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Medical Studies 1 > 7.4 Upper Respiratory Tract Infections > Flashcards

7.4 Upper Respiratory Tract Infections Flashcards

1
Q

How many URTIs does the typical child/adult get in a year?

A

Child: 7
Adult: 2-3

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2
Q

What percentage of missed work days are due to URTIs?

A

40%

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3
Q

What percentage of URTIs are viral/bacterial?

A

75% viral
25% bacterial

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4
Q

What is a syndrome?

A

A group of symptoms

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5
Q

What is the common cold?

A

Syndrome including:
- Rhinorrhoea
- Nasal congestion
- Cough
- Sneezing
- Sore throat
- Etc.

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6
Q

What differentiates common cold from other syndromes?

A

No prominent localisation to one anatomical location

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7
Q

What percentage of common colds are caused by viruses vs bacteria?

A

Bacteria: 0%
Viruses: 100%

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8
Q

What is the most common virus that can cause a cold?

A

Rhinovirus

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9
Q

Describe transmission of the common cold

A
  • Hand-hand contact (fomites)
  • Respiratory particles (droplets/aerosols)
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10
Q

Is antibacterial treatment indicated for common cold?

A

Very rarely

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11
Q

In what percentage of common colds does secondary bacterial infection occur?

A

0.5-2%

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12
Q

What are coryzal symptoms?

A

Cold symptoms

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13
Q

Is pharyngitis predominantly caused by bacteria or viruses?

A

Viruses (in high income countries, bacterial rate is dropping more and more)

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14
Q

Can pharygnitis ever have non-infective aetiology? Provide examples if applicable.

A

Yes:
- GORD
- Chemo
- Allergy

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15
Q

Epstein-Barr virus (glandular fever) can cause pharyngitis. List some additional symptoms caused by this virus

A
  • Tender cervical lymphadenopathy
  • Tonsillar exudate
  • Fever
  • Splenomegaly
  • Weeks/months of fever/malaise
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16
Q

List two bacteria that can cause pharyngitis

A
  • Gonorrhoea
  • Group A streptococcal
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17
Q

Clinical features of peritonsillar abscess

A
  • Voice change
  • Severe unilateral throat pain
  • Fever
  • Dysphagia
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18
Q

Does peritonsillar abscess require hospital admission? Why, or why not?

A
  • Yes
  • May block airway
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19
Q

Complications that can occur alongside pharyngitis (other than peritonsillar abscess/quinsy)

A
  • Rheumatic fever
  • Post-streptococcal glomerulonephritis
  • Scarlet fever
20
Q

A patient who is at high risk of rheumatic fever comes in with non-life-threatening pharyngitis. Do you prescribe antibiotics?

A

Yes. Always.

21
Q

Overview: steps of pharyngitis management.

A
  1. Check if life-threatening (airway obstruction, sepsis etc.)
  2. Check if viral/bacterial
22
Q

A patient has coryzal symptoms while concurrently having pharyngitis. Is this more likely to be bacterial or viral?

23
Q

What are the four centor criteria for bacterial pharyngitis?

A
  • Fever
  • Tender cervical lymphadenopathy
  • Tonsillar exudate
  • Absence of cough
24
Q

Under what circumstances would you prescribe antibiotics for bacterial pharyngitis?

A
  • Severe symptoms
  • No improvement after 3-7 days
  • Immunosuppression
  • ‘Shared decision making’
25
Is epiglottitis life-threatening?
- Yes - Can cause airway obstruction within minutes to hours
26
Symptoms of epiglottitis
- High fever - Resp. distress - Stridor - tripod position
27
Managemment/treatment of epiglottitis
- Priority is securing airway - Limit interventions (in kids: IV access) - Treated by airway management + IV antibiotics +/- steroids
28
Diagnosis of epiglottitis
- Normally on direct inspection - Lateral X-ray can be used
29
What is acute otitis media? Provide a common mechanism
- It is the accumulation of infected fluid/inflammation in the middle ear - Often caused by inflammation of eustachain tube leading to fluid accumulation and viral/bacterial colonisation
30
Bacteria and viruses can be found simultaneously in some instances of acute otitis media. Does this happen in a majority or minority of cases?
Majority
31
What symptoms do people present with when they have acute otitis media?
- Pain - Hearing loss - Fever - Lethargy - Ear discharge (if tympanic membrane ruputed)
32
In which age group is acute otitis media most common?
6-24 months
33
How is acute otitis media diagnosed?
Otoscopy
34
What proportion of acute otitis media cases self-resolve within 3 days?
>80%
35
Describe acute otitis media with effusion
- Presence of middle ear effusion after resolution of infection - If persistent, can cause hearing loss (learning difficulty etc.)
36
Describe chronic suppurative otitis media
- Perforated tympanic membrane and >=6 weeks purulent drainage
37
Describe mastoiditis as a consequence of acute otitis media. How is it treated?
- Spread of infection into mastoid air cells of temporal bone - Can lead to postauricular swelling, erythema, systemic illness, and pain - Treated with IV antibiotics and possibly surgical intervention
38
What is universal treatment for acute otitis media? What kind of patients would require antibiotics?
- Universal: analgesia Give antibiotics if: - <6 months old - Bilateral infection - Perforated TM
39
Symptoms of sinusitis?
- Severe nasal congestion - Purulent nasal discharge - Facial pressure/fullness; often worsened when lying down - Maxillary tooth pain
40
Are the vast majority of acute sinusitis cases caused by viruses or bacteria?
Viruses
41
Mechanism of sinusitis
- Epithelial inflammation - Limiting mucous drainage - Pressure buildup
42
How does vigorous nose-blowing increase sinusitis risk?
- Pushing more material into sinuses - Increased risk of secondary infection
43
Complications of sinusitis
- Orbital cellulitis (inflammation of eye socket) - Frontal bone subperiosteal abscess - Intracranial complications (meningitis etc.)
44
Acute sinusitis management (except antibiotics)
- Analgesia - Nasal saline/corticosteriods
45
Is purulent nasal discharge a sign of bacterial sinusitis?
NO
46
Signs of bacterial sinusitis
- Duration >7-10 days - High fever - Worsening of symptoms after improvement

Medical Studies 1 (90 decks)

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