MODULE 2

L.V., a 38-year-old woman, comes into the drugstore and says she has “the flu.” She recently started
a new job and is afraid she will lose her job if she misses too many days from work.
1. What questions would you ask her to differentiate the common cold from an influenza infection? (5
points)
2. What treatment options exist for the treatment of influenza? (5 points)
3. Why is she a candidate for a neuraminidase inhibitor agent such as zanamivir or oseltamivir? (5 points)

ANSWER:
1. I would like to ask what symptoms Ms. L. V is experiencing. Flu typically results in a high fever, body
and head aches, chills, and extreme fatigue, despite the possibility of some common symptoms. Low-grade
fever, a slight sore throat, a runny nose, and a cough are common symptoms of a cold. Another question
is whether the symptoms come on her suddenly or they have been getting gradually worse? one of the
biggest distinctions between a cold and the flu is how quickly the onset of symptoms occur. The symptoms
of flu typically occur very suddenly.

2. Prevention is the most effective management strategy for influenza. Antiviral drugs are prescription
medications that may help prevent flu complications or shorten the severity and duration of flu once you
have it. These drugs can include oseltamivir (Tamiflu), zanamivir (Relenza), peramivir (Rapivab) or
baloxavir (Xofluza). These medications may shorten your illness by a day or so and help prevent serious
complications.

3. Since Ms. L.V. recently started a new job and she is worried that if she misses too many days of work,
she may lose her job. Oseltamivir and zanamivir are neuraminidase inhibitors that have activity against
both influenza A and influenza B viruses. When administered within 48 hours of the onset of illness,
oseltamivir and zanamivir may reduce the duration of illness by approximately 1 day versus placebo.

MODULE 3
M.M., a 44-year-old man with a 41-year, one-pack/day smoking history reports producing two cupful’s of
whitish-clear, occasionally mucoid sputum per day over the past several years; he coughs up the largest
volumes in the morning on arising. M.M. has a raspy voice and a crackling cough, which often interrupts
his talking. Two days ago, he noted that his sputum had increased in volume and had changed in
appearance. A sputum sample, which was yellowish-green, tenacious, and purulent was sent for culture;
the Gram stain showed few epithelial cells, moderate white cells, and a few Gram-positive cocci and
Gram-negative rods with no predominant organisms. M.M. denies fever or chills and had no signs of
pneumonia; a chest radiograph is negative for consolidation. M.M. has experienced similar episodes
three or four times per year.

1. ANSWER:
• He coughs up the largest volumes in the morning on arising.
• He has a raspy voice and a crackling cough, which often interrupts his talking.
• He noted that his sputum had increased in volume and had changed in appearance. A
sputum sample, which was yellowish-green, tenacious, and purulent was sent for culture;
the Gram stain showed few epithelial cells, moderate white cells, and a few Gram-
positive cocci and Gram-negative rods with no predominant organisms.

2. ANSWER:
• Do not smoke. This is the most important step you can take to prevent more damage to
your lungs and prevent problems. If you already smoke, it is never too late to stop. If you
need help quitting, talk to your doctor about stop-smoking programs and medicines.
These may increase your chances of quitting for good.
• Take your daily medicines as prescribed.
• Avoid infections such as COVID-19, colds, and influenza (flu). Wash your hands often.
• Avoid second-hand smoke and air pollution. Try to stay inside with your windows closed
when air pollution is bad.
• Learn breathing techniques for COPD, such as pursed-lip breathing. These techniques
may help you breathe easier during an exacerbation.