{"showCoverPage":false,"bookCover":{"coverDescription":"

<\/p>"},"chapters":[{"params":{"content":[{"content":{"params":{"text":"

Margaret, a 65-year-old woman with hypertension, works at a local primary school. In early December, she began to feel quite ill and made an appointment with her family physician. Margaret reported experiencing fever, severe muscle aches, coughing, and fatigue. A nurse took Margaret\u2019s temperature and found that she was running a fever of 39\u00b0C (102.2\u00b0F). The flu season had been particularly aggressive this year, with a predominant circulation of influenza A, known for affecting older adults more severely. Margaret confirms that she had not received this year\u2019s flu vaccine. The most effective means of controlling influenza outbreaks is through vaccination. Every year, new influenza vaccines are developed to be effective against the strains expected to be predominant.<\/p>\n\n

Age<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"

Work type<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"

Medical history<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"

No flu vaccine<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"

Doctor's visit<\/div>\n"}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"

Based on this information, what factors may have contributed to Maragret\u2019s illness? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"The Factors"},"subContentId":"c8c620fc-1e8a-48c2-ace8-96ddb65e3bc8"},"useSeparator":"auto"}]},"library":"H5P.Column 1.16","metadata":{"contentType":"Column","license":"U","title":"Patient Information"},"subContentId":"fbb4e4df-2c61-41a0-90f0-8bc6c5348291"},{"params":{"content":[{"content":{"params":{"text":"

<\/p>\n\n

Commonly known as the flu, influenza is a common viral disease caused by an orthomyxovirus that primarily affects the upper respiratory tract but can also extend into the lower respiratory tract. Influenza is pervasive worldwide and causes 3,000-50,000 deaths each year in the United States. The annual mortality rate can vary greatly depending on the virulence of the strain(s) responsible for seasonal epidemics. Influenza infections are most typically characterized by fever, chills, and body aches. This is followed by symptoms similar to the common cold that may last a week or more. <\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"c01393d8-bb8a-4023-ba47-739252fd1823"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-665a307318b29.png","mime":"image\/png","copyright":{"license":"U"},"width":1256,"height":538},"alt":"Table 22.1 compares the signs and symptoms of influenza and the common cold.","title":"Table 22.1 compares the signs and symptoms of influenza and the common cold."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"b17ffecd-bdbb-42b0-b31c-a6a97aa85ecc"},"useSeparator":"auto"},{"content":{"params":{"scoreShow":"Check","submit":"Submit","tryAgain":"Retry","scoreExplanation":"Correct answers give +1 point. Incorrect answers give -1 point. The lowest possible score is 0.","question":{"settings":{"size":{"width":620,"height":310},"background":{"path":"images\/background-665a320071cfa.png","mime":"image\/png","copyright":{"license":"U"},"width":1328,"height":832}},"task":{"elements":[{"x":4.366812227074235,"y":8.73362445414847,"width":4.984061211790393,"height":1.768995709606987,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Low Fever<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":78.60262008733625,"y":48.03493449781659,"width":4.984061211790393,"height":3.461135447598253,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Mild aches and pains<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":4.366812227074235,"y":52.40174672489083,"width":4.984061211790393,"height":2.61506557860262,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Slight fatigue<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":78.60262008733625,"y":74.23580786026201,"width":5.15327518558952,"height":3.37652846069869,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Nasal congestion<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":78.60262008733625,"y":4.366812227074235,"width":4.984061211790393,"height":1.768995709606987,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Sneezing<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":4.366812227074235,"y":30.56768558951965,"width":4.984061211790393,"height":1.768995709606987,"dropZones":["1","0"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

High fever<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":78.60262008733625,"y":21.83406113537118,"width":4.984061211790393,"height":3.461135447598253,"dropZones":["1","0"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Severe aches and pains<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":4.366812227074235,"y":78.60262008733625,"width":4.984061211790393,"height":2.61506557860262,"dropZones":["1","0"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Severe fatigue<\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false}],"dropZones":[{"x":21.83406113537118,"y":26.200873362445414,"width":10.152838427947598,"height":10.152838427947598,"correctElements":["0","1","2","3","4"],"showLabel":true,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"

Common Cold<\/div>\n"},{"x":50.21834061135371,"y":26.200873362445414,"width":10.152838427947598,"height":10.152838427947598,"correctElements":["5","6","7"],"showLabel":true,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"

Influenza<\/div>\n"}]}},"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableCheckButton":true,"singlePoint":false,"applyPenalties":true,"enableScoreExplanation":true,"dropZoneHighlighting":"dragging","autoAlignSpacing":2,"enableFullScreen":false,"showScorePoints":true,"showTitle":true},"grabbablePrefix":"Grabbable {num} of {total}.","grabbableSuffix":"Placed in dropzone {num}.","dropzonePrefix":"Dropzone {num} of {total}.","noDropzone":"No dropzone.","tipLabel":"Show tip.","tipAvailable":"Tip available","correctAnswer":"Correct answer","wrongAnswer":"Wrong answer","feedbackHeader":"Feedback","scoreBarLabel":"You got :num out of :total points","scoreExplanationButtonLabel":"Show score explanation","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","localize":{"fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen"}},"library":"H5P.DragQuestion 1.14","metadata":{"contentType":"Drag and Drop","license":"U","title":"Match which symptoms are characteristic of a common cold versus the flu."},"subContentId":"1f658ac0-ee00-49ff-9305-6a8d6ee2ccb8"},"useSeparator":"auto"},{"content":{"params":{"text":"

In general, influenza is self-limiting. A self-limiting disease typically goes away on its own. However, serious cases can lead to pneumonia and other complications that can be fatal. Such cases are more common in the very young and the elderly; however, certain strains of influenza virus (like the 1918-1919 variant) are more lethal to young adults than to the very young or old. Strains that affect young adults are believed to involve a cytokine storm\u2014a positive feedback loop that forms between cytokine production and leukocytes. This cytokine storm produces an acute inflammatory response that leads to rapid fluid accumulation in the lungs, culminating in pulmonary failure. In such cases, the ability to mount a vigorous immune response is actually detrimental to the patient.<\/p>\n\n