PCN anaphylaxis.

Pharyngitis - N. Gonorrhea

  • Treatment: Single injection of Ceftriaxone 500mg IMx1

Pharyngitis - Allergic

  • Does not present w/ fever.
  • Persistent symptoms: A/c w/ persistent post nasal drip, sneezing, itchy watery eyes, rhinorrhea, and mild sore throat, worsened by lying down
  • Treatment: Symptomatic relief (antihistamines, nasal sprays).

Rhinosinusitis

  • Inflammation of the mucous membrane of the paranasal sinuses; caused by blockage of normal drainage pathways leading to mucus retention.
  • Predisposing factors: Bacteria growth, recent URI or influenza, allergic rhinitis, environmental pollutants, environmental pollutants, abnormalities/hormones.
  • Clinical Presentation: Nasal congestion/obstruction, nasal discharge, anosmia (loss of smell), dental pain, increased head pressure, sore throat, cough, facial pain above eyebrows, fatigue.
  • Management: Abx may be necessary if there's evidence of bacterial infection/purulent nasal discharge/facial pain lasting for 3-4 days consecutively at the start of the illness. Supportive management generally involves saline irrigation and avoiding allergens/irritants.

Acute Otitis Media

  • Etiology: Bacterial (S. pneumoniae, H. influenzae), Viral, Fungal
  • Symptoms: Earache, fever (may/may not be present), hearing loss, muffled sound, stuffiness, fullness, vertigo
  • Diagnsotic: Cloudy/Opacified/full, red, bulging tympanic membrane. Decrased/absent bony landmarks, distorted absent light reflex from impaired tympanic membrane vascularity.
  • Treatment: Amoxicillin (1000mg TID x 10days); Amoxicillin/clavulanate (875/125 mg BIDx10days). More severe/non-responsive → different abx regimen; Supportive management + symptomatic relief
  • Pt history: recent URI/hx of previous infections/treatment.

Cardio/ECG Eval

  • Basic ECG interpretation
  • 12 views/leads (6 limb, 6 chest)
  • Vertical = amplitude mV, horizontal = time mSec
  • Upward = positive, downward = negative
  • Each block = 0.04 seconds
  • Cardiac Conduction Cycle
  • ECG interval, PR interval: 0.12-0.20 sec; QRS Complex: 0.06-0.12 sec; QT Interval: <0.44-0.46 sec.
  • Rate, Rhythm, Axis, Hypertrophy, Infarction, Conclusion.

Other conditions

  • Further details regarding other specific diseases (e.g., acute bacterial rhinosinusitis, acute otitis media, chronic rhinosinusitis) are not included in the summary.

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Description

Test your knowledge on the management and treatment of respiratory infections like acute bacterial rhinosinusitis and conditions related to Atrial Fibrillation. This quiz covers antibiotic treatments, symptom recognition, and evidence-based practices for managing asthma. Ideal for healthcare professionals and students alike.

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