Colds, Otitis Media, and Sinusitis

Question 1

What are the 2 most common causes of the cold?

Answer 1

1. Rhinovirus (50% of the time) [non-enveloped]
2. Coronavirus (20% of the time) [enveloped]

Question 2

What is one of the most common complications of colds in infants and children?

Answer 2

Acute otitis media (age 6-36 months)

Question 3

Why do children get otitis media when they get a cold?

Answer 3

They’re eustachian tubes are shorter and more horizontal so fluid accumulation leads to bacterial infection.

Question 4

What are the 3 most common causes of acute otitis media?

Answer 4

1. Pnuemococcus pneumoniae
2. Haemophilus influenzae
3. Moraxella catarrhalis

Question 5

What is the most important diagnostic clue for acute otitis media?

Answer 5

There must be fluid on the ear.

Question 6

What is the treatment for acute otitis media?

Answer 6

1. Wait and see (for 6-36 months old)
2. Amoxicillin
3. Augmentin (Amoxicillin + clavulanate) or ceftriaxone
4. Topical analgesic spray/drops

Question 7

What is the gold standard for sinusitis diagnosis and how is it treated?

Answer 7

1. Sinus aspiration is gold standard
2. Amoxicillin or Amoxicillin-clavulanate

Question 8

What are some general properties of Streptoccus pneumoniae and how is it treated?

Answer 8

1. Gram positive
2. diplococci
3. optocin sensitive
4. alpha hemolytic
5. positive bile solubility test
6. encapsulated
7. penicillin, ampicillin, tetracyclin, doxycyclin
8. Levofloxacin for resistant strains
9. All people at risk (children, elderly, immunocompromised) should get pneumovax

Question 9

What are the general characteristics of Haemophilus influenzae?

Answer 9

1. Gram negative
2. pleomorphic coccobacilli
3. Non-motile
4. Grows on blood agar (needs V and X factor)
5. Polysaccharide capsule (6 different serotypes)

Question 10

What type of Haemophilus influenzae is the one that causes otitis media and sinusitus?

Answer 10

Non-typable H. influenzae

(but… H. influenzae type B causes the most serious infections)

Question 11

Rhinovirus is a genus in what family of viruses?

Answer 11

Picornavirdae (+ssRNA nonenveloped)

Question 12

What season is rhinovirus most common and what are its most common symptoms?

Answer 12

1. Summer
2. Runny nose

Question 13

How can you tell if someone is more likely to have Rhinovirus or Coxsackievirus?

Answer 13

1. Rhinovirus stays in the nose
2. Rhinovirus can’t tolerate acid (so no GI symptoms)

Question 14

What is the treatment for Haemophilus influenzae?

Answer 14

Penicillin

Question 15

Coxsackievirus is a subgroup of what genus and what family?

Answer 15

1. Genus - Enterovirus
2. Family - Picornaviridae

Question 16

How is Cocksackievirus transmitted?

Answer 16

fecal oral… so wash your hands!