17 URTI's

Question 1

What is the aetiology and symptoms of rhino-sinusitis?

Complications? (3)

Answer 1

Post viral inflammation - nasal pain and blockage, reduction in smell.
Osteomyelitis, meningitis, cerebral abscess.

Question 2

How is rhino-sinusitis managed? (3)

Answer 2

Imaging for severe complications. Sinus washouts.

Amoxicillin if severe + bacterial.

Question 3

What are the signs of pharyngitis? (6)

Answer 3

S/T
Dysphagia
Fever
Headache
Red tonsillar area ± exudate.
Lymphadenopathy.

Question 4

Who gets Group A Strep Pharyngitis?
Common complications? (3)
Prevention of these?

Answer 4

Children.
Acute gloemrulonephritis, rheumatic fever, scarlet fever.
Penicillin to prevent.

Question 5

Symptoms of EBV pharyngitis? (30
Complications?
What to avoid?

Answer 5

S/T, fever, cervical lymphadenopathy.
Splenic rupture.
Ampicillin: causes mac-pap rash.

Question 6

Which organism causes diphtheria pharyngitis?
Symptoms?
Rx? (3)

Answer 6

Corynebacterium diphtheria.
Non-specific.
Erythromycin/penicillin/antitoxin.

Question 7

What is epiglottis?

Symptoms? (6)

Answer 7

Medical emergency.
2-4yrs
Fever, hot potato voice, difficulty swallowing, leans forward, drools, stridor.

Question 8

What should be avoided in epiglottitis?

Rx?

Answer 8

Anything in throat - asphyxiate.

Maintain airway, cefotaxime.

Question 9

Symptoms of acute laryngitis? (5)

Disease course?

Answer 9

Hoarse voice, globus pharyngeus, fever, myalgia, dysphagia.

Viral + self-limiting.

Question 10

What is acute laryngotracheobronchitis?
Who gets it?
Cause?

Answer 10

Croup - inflame of larynx + trachea after URTI.
Children.
Viral- parainfluenza type 2.

Question 11

Cause of whooping cough?

Course of disease? (2)

Answer 11

Bordetella pertussis.
Initial catarrhal phase - URTI Sx.
Later: dry cough, whooping (short exhalation, inspiratory gasp).

Question 12

Rx of whooping cough?
Complications? (4)
Management?

Answer 12

Supportive and erythromycin.
Otitis media, pneumonia, convulsions, subconjunctival haemorrhages.
Erythromycin to household.

Question 13

Causes of acute otitis externa?

Treatment?

Answer 13

S aureus (if pustular), pseudomonas (swimming).
Saline/alcohol + acetic acid. topical drops.

Question 14

Cause of chronic otitis externa?

Treatment?

Answer 14

Irritation from drainage from perforated tympanic membrane.
Avoid ahminoglycosides (gentamicin) if perforation.

Question 15

What is malignant otitis external?
Cause?
Who in? (3)
Rx?

Answer 15

Severe, necrotising. Life threatening: may invade brain.
Pseudomonas aeruginosa.
Elderly, diabetics, immunosuppressed.
Ceftazidime then ciprofloxacin.

Question 16

Symptoms of otitis media? (4)

Causes? (3)

Answer 16

Fever, pain, red bulging tympanic membrane, impaired hearing.
H influenza, S pneumonia, M catarrhalis.

Question 17

What is mastoiditis?

Rx?

Answer 17

Inflamm of mastoid air cells after middle ear infection.

Co-amoxiclav.

Question 18

Which antibiotics are commonly used for URTI?

Answer 18

Penicillin and amoxicillin.

Erythromycin (if pen allergic and whooping cough/diptheria).

Question 19

What is the normal flora of the URT? (4).

Answer 19

Streptococcus viridians.
Commensal Neisseria
Diphtheroids.
Anaerobes.

Question 20

Which organisms transiently colonise the URT after antibiotics? (3)

Answer 20

Coliforms.
Pseudomonas.
Candida.

Question 21

Which respiratory pathogens may be carried asymptomatically? (5)

Answer 21

Streptococcus pneumoniae 
Streptococcus pyogenes
Moraxella catarrhalis
Haemophilus influenzae
Neisseria meningitidis