Cough and Cold Pt2

Question 1

What is tonsillitis

Answer 1

The tonsils are two lymph nodes on the back of your throat and caused by many viruses and bacteria (inflammation of the tonsils)

Question 2

tonsillitis symptoms

Answer 2

very sore throat, pain swallowing, bad breath, chills/ fever, scratchy sounding voice
- Easily diagnosed and symptoms usually go away within 7-10 days

Question 3

What is laryngitis

Answer 3

• Inflammation of vocal cords
  
  • Usually not serious and most cases resolve without treatment in about 7 days

Question 4

Fifth/ sixth disease

Answer 4

• Skin conditions in kids after cold symptoms
  
  • Only know its this when the rash starts

Question 5

How do Fifth/ sixth disease appear

Answer 5

• Fifth: blush on face
  
  • Sixth: rash like chicken pox on skin (maculopapular)

Question 6

What is bronchiolitis

Answer 6

• Deeper then bronchitis
  
  • Determined by an MD
  • Most cases are mild but 1-2% lead to hospitalization in a child’s 1st year

Question 7

What is croup

Answer 7

• Younger kids: croup
  
  • Older kids: laryngitis
  • Bark like cough and is very dry
  • Mainly a viral cause
  • It is upper respiratory (in trachea) rather then lower such as pneumonia

Question 8

When is croup most common

Answer 8

• Winter and early spring

Question 9

How is croup treated

Answer 9

• Most cases it will clear up on its own within 5-7 days
  
  • Antibiotics are not used (viral not bacteria)
  • Can use humidity to try to add moister back into the respiratory system
  • Can use otc pain meds for fever

Question 10

whooping cough (pertussis)

Answer 10

• Bacterial
  
  • Is making a comeback even with a vaccine
  • Cold for 2-3 weeks then 100 day cough
  • Whoop sound on inhale
  • Coughs so much so that you literally run out of air
    
    • There is vaccinations

Question 11

Prevention and treatment of pertussis

Answer 11

a) Prevention: vaccination
b) Treatment: early is important as it helps prevent the spread to other people
- Usually treated with antibiotics but arent likely to help if the cough has been longer then 2-3 weeks

Question 12

Mono

Answer 12

• Present like flu or strep throat but with slower onset
  
  • Sore throat, fatigue, fever, swollen neck glands, no coughing
  • Have tried the simple things first and then if they have had a “cold” for around a month then can test

Question 13

Lyme disease

Answer 13

• Caused from an infected tick bite,
  
  • Risk in sask is low but not 0
    a) Early symptoms include:
  • Fever, chills, muscle and joint pain, swollen lymph nodes
  • A rash at site of tick bite
  • Expanding rash
  • Later symptoms: dizziness, weird heartbeat, mental confusion, nervous system disorders

Question 14

Rhinitis of pregnancy (symptoms and treatment)

Answer 14

• Seems like a cold but lasts months , 1/5 pregnant women have (while the cold is still more common at 4/5)
  a) Symptoms: sneezing, congestion, runny nose
  b) Natural Treatment: saline irrigation, breathe right strips (don’t work really)

Question 15

Thought process when differential diagnosis of colds and coughs

Answer 15

• Common cold-> bronchitis/ sinusitis-> influenza-> strep throat
  
  • Play the odds

Question 16

Rule in/out for bronchitis, flu, and strep

Answer 16

• Flu: body aches, sudden fever, dry cough
  
  • Bronchitis: productive cough
  • Strep: more pain in throat, swollen glands, exudate at back of throat, no cough

Question 17

When to refer for a cold (adult, infant, senior)

Answer 17

a) Typical cold in healthy adults almost never refer
b) Infant with cold always refer
c) Senior and cold almost never ( more worried about the drug we will give them)

Question 18

When to refer children (<1, 1-2, 3-6)

Answer 18

a) <1: always
b) 1-2: be very cautious
c) 3-6: cautious

Question 19

When to refer for sinusitis (inflammation of sinuses in the face)

Answer 19

• Consider MD referral as the MD may want to give an antibiotic even if it is viral
  a) Acute viral cases: <10 days
  b) Acute bacterial cases: >10 days
  
  • discolored discharge, severe local pain, fever, double sickening

Question 20

What is double sickening

Answer 20

• Means if you had a bad cold last weak (chest), got better for a bit and then came back.
  - Could be another bronchitis but also could be a relapse of sinusitis (almost impossible to tell)

Question 21

When to refer for coughing

Answer 21

a) How deep does it seem in the chest? We don’t know how deep it really is
b) Productive or dry: dry and raspy is near the top so not deep
c) How long so far: The key
- Comfort zone for about 2 weeks, if its getting better but same severity then we might refer this patient
- If you get nervous then maybe Referral

Question 22

When to get worried (referral) with infants, kids, adults

Answer 22

a) Infants: always worry <1 year
- They normally cough about 11 days throughout the day
b) Kids
- 1-3: after 1 week
- 4-6 after 2 weeks
c) Adults
- 1/2 of adults with coughs have post cold inflammation (lasts about 3-8 weeks)
- Resolves on its own

Question 23

Statements that get us worried

Answer 23

• Not my usual
  
  • Its getting worse
  • Also have a fever
  • It got better and now its back (double sickening)

Question 24

On average how long do coughs last

Answer 24

• About 18 days
  Patients think it should be over in a week and want a prescription (antibiotic)

Question 25

Some common causes of chronic cough

Answer 25

• Smokers
  
  • Asthma
  • PND
  • GERD
    ACE inhibitors