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Systems: Resp. WK > 16. Upper Respiratory Tract Infections > Flashcards

16. Upper Respiratory Tract Infections Flashcards

1
Q

What is the most common way respiratory infections present themselves?

A

As a cold

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2
Q

What is the upper respiratory tract?

A

Anything from larynx and above

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3
Q

What are the most common URTIs? (6)

A
  1. otitis media
  2. rhinitis
  3. tonsillitis
  4. pharyngitis
  5. laryngitis (epiglottitis)
  6. sinusitis
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4
Q

What are the most common VIRAL infective agents in URTIs? (6)

A
  1. adenovirus
  2. Influenza A and B
  3. Para flu 1 and 3
  4. RSV (respiratory syncytial virus)
  5. Rhinovirus
  6. Epstein-barr virus (EB)
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5
Q

What are the most common BACTERIAL infective agents in URTIs? (4)

A
  1. H influenzae
  2. M catarrhalis (mycoplasma)
  3. S. aureus
  4. Streptococci:
    - B haemolytic, S. pyogenes
    - Non-haemolytic, S. pneumoniae
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6
Q

What is another name for croup?

A

laryngotracheobronchitis (inflammation of lower and upper resp. tracts commonly caused by para influenza type 1)

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7
Q

How many respiratory infections does an average human have a year?

A

5-10 a year (particularly clustered around winter time)

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8
Q

What is the most common type of URTI with the most admissions per year?

A

Acute URTIs

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9
Q

If the child is very ill, what must the URTI be most likely caused by?

A

bacteria

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10
Q

If the child is well, what must be the URTI be most likely caused by?

A

virus

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11
Q

When is rhinitis most common?

A

During winter months (self-limiting condition)

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12
Q

Rhinitis is an early symptoms which can often lead to which 3 other conditions?

A
  1. pneumonia (bronchiolitis)
  2. meningitis
  3. septicaemia
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13
Q

What is rhinitis?

A
  • Inflammation of mucous membranes inside the nose

- can be caused by viruses, bacteria, allergens and irritants

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14
Q

What are common symptoms for rhinitis?

A

cold-like symptoms:

itchiness, sneezing, runny or blocked nose

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15
Q

What is best treatment for rhinitis?

A

Usually similar to cold treatment but in more serious cases non-sedating anihistamines or rinsing nasal passages may be prescribed

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16
Q

Among which population group is otitis media very common among?

A

children (esp. infants between 6-15 months)

17
Q

What is otitis media?

A
  • infection of the middle ear

causing build up of fluid behind the ear drum

18
Q

What colour is the ear drum in otitis media patients?

A

very red (pink in normal)

19
Q

What is the pathogen causing primary otitis media?

A

virus

20
Q

What is the pathogen causing secondary infection in otitis media?

A

bacterial (pneumococcus/ Haemophilus influenzae)

21
Q

What is used to treat otitis media?

A
  • antibiotics don’t usually help
  • most clear up within 3-5 days
  • painkillers used for pain and pyrexia
22
Q

Why is the use of drugs to treat many common URTs a common clinical dilemma?

A

Because they include many side effects (e.g. diarrhoea, nappy rash, discomfort) yet they only help slightly whereas without them, the child will become well naturally- do benefits outweigh harm??

23
Q

When is pain in otitis media at its worse and when do antibiotics usually start working?

A
  • pain worse at day 1
  • antibiotics only start their action in day 2-3
  • antibiotics often make little difference as treatment for pain can be given instead
24
Q

What percentage of patients will experience side effects from antibiotics?

A

~50% (“do not harm” is the dilemma)

25
Q

What is the main dilemma with tonsillitis (infected tonsils) and pharyngitis (infected throat)?

A

Is it viral or bacterial?

By the time it’s identified, the child is usually better

26
Q

What is the main virus and bacteria causing tonsillitis/ pharyngitis?

A

virus: EBV (Epstein-barr virus)
bacteria: Group A strep

27
Q

What are the main symptoms of epiglottitis? (which can be very serious)

A
  • severe sore throat
  • difficulty and pain in breathing and swallowing
  • drooling and sitting forward
  • pyrexia
  • restlessness/ irritability
  • hoarse and muffled voice
28
Q

What two URTIs are often misdiagnosed for each other and can lead to severe complications?

A

CROUP (laryngotracheobronchitis) and epiglottitis

29
Q

What are the main features of Croup?

  • what causes it?
  • common/rare
  • toxic/non-toxic
  • common symptoms
  • course of treatment
A
  • para’flu 1 (parainfluenza type 1)
  • common
  • well (non-toxic)
  • coryza (inflammation of mucous membrane in the nose), stridor, hoarse voice, barking cough
  • oral dexamethasone
30
Q

What are the main features of epiglottitis?

  • what causes it?
  • common/ rare
  • toxic/non-toxic
  • common symptoms
  • course of treatment
A
  • H.influenzae type B
  • rare
  • toxic
  • stridor, drooling, difficulty breathing and swallowing,pyrexia, tachycardia
  • intubation and antibiotics (v serious)
31
Q

What is the usual duration of croup?

A

2-3 days

32
Q

What is the usual recovery period for epiglottitis?

A

around a week ( after intubation in hospital)

33
Q

Are majority of URTIs caused by many or few pathogens?

A

few pathogens

34
Q

What are 99% of all URTIs described as?

A

“self-limitng” (NOT viral) and antibiotics don’t usually help

35
Q

What is the most effective for of treatment for most URTIs?

A

analgesia (and review case)

Systems: Resp. WK (40 decks)

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