11. Upper Respiratory Tract Infections MT2 Flashcards
true or false: upper respiratory tract infections are the most common infections in community
true
this is an infection or inflammatory condition of one or more of the paranasal sinuses (maxillary, frontal, ethmoid or sphenoid).
acute bacterial sinusitis (ABS)
true or false: the sinuses are normally sterile
true
this is inflammation of the middle ear with rapid onset of signs and symptoms. there are two type: with effusion and with persistent effusion
acute otitis media (AOM)
this type of acute otitis media has presence of middle ear effusion without signs or symptoms of acute infection. the effusion should resolve in 1-3 months
otitis media with effusion
this type of acute otitis media has effusion that persists more than 3 months
otitis media with persistent effusion
this is a rapid onset of sore throat and pharyngeal inflammation (with or without exudate); the absence of cough, nasal congestion and discharge suggest bacterial aetiology
acute pharyngitis
true or false: most URTI are bacterial
false most are viral but sometimes it can be hard to tell
what bacteria cause URTI
- s. pneumoniae and H. influenza are most common
- m. catarrhalis
- s. pyogenes
- s. aureus
- GNB
what viruses cause URTI
- adenovirus
- coronavirus
- enterovirus
- parainfluenzae
- respiratory syncytial virus (RSV)
- rhinovirus
what are some ways to prevent getting an URTi
- face masks
- hand hygiene
- smoking cessation
- vaccination
match the description with: cold, allergic rhinitis, vasomotor rhinitis, influenza virus or bacterial sinusitis
- acute onset, faster than the common cold
- quantity varies
- initially clear than may become green after 3-5 days
- myalgia, arthralgia, more cough
- high fever
influenza
match the description with: cold, allergic rhinitis, vasomotor rhinitis, influenza virus or bacterial sinusitis
- slow progressive onset (12-48hrs)
- quantity varies
- initially clear then may become green after 3-5 days
- sneezing, cough, sore throat
- fever is mild to none
cold
match the description with: cold, allergic rhinitis, vasomotor rhinitis, influenza virus or bacterial sinusitis
- onset is relatively sudden, may be on and off
- quantity is copious
- clear and watery
- sneezing, itchiness, watery red eyes
- no fever
allergic rhinitis `
match the description with: cold, allergic rhinitis, vasomotor rhinitis, influenza virus or bacterial sinusitis
- onset is relatively sudden, may be on and off
- quantity is copious
- clear and watery
- sneezing, itchiness, dry red eyes
- no fever
vasomotor rhinitis
match the description with: cold, allergic rhinitis, vasomotor rhinitis, influenza virus or bacterial sinusitis
- onset is when symptoms go beyond 7 days
- quantity varies
- usually purulent, dark yellow, foul tasting
- face pain, sore teeth
- fever present
bacterial sinusitis
match the description with acute otitis media, acute otitis media with effusion, chronic suppurative otitis media, otitis external and TMJ
- relatively sudden, may be on and off
- ear pain varies from nothing to really bad
- discharge, decreased hearing
- usually no fever
chronic suppurative otitis media
match the description with acute otitis media, acute otitis media with effusion, chronic suppurative otitis media, otitis external and TMJ
- post acute otitis media
- painless unless on a plane
- fullness in ear
- ear popping when yawn, decreased hearing
- no fever
acute otitis media with effusion
match the description with acute otitis media, acute otitis media with effusion, chronic suppurative otitis media, otitis external and TMJ
- 2-3 days often after a upper respiratory infection starts
- severe discomfort
- discharge if TM ruptures, decreased hearing
- mild to mod fever
acute otitis media
match the description with acute otitis media, acute otitis media with effusion, chronic suppurative otitis media, otitis external and TMJ
- ache to muscle spasm
- headache or popping noise when open mouth
- no headache
TMJ
match the description with acute otitis media, acute otitis media with effusion, chronic suppurative otitis media, otitis external and TMJ
- onset happens after excessive moisture
- pain varies from nothing to really bad
- discharge, decreased hearing
- usually no fever
otitis externa
match the description with acute bronchitis, bacterial pneumonia and COPD
- happens very slowly after years of smoking, environmental or occupation hazard exposure
- primarily mucoid sputum
-no fever
COPD
match the description with acute bronchitis, bacterial pneumonia and COPD
- happens gradually near the end of an upper respiratory infection
- request coughing
- mucoid sputum worse in the am and night
- may have symptoms of a viral URI
- low grade fever
acute bronchitis
match the description with acute bronchitis, bacterial pneumonia and COPD
- onset is gradual, 7-10 days after onset of a viral URI or acute bronchitis
- frequent coughing
- purulent (dark yellow/brown blood tinged) sputum throughout the day
-chest pain, tachycardia, tachypnea, elderly may present with behaviour change, fatigue, malaise, SOB
-high grade fever
bacterial pneumonia
match the description with TB, cancer, GERD, drugs, or pertussis
- onset is sudden and dramatic initially. may last for up to 8 weeks
- worse at night
- dry, hacking cough >90% have episodic coughing spasm
- >15% have trouble breathing after coughing spasm. 30-40% have episode of vomiting due to violent coughing spasm
- no fever or low grade
pertussis
match the description with TB, cancer, GERD, drugs, or pertussis
- worse at night in some stages
- usually dry, hacking cough
- weight loss, night sweats, fatigue, malaise
- fever common in early stages
TB
match the description with TB, cancer, GERD, drugs, or pertussis
- onset starts within 1 hour after lying down
- dry hacking
- frequent heartburn that’s worse at night
- no fever
GERD
match the description with TB, cancer, GERD, drugs, or pertussis
- onset starts within days to years of being on med
- dry hacking, very mild not forceful.
- no fever
drugs
match the description with TB, cancer, GERD, drugs, or pertussis
- dry hacking
- weight loss, night sweats, fatigues, malaise
- no fever
cancer
match the description with upper airway cough syndrome, post-infectious cough syndrome, influenza/viral pneumonia, congestive heart failure, atypical pneumonia
- starts 2-4 hours after lying down
- excess fluid pooled in lower extremities redistributes to vascular system
- dry cough in early stages. productive as pulmonary edema progresses
- dyspnea
- no fever
congestive heart failure
match the description with upper airway cough syndrome, post-infectious cough syndrome, influenza/viral pneumonia, congestive heart failure, atypical pneumonia
- develops over several days/weeks
- mild symptoms that may worsen with time
- cough is initially dry but can progress to productive
- fever, malaise, myalgia, arthralgia, sore throat, possible GI symptoms
- may have fever
atypical pneumonia
match the description with upper airway cough syndrome, post-infectious cough syndrome, influenza/viral pneumonia, congestive heart failure, atypical pneumonia
- during or after viral URI or allergic rhinitis
- thought to be caused by post-nasal drip occurs frequently during the first hour after lying down to sleep
- cough is usually dry. potentially some productivity in the A.M.
- history or symptoms of allergic rhinitis and/or viral URI
- none or low grade fever
upper airway cough syndrome
match the description with upper airway cough syndrome, post-infectious cough syndrome, influenza/viral pneumonia, congestive heart failure, atypical pneumonia
- sudden onset
- cough is initially dry, can change to mildly productive
- malaise, myalgia, arthalgia, sore throat, runny nose
- high fever
influenza/viral pneumonia
match the description with upper airway cough syndrome, post-infectious cough syndrome, influenza/viral pneumonia, congestive heart failure, atypical pneumonia
- after a viral respiratory infection
- lasts 2-8 weeks post infection
- cough is usually dry. potential some productivity in the AM
- recent history of URI
- no fever
post-infectious cough syndrome
this is symptomatic inflammation of the paranasal sinuses and nasal cavity that is less than 4 weeks. often preceded by a viral infection causing mucosal inflammation and obstruction.
acute bacterial rhinosinusitis
how is acute bacterial rhinosinusitis treated
primary: amoxicillin or amoxi/clav or doxy
allergy: doxy or levo/moxi or cefixime +/- clindamycin
what is the duration of therapy for adults vs children with acute bacterial rhinosinusitis
adults = 5-7days
children = 10-14 dayst
this is symptomatic inflammation of the paranasal sinuses lasting more than 12 weeks. cannot be cured in most patients and tx is directed at improving symptoms and QoL.
chronic bacterial sinusitis
what is used to treat chronic bacterial sinusitis
- saline rinse
- intranasal corticosteroids
this is inflammation of the middle ear. more common in boys than girls and usually occurs around 6-24 months. children are more susceptible because they get predisposing viral infections more often and the Eustachian tubes are short and more horizontal which impairs drainage
scute ottis media
when should you treat with Abx in acute otitis media
if symptoms get worse or do not improve in 24-48 hrs
- children < 6 months, always treat with ABx
what is the treatment for acute otitis media where there were no antibiotics in prior 30 days or no concurrent purulent conjunctivitis
amoxicillin or cefuroxime/cefprzil or ceftriaxone
if clinical failure after 48-72 hrs: amoxi/clav or IM ceftriaxone
< 2 y/o: treat for 10 days in >2 y/o treat for 5-7 days
what is the treatment for acute otitis media where they have received antibiotics in the last 30 days or has purulent conjunctivitis or a history of AOM failure tp amoxicillin
amoxi/clav or cefuroxime/cefprozil or ceftriaxone
if clinical failure after 48-72 hours IM ceftrixaone for 3 days
< 2 y/o: treat for 10 days in >2 y/o treat for 5-7 days
this is an cute infection of the nasopharynx or oropharynx. presents primarily with a sore throat. may also have that redness, whitish spots on tonsils and swollen tonsils.
pharyngitis
what pathogen commonly causes pharyngitis
group A beta hemolytic streptococcus (GABS)
