American Board of Internal Medicine (ABIM) Certification Practice Exam

What is an effective treatment for viral upper respiratory tract infections?

1. Leukotriene receptor antagonists

2. First-generation antihistamines and decongestants

3. Macrolide antibiotics

4. Corticosteroids

The correct answer is: First-generation antihistamines and decongestants

An effective treatment for viral upper respiratory tract infections includes the use of first-generation antihistamines and decongestants. These medications work by alleviating symptoms associated with viral infections, such as nasal congestion, sneezing, and runny nose. First-generation antihistamines, like diphenhydramine and chlorpheniramine, are particularly beneficial because they have sedative properties that can help patients get better rest during their illness. Additionally, decongestants such as pseudoephedrine can reduce nasal congestion by causing vasoconstriction in the nasal passages, leading to reduced swelling and improved airflow. In the context of viral upper respiratory infections, which are predominantly caused by viruses like rhinoviruses and coronaviruses, antiviral therapies are often not effective, as these conditions typically resolve spontaneously. Instead, the focus is on managing symptoms to improve patient comfort and quality of life during the course of the illness. The other treatment options are not suitable for viral upper respiratory infections; for example, leukotriene receptor antagonists are used primarily in asthma and allergic rhinitis, macrolide antibiotics target bacterial infections and would not be effective against viruses, and corticosteroids, while they can reduce inflammation, are not standard for treating uncomplicated viral upper respiratory