NLE Respiratory Nursing — Upper & Lower Respiratory InfectionsCheat Sheet
A printable cheat sheet for Upper & Lower Respiratory Infections, built for NLE reviewers who want one go-to reference in the final stretch. Covers formulas, key definitions, common question types, and the Professional Regulation Commission (PRC) — Board of Nursing-specific twists you will see on NLE day.
Exam context
For the Philippine Nurse Licensure Examination (PNLE), Professional Regulation Commission (PRC) — Board of Nursing tests Respiratory Nursing under a "Core" label, with Upper & Lower Respiratory Infections in the 2nd slot across 4 chapters. NLE candidates must clear the 75% weighted average with no sub-test below 60% cut on the 2026 paper, which draws about 50 Respiratory Nursing questions. Date to watch: Bi-annual.
Upper & Lower Respiratory Infections - Cheat Sheet
Your 30-minute exam-ready reference covering upper & lower respiratory infections, with special emphasis on TB (Philippine NTP priority), pneumonia management, and high-yield pharmacology. Memorise the RIPE regimen, DOTS principles, GeneXpert, airborne vs. droplet precautions, and antibiotic first-lines.
Sections
Section Title
SINUSITIS
Important Facts
- Most are VIRAL — supportive care (saline irrigation, steam, decongestants, analgesics).
- Bacterial suspected when symptoms persist >10 days or worsen after initial improvement.
- First-line antibiotic: amoxicillin.
- Classic signs: facial pressure/pain, post-nasal drip, nasal congestion, headache.
- Teach warm compresses, increased fluids, and saline irrigation.
Key Definitions
Term
Sinusitis
Example
Facial pain worse on bending forward + purulent nasal discharge after a cold = likely bacterial sinusitis.
Definition
Inflammation of paranasal sinuses; mostly viral, bacterial if persisting >10 days or worsening after initial improvement.
Section Title
PHARYNGITIS (SORE THROAT)
Important Facts
- Majority of pharyngitis is VIRAL — supportive care only.
- Identify GABHS: sudden onset, high fever, tonsillar exudate, tender anterior cervical nodes, ABSENCE of cough.
- Confirm with rapid antigen test or throat culture before starting antibiotics.
- First-line treatment for GABHS: penicillin (full course) or amoxicillin.
- If penicillin-allergic: macrolide (azithromycin, clarithromycin) — FULL COURSE mandatory.
- CRITICAL TEACHING: complete the entire antibiotic course even after symptoms resolve — THIS prevents rheumatic fever.
- Viral pharyngitis: fluids, analgesics, warm saline gargles.
Key Definitions
Term
Pharyngitis
Example
Sudden sore throat + fever + tonsillar exudate + tender anterior cervical nodes + NO cough = GABHS (strep throat).
Definition
Pharyngeal inflammation; mostly viral, but Group A beta-haemolytic streptococcus (GABHS) requires full antibiotic course to prevent rheumatic fever.
Term
GABHS (Strep Throat)
Example
Positive rapid antigen test or throat culture + fever + exudate = treat with full course penicillin or amoxicillin.
Definition
Group A beta-haemolytic streptococcus; critical because untreated cases lead to acute rheumatic fever (ARF) and acute glomerulonephritis (AGN).
Section Title
INFLUENZA (FLU)
Important Facts
- MORE SYSTEMIC & ABRUPT than common cold.
- High-risk for complications: viral/secondary bacterial pneumonia (elderly, pregnant, chronic disease).
- Antivirals (oseltamivir) MOST EFFECTIVE within 48 hours of symptom onset.
- After 48 hours: supportive care (rest, fluids, antipyretics).
- Prevention: annual influenza vaccine (high-risk groups), respiratory/droplet precautions, hand hygiene.
- Teach cough etiquette and contact precautions.
Key Definitions
Term
Influenza
Example
Abrupt onset + high fever + myalgia + dry cough + fatigue = influenza (not common cold).
Definition
Acute viral respiratory illness (Influenza A & B) with abrupt onset, high fever, myalgia, headache, dry cough, profound fatigue.
Section Title
ACUTE BRONCHITIS
Important Facts
- Hallmark: initially DRY cough → becomes PRODUCTIVE, lasts up to 3 weeks.
- May have low-grade fever and chest discomfort.
- MANAGEMENT IS SUPPORTIVE ONLY: fluids, rest, humidification, antipyretics/analgesics.
- ANTIBIOTICS NOT INDICATED — it is viral; unnecessary antibiotics drive resistance.
- Teach smoking cessation and warning signs of pneumonia: high fever, dyspnoea, pleuritic pain.
Key Definitions
Term
Acute Bronchitis
Example
Productive cough lasting 3 weeks after a cold + low-grade fever + chest discomfort = acute bronchitis.
Definition
Bronchial inflammation; mostly viral, self-limiting, often following upper respiratory infection.
Section Title
PNEUMONIA — Overview & Pathophysiology
Important Facts
- Alveolar consolidation reduces surface area for gas exchange → hypoxaemia.
- Consolidated lung transmits sound differently: increased fremitus, dullness to percussion, bronchial breath sounds.
- Three main types: Community-Acquired (CAP), Hospital-Acquired/Nosocomial (HAP), Aspiration.
Key Definitions
Term
Pneumonia
Example
Pathogens reach alveoli → inflammatory response → alveoli fill with exudate/WBCs (consolidation) → reduced gas exchange.
Definition
Infection of lung parenchyma causing alveolar consolidation with exudate, impairing gas exchange and causing hypoxaemia.
Section Title
PNEUMONIA — Types & Causative Agents
Important Facts
- CAP most common: S. pneumoniae (produces rust-coloured sputum — HIGH-YIELD).
- HAP/VAP: resistant Gram-negatives (e.g., Pseudomonas) + S. aureus.
- Aspiration: risk factors = impaired swallowing, decreased LOC, NG tube feeding, GORD.
Key Definitions
Term
Community-Acquired Pneumonia (CAP)
Example
Patient presents with fever, productive cough, pleuritic pain; CXR shows infiltrate = CAP.
Definition
Pneumonia acquired in the community; most common bacterial cause is Streptococcus pneumoniae; also viral and atypical organisms (Mycoplasma, Legionella).
Term
Hospital-Acquired / Nosocomial Pneumonia (HAP)
Example
Patient intubated 72 hours ago develops fever, purulent sputum = HAP (ventilator-associated pneumonia if intubated).
Definition
Pneumonia occurring >48 hours after hospital admission; often more resistant Gram-negative organisms and Staphylococcus aureus.
Term
Aspiration Pneumonia
Example
Unconscious patient or patient with dysphagia develops pneumonia in dependent (lower) lung segments.
Definition
From inhalation of gastric contents/secretions; high risk with impaired swallowing, decreased LOC, NG feeding.
Section Title
PNEUMONIA — Clinical Manifestations & Assessment
Important Facts
- Fever & chills, productive cough with purulent or RUST-COLOURED sputum (pneumococcal — classic).
- Pleuritic chest pain, dyspnoea, tachypnoea.
- Physical exam findings: crackles & bronchial breath sounds over consolidation, dullness to percussion, increased tactile fremitus, positive egophony.
- IN THE ELDERLY: atypical presentation — confusion, lethargy, falls may be ONLY signs; blunted fever response.
- ELDERLY CONFUSION = KEY EXAM POINT — do not miss subtle presentations in older adults.
Key Definitions
Term
Egophony
Example
Patient says 'ee' over consolidated area, auscultation sounds like 'ay' = positive egophony.
Definition
Increased resonance of voice over consolidated lung tissue (patient says 'ee', sounds like 'ay'); sign of consolidation.
Section Title
PNEUMONIA — Diagnostics
Important Facts
- CHEST X-RAY: shows infiltrates/consolidation (confirms diagnosis).
- SPUTUM Gram stain & culture: collect BEFORE starting antibiotics if possible.
- CBC: leukocytosis (elevated WBC count).
- Blood cultures: if severe/sepsis suspected.
- Pulse oximetry & ABG: assess oxygenation status.
- Order investigations BEFORE antibiotics for best diagnostic yield.
Key Definitions
Term
Chest X-Ray (CXR)
Example
Fever + cough + CXR infiltrate = confirms pneumonia diagnosis.
Definition
Gold standard for pneumonia diagnosis; shows infiltrates/consolidation confirming the infection.
Section Title
PNEUMONIA — Nursing Management & Priority Interventions
Important Facts
- PRIORITY #1: MAINTAIN PATENT AIRWAY & ADEQUATE OXYGENATION.
- Give oxygen to maintain SpO2 within target; position in HIGH-FOWLER'S.
- AIRWAY CLEARANCE: encourage deep breathing, coughing, incentive spirometry, adequate hydration (2–3 L/day unless contraindicated) to loosen secretions.
- Perform chest physiotherapy/suctioning as needed to mobilise secretions.
- ANTIBIOTICS: give promptly & on time to maintain therapeutic blood levels; monitor response.
- Manage fever (paracetamol), provide rest, cluster care to conserve energy.
- Monitor for deterioration: rising RR, falling SpO2, confusion, worsening hypoxaemia.
Key Definitions
Term
High-Fowler's Position
Example
Dyspnoeic patient with pneumonia placed in high-Fowler's to improve ventilation and gas exchange.
Definition
Head of bed elevated 45–90 degrees; maximises lung expansion and facilitates easier breathing in respiratory distress.
Section Title
PNEUMONIA — Pharmacology
Important Facts
- CAP FIRST-LINE: amoxicillin OR macrolide (azithromycin, clarithromycin).
- Severe/comorbid CAP: respiratory fluoroquinolone (levofloxacin) OR beta-lactam + macrolide.
- MACROLIDES (azithromycin, clarithromycin): GI upset; monitor for QT prolongation.
- FLUOROQUINOLONES (levofloxacin): risk of tendon rupture & QT prolongation; caution in elderly; affects blood glucose.
- Antipyretics/analgesics: paracetamol for fever & pleuritic pain.
- PREVENTION: pneumococcal & influenza vaccines for at-risk (elderly, chronic illness).
- Duration: typically 7–10 days for CAP (adjust based on response).
Key Definitions
Term
CAP First-Line Antibiotic
Example
Uncomplicated CAP in primary care → amoxicillin or azithromycin; severe CAP or comorbidities → levofloxacin or amoxicillin-clavulanate + azithromycin.
Definition
Amoxicillin or macrolide (azithromycin, clarithromycin); fluoroquinolone or beta-lactam + macrolide for severe/comorbid cases.
Section Title
PNEUMONIA — Complications
Important Facts
- Pleural effusion & empyema (pus in pleural space).
- Sepsis & septic shock (systemic inflammatory response).
- Respiratory failure & ARDS (acute respiratory distress syndrome).
- Atelectasis (lung collapse).
- Lung abscess (localised necrosis/pus collection).
Section Title
TUBERCULOSIS (TB) — Philippine Priority
Important Facts
- Philippines has ONE OF THE HIGHEST TB BURDENS in the world — very high-yield NLE topic.
- Spread: AIRBORNE droplet nuclei (cough, sneeze, talk).
- TB is AIRBORNE, not droplet — CRITICAL for precautions.
- Pathophysiology: bacilli inhaled → lodge in alveoli → immune system forms granuloma → latent TB (usually) or reactivation → active TB.
- Cough ≥2 WEEKS is the key screening trigger in Philippine context.
Key Definitions
Term
Tuberculosis (TB)
Example
Chronic cough ≥2 weeks + low-grade fever + night sweats + weight loss = TB until proven otherwise.
Definition
Infection by Mycobacterium tuberculosis (acid-fast bacillus) spread via airborne droplet nuclei; leading cause of illness/death in Philippines; highest-yield NLE topic.
Term
Latent TB Infection (LTBI)
Example
Close contact of TB patient with positive Mantoux test but no symptoms, normal CXR = LTBI.
Definition
Person is infected with M. tuberculosis but NOT infectious, asymptomatic; immune system walls off bacilli into granuloma; positive PPD/TST.
Term
Active (Pulmonary) TB
Example
Productive cough ≥2 weeks + fever + haemoptysis + upper-lobe infiltrates on CXR = active TB.
Definition
Bacilli reactivate (immunosuppression, HIV, diabetes, malnutrition), causing tissue destruction & cavitation; person is infectious.
Section Title
TUBERCULOSIS — Manifestations & Assessment
Important Facts
- CLASSIC TRIAD (high-yield): chronic productive cough ≥2 weeks + low-grade afternoon fever + night sweats.
- Unexplained weight loss, fatigue, anorexia, haemoptysis (blood-streaked sputum).
- COUGH ≥2 WEEKS = screen for TB in Philippine setting.
Section Title
TUBERCULOSIS — Diagnostics (Philippine NTP First-Line)
Important Facts
- GENEEXPERT MTB/RIF: PHILIPPINE NTP FIRST-LINE TEST (primary diagnostic).
- Detects TB + rifampicin resistance in ~2 hours (rapid).
- Sputum AFB smear: collect per NTP protocol; still used for treatment monitoring.
- CXR: supports diagnosis (upper-lobe infiltrates, cavitation) but NOT confirmatory alone.
- Mantoux/PPD: READ AT 48–72 HOURS; measure INDURATION (not redness).
- Mantoux positive indicates infection/exposure but NOT active disease; can be positive in BCG-vaccinated individuals.
Key Definitions
Term
GeneXpert MTB/RIF
Example
Presumptive TB patient → GeneXpert MTB/RIF → results within 2 hours; if positive, start DOTS; if resistant, escalate to MDR-TB regimen.
Definition
Rapid molecular diagnostic test; detects M. tuberculosis AND rifampicin resistance in ~2 hours; Philippine NTP first-line primary diagnostic (has replaced sputum smear as initial test).
Term
Sputum AFB Smear Microscopy (DSSM)
Example
Patient on TB treatment; DSSM at months 2, 5, 6 to confirm bacteriological response.
Definition
Microscopic examination for acid-fast bacilli; still used for monitoring treatment response per NTP protocol.
Term
Tuberculin Skin Test (Mantoux / PPD)
Example
Inject 0.1 mL PPD intradermally → measure induration at 48–72 h; ≥5 mm = positive in TB contacts; ≥10 mm = positive in general population.
Definition
Intradermal injection of purified protein derivative; READ AT 48–72 HOURS measuring INDURATION (not redness); indicates infection/exposure, not active disease.
Section Title
TUBERCULOSIS — DOTS & National TB Control Program (NTP)
Important Facts
- DOTS PRINCIPLE: health worker directly watches patient swallow EVERY dose.
- DOTS prevents MDR-TB by ensuring ADHERENCE — the single biggest reason NOT to stop treatment early.
- TB diagnosis & full drug regimen provided FREE through DOTS.
- Non-adherence = incomplete treatment = MULTIDRUG-RESISTANT TB (MDR-TB) = much longer, more toxic regimen.
- Treatment partner (family member) can also directly observe doses if trained.
Key Definitions
Term
DOTS (Directly Observed Therapy, Short-Course)
Example
TB patient takes daily rifampicin under direct observation of health worker at clinic; ensures 100% adherence.
Definition
Backbone of NTP; trained treatment partner/health worker directly watches patient swallow every dose to guarantee adherence; incomplete treatment breeds MDR-TB.
Term
Philippine National TB Control Program (NTP)
Example
Patient diagnosed with TB at barangay health station → referred to district TB facility → enrolled in DOTS → receives free drugs × 6 months under direct observation.
Definition
Government programme providing TB diagnosis, full drug regimen, and DOTS support FREE through public health facilities; GeneXpert MTB/RIF is first-line diagnostic.
Formulas
Formula
RIPE Intensive Phase (2 months) + Continuation Phase (4 months) = 6 months total
Meaning
Intensive phase = 4 drugs daily (RIPE); Continuation phase = 2 drugs daily (R + I)
Watch Out
Do NOT stop after 2 months; must complete full 6 months or MDR-TB develops. Missing doses = treatment failure.
When To Use
All drug-susceptible TB patients follow this standard regimen unless contraindicated.
Common Values
Value
450–600 mg
Symbol
~10 mg/kg/day
Quantity
Rifampicin dose
Value
300 mg
Symbol
~5 mg/kg/day
Quantity
Isoniazid dose
Value
Variable (~25 mg/kg/day)
Symbol
Weight-based
Quantity
Pyrazinamide dose
Value
Variable (~15 mg/kg/day)
Symbol
Weight-based
Quantity
Ethambutol dose
Section Title
TUBERCULOSIS — RIPE Drug Regimen (MUST MEMORISE)
Important Facts
- INTENSIVE PHASE (2 MONTHS): 4 drugs daily — R, I, P, E.
- CONTINUATION PHASE (4 MONTHS): 2 drugs daily — R (rifampicin) + I (isoniazid).
- TAKE ON EMPTY STOMACH (best absorption) unless GI upset; single daily dose.
- R, I, P are ALL HEPATOTOXIC — monitor LFTs; teach patient to AVOID ALCOHOL; report jaundice, dark urine, nausea, RUQ pain.
- RIFAMPICIN: orange-red body fluids (harmless), reduces OCP efficacy (use barrier contraception).
- ISONIAZID: ALWAYS give PYRIDOXINE (B6) to prevent peripheral neuropathy — EXAM FAVOURITE.
- PYRAZINAMIDE: raises uric acid (gout risk).
- ETHAMBUTOL: optic neuritis risk — report visual changes immediately; baseline vision check required.
Key Definitions
Term
Rifampicin (R)
Example
Patient taking rifampicin notices orange-red urine; assure them this is normal & harmless. Also counsel to use barrier contraception because rifampicin reduces OCP effectiveness.
Definition
~10 mg/kg/day (usually 450–600 mg). Signature effect: orange-red body fluids (urine, sweat, tears) — reassure patient this is HARMLESS. Hepatotoxic; potent ENZYME INDUCER that REDUCES oral contraceptive efficacy.
Term
Isoniazid (INH)
Example
Patient on isoniazid must receive pyridoxine (B6) concurrently; if develops tingling/numbness in hands/feet, report immediately (neuropathy).
Definition
~5 mg/kg/day (usually 300 mg). Signature effect: PERIPHERAL NEUROPATHY — ALWAYS give PYRIDOXINE (vitamin B6) to prevent. Hepatotoxic.
Term
Pyrazinamide (P)
Example
Patient develops sudden joint pain (especially big toe); check uric acid; likely gout from pyrazinamide.
Definition
~25 mg/kg/day. Hepatotoxic; RAISES uric acid → hyperuricaemia/gout (joint pain).
Term
Ethambutol (E)
Example
Patient on ethambutol reports blurred vision & colour blindness; STOP immediately & refer to ophthalmology; ethambutol-induced optic neuritis can cause permanent blindness.
Definition
~15 mg/kg/day. Signature effect: OPTIC NEURITIS — decreased visual acuity & RED-GREEN colour blindness. Patient MUST report visual changes immediately; baseline & periodic vision checks mandatory.
Section Title
TUBERCULOSIS — Nursing Management & Priority Interventions
Important Facts
- INFECTION CONTROL IS TOP PRIORITY.
- TB IS AIRBORNE — requires NEGATIVE-PRESSURE ISOLATION ROOM.
- Staff must wear N95 RESPIRATOR (NOT surgical mask) — CLASSIC NLE DISTRACTOR.
- Patient wears surgical mask during transport.
- Patient considered NON-INFECTIOUS after 2–3 weeks of effective therapy + clinical improvement + reduced cough.
- ADHERENCE IS SECOND PRIORITY — emphasise DOTS, use treatment partner, stress full 6-month completion.
- Promote nutrition, monitor drug toxicity, report to NTP for contact tracing.
- Teach cough etiquette: cover mouth, dispose tissues properly, ensure home ventilation.
- Contacts must be screened; infants in household receive BCG per national schedule.
Key Definitions
Term
Airborne Precautions (TB)
Example
Confirmed/suspected pulmonary TB admitted → place in negative-pressure isolation → staff use N95 respirators when entering → patient non-infectious after 2–3 weeks of effective treatment + symptom improvement.
Definition
Negative-pressure isolation room + N95 respirator for staff (NOT surgical mask). Patient wears surgical mask during transport. Maintained until patient is non-infectious (2–3 weeks into effective therapy + clinical improvement).
Section Title
TUBERCULOSIS — Patient Teaching (Exam Favourite)
Important Facts
- COMPLETE THE ENTIRE 6-MONTH REGIMEN — stopping early causes MDR-TB.
- Expect ORANGE-RED URINE/SECRETIONS from rifampicin (completely harmless).
- REPORT VISUAL CHANGES immediately (ethambutol optic neuritis) — do NOT wait.
- REPORT SIGNS OF LIVER PROBLEMS: jaundice, dark urine, nausea, RUQ pain.
- AVOID ALCOHOL completely (increases hepatotoxicity).
- TAKE PYRIDOXINE (B6) with isoniazid (prevents neuropathy).
- KEEP ALL DOTS APPOINTMENTS — do NOT miss doses.
- ENSURE HOUSEHOLD CONTACTS ARE SCREENED (TB spreads).
- Infants in household get BCG per national schedule.
- Use BARRIER CONTRACEPTION (rifampicin reduces OCP effectiveness).
- COUGH ETIQUETTE: cover mouth, dispose tissues, ensure good ventilation at home.
Must Remember
- PNEUMONIA PRIORITY = AIRWAY + OXYGENATION: position high-Fowler's, give oxygen to maintain SpO2, encourage deep breathing & coughing, adequate hydration to loosen secretions. In ELDERLY, confusion/lethargy/falls may be ONLY signs — do not miss subtle presentations.
- TB IS AIRBORNE (not droplet): negative-pressure isolation room + N95 respirator for staff (NOT surgical mask). Classic NLE distractor — TB requires airborne, pneumonia requires droplet.
- PHILIPPINE NTP: GeneXpert MTB/RIF is FIRST-LINE primary diagnostic test (detects TB + rifampicin resistance in ~2 hours). Cough ≥2 weeks = screening trigger.
- RIPE REGIMEN = 2 months (R, I, P, E) + 4 months (R, I) = 6 months total. MUST complete full course or MDR-TB develops. Isoniazid ALWAYS gets pyridoxine (B6) to prevent peripheral neuropathy.
- RIFAMPICIN = orange-red body fluids (harmless), hepatotoxic, REDUCES OCP efficacy (use barrier contraception). Ethambutol = optic neuritis risk (report visual changes immediately). R, I, P all hepatotoxic — avoid alcohol, monitor LFTs.
- DOTS (Directly Observed Therapy) = health worker directly watches patient swallow EVERY dose; prevents MDR-TB by ensuring adherence; drugs & care provided FREE through NTP. Non-adherence = incomplete treatment = MDR-TB.
- CAP FIRST-LINE ANTIBIOTICS: amoxicillin OR macrolide (azithromycin/clarithromycin). Fluoroquinolones (levofloxacin) for severe/comorbid cases; watch for tendon rupture & QT prolongation. Rust-coloured sputum = pneumococcal (classic).
- STREP PHARYNGITIS = sudden sore throat + fever + tonsillar exudate + tender anterior cervical nodes + NO cough. MUST complete full antibiotic course (penicillin/amoxicillin) to PREVENT RHEUMATIC FEVER. This is the critical teaching point.
- TB PATIENT NON-INFECTIOUS after 2–3 weeks of effective therapy + clinical improvement + reduced cough. Ensure household contacts screened, infants receive BCG. Rifampicin reduces OCP efficacy — counsel barrier contraception.
- LATENT TB = infected but not infectious, asymptomatic, positive PPD/Mantoux (read at 48–72 hours measuring induration). ACTIVE TB = reactivation, person is infectious, requires 6-month DOTS. Distinguish clearly for exam.
Last Minute Tips
- TB precautions = AIRBORNE (negative-pressure + N95), NOT droplet. This distinction is tested every exam cycle. Pneumonia = droplet (surgical mask). Memorise this difference.
- Isoniazid ALWAYS pairs with pyridoxine (B6) — if you see isoniazid in a question without B6, the answer is usually asking you to ADD pyridoxine. Do not let this trap you.
- When you see 'cough ≥2 weeks' in a Filipino patient context → think TB first and screen with GeneXpert MTB/RIF. This is the Philippine NTP priority.
- For strep pharyngitis questions, the KEY teaching is completing the full antibiotic course (even after symptoms resolve) to prevent rheumatic fever & acute glomerulonephritis. Emphasise this in your answer; examiners love this clinical pearl.
- If a TB question mentions 'orange-red urine,' the answer includes reassuring the patient this is harmless from rifampicin. Do NOT tell the patient to stop the drug. This is a common wrong-answer trap.
Comparison Tables
Rows
Values
- Mostly viral (sometimes bacterial)
- Facial pain/pressure, post-nasal drip, nasal congestion
- Supportive care; antibiotics (amoxicillin) if bacterial
- Persistent >10 days or worsening = suspect bacterial
Property
Sinusitis
Values
- Viral (non-strep)
- Sore throat, mild fever, no exudate
- Supportive: fluids, analgesics, warm saline gargles
- No antibiotics needed
Property
Pharyngitis (Viral)
Values
- Group A Streptococcus
- Sudden sore throat, fever, tonsillar exudate, NO cough
- Penicillin or amoxicillin (full course); macrolide if allergic
- COMPLETE FULL COURSE = prevents rheumatic fever
Property
GABHS (Strep)
Values
- Influenza A/B (viral)
- Abrupt fever, myalgia, headache, dry cough, profound fatigue
- Oseltamivir within 48 h; otherwise supportive
- Complications: pneumonia (elderly, pregnant, chronic disease)
Property
Influenza
Values
- Mostly viral
- Dry cough → productive, lasts 3 weeks, low-grade fever
- Supportive only: fluids, rest, humidification, antipyretics
- NO antibiotics (viral); teach warning signs of pneumonia
Property
Acute Bronchitis
Columns
- Condition
- Causative Agent
- Key Manifestations
- Management
- Critical Point
Table Title
Upper Respiratory Infections: Quick Comparison
Rows
Values
- S. pneumoniae (most common), viral, atypical (Mycoplasma, Legionella)
- Mycobacterium tuberculosis (acid-fast bacillus)
Property
Causative Agent
Values
- Respiratory droplets (short-range); larger droplets
- AIRBORNE droplet nuclei (long-range); suspended in air
Property
Transmission
Values
- Droplet precautions (surgical mask)
- AIRBORNE precautions (negative-pressure room, N95 respirator)
Property
Precautions
Values
- Acute (days); high fever, productive cough, pleuritic pain
- Insidious (weeks); low-grade afternoon fever, night sweats, chronic cough
Property
Onset
Values
- Usually <3 weeks
- ≥2 WEEKS (screening trigger in Philippines)
Property
Cough Duration
Values
- Purulent or rust-coloured (pneumococcal)
- May be blood-streaked (haemoptysis)
Property
Sputum
Values
- Infiltrates/consolidation (lobar or segmental)
- Upper-lobe infiltrates, cavitation (classic)
Property
CXR Findings
Values
- CXR (gold standard), sputum Gram/culture, CBC, blood cultures
- GeneXpert MTB/RIF (first-line NTP test, ~2 h), sputum AFB smear, Mantoux, CXR
Property
Diagnostics
Values
- Amoxicillin or macrolide (azithromycin)
- RIPE × 2 months (R, I, P, E) + R, I × 4 months (6 months total)
Property
First-Line Antibiotics
Values
- 24–48 hours with effective therapy
- 2–3 weeks with effective therapy + clinical improvement + reduced cough
Property
Non-Infectious After
Values
- 7–10 days (typical CAP)
- 6 months (standard drug-susceptible TB)
Property
Treatment Duration
Values
- Relapse, resistance
- MULTIDRUG-RESISTANT TB (MDR-TB) — much longer, more toxic regimen
Property
Major Complication if Non-Adherent
Columns
- Feature
- Community-Acquired Pneumonia (CAP)
- Tuberculosis (Active)
Table Title
Lower Respiratory Infections: Pneumonia vs. TB
Rows
Values
- ~10 mg/kg/day (450–600 mg)
- Orange-red body fluids (urine, sweat, tears) — HARMLESS; HEPATOTOXIC; enzyme inducer (reduces OCP efficacy)
- Reassure re: discolouration; LFTs; counsel barrier contraception
Property
Rifampicin (R)
Values
- ~5 mg/kg/day (300 mg)
- PERIPHERAL NEUROPATHY; HEPATOTOXIC
- ALWAYS give PYRIDOXINE (B6); LFTs; teach to report tingling/numbness
Property
Isoniazid (I)
Values
- ~25 mg/kg/day (weight-based)
- HEPATOTOXIC; RAISES URIC ACID (hyperuricaemia/gout — joint pain)
- LFTs; monitor for joint pain; uric acid if symptomatic
Property
Pyrazinamide (P)
Values
- ~15 mg/kg/day (weight-based)
- OPTIC NEURITIS (decreased acuity, RED-GREEN colour blindness); can cause permanent blindness
- BASELINE & PERIODIC VISION CHECKS; patient reports visual changes immediately; stop drug if vision changes
Property
Ethambutol (E)
Columns
- Drug
- Typical Dose
- Signature Toxicity / Effect
- Monitoring / Intervention
Table Title
TB Drug Regimen: RIPE Agents & Toxicities
Rows
Values
- M. tuberculosis + rifampicin resistance
- FIRST-LINE PRIMARY DIAGNOSTIC (has replaced sputum smear)
- Results in ~2 hours; rapid; if positive → start DOTS; if resistant → escalate to MDR-TB regimen
Property
GeneXpert MTB/RIF
Values
- Acid-fast bacilli in sputum
- MONITORING treatment response (not initial diagnostic)
- Collect per NTP protocol; read at months 2, 5, 6; negative smear = good response
Property
Sputum AFB Smear Microscopy (DSSM)
Values
- Upper-lobe infiltrates, cavitation
- SUPPORTIVE (not confirmatory alone)
- Classic TB findings = upper-lobe, cavitary; helps assess extent; monitor for complications
Property
Chest X-Ray
Values
- TB infection/exposure (induration only, NOT redness)
- Contact screening, latent TB diagnosis
- READ AT 48–72 HOURS; ≥5 mm = positive in contacts; ≥10 mm = positive in general population; positive in BCG-vaccinated individuals
Property
Mantoux / PPD
Columns
- Test
- What It Detects
- Philippine NTP Role
- Key Points
Table Title
TB Diagnostic Tests: Comparison
Previous chapter
Respiratory Assessment & Diagnostics
Next chapter
Chronic Obstructive & Restrictive Pulmonary Disorders
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