ENT- URI, common cold Flashcards

1
Q

What is the most frequent acute illness in the US?

A

URI

500 million non-influenza viral respiratory infections annually

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2
Q

Do children or adults experience URIs more?

A

Children!

Preschool children experience 5-7 episodes/year

Adults experience 2-3 episodes/year

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3
Q

What is the most common etiology of the common cold?

A

30-50% of cases are caused by Rhinovirus

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4
Q

How is the common cold transmitted?

A

Through direct contact and respiratory droplets

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5
Q

What are the risk factors of the common cold?

A
  1. Daycare
  2. At home parents
  3. Psychological stress
  4. Poor sleep
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6
Q

What are risk factors for more severe infections of the common cold?

A
  1. Chronic disease
  2. Immunodeficiency
  3. Malnutrition
  4. Cigarette smoking
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7
Q

What are the symptoms of the common cold?

A
  1. cough
  2. rhinorrhea
  3. fatigue
  4. sore throat
  5. body aches
  6. +/- fever
  7. +/- conjunctivitis
  8. +/- Headache (mild)
  9. +/- watery eyes
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8
Q

What is the incubation time for the common cold?

A

2-3 days

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9
Q

What is the typical clinical presentation of the common cold?

A

Day 1: sore throat

Day 2-3: Nasal congestion, rhinorrhea

Day 4-5: cough

(usually resolves in the same order with the cough being last)

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10
Q

What is the typical duration of the common cold?

A

~7-10 days

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11
Q

What are the physical exam findings?

A
  1. Nasal mucosal edema
  2. Nasal congestion
  3. Pharyngeal erythema
  4. +/- adenopathy
  5. Lungs clear
  6. +/- Conjunctival infection
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12
Q

How do you diagnose the common cold?

A

Based on H&P!

sinus imaging should not be needed unless sxs have persisted for months

Viral cultures should only be ordered if sxs are during flu season

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13
Q

What are complications of the common cold?

A
  1. Viral sinusitis
  2. Bacterial sinusitis
  3. Lower respiratory disease (pneumonia is typically seen in people with comorbidities)
  4. Acute asthma exacerbation
  5. AOM
  6. ETD/transient middle ear effusion
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14
Q

How do you treat the common cold?

A
  1. Supportive care- fluids and rest
  2. Patient eduction
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15
Q

What medications can be used to treat the common cold?

A
  1. Zinc, >75mg/day
  2. Hypertonic nasal saline irrigation
  3. Nasal decongestant sprays
  4. Oral decongestants (Psudoephedrine, Phenylephrin)
  5. Antihistimines (diphenhydramine, chlorpheniramine)
  6. Intranasal ipratropim bromide (Atrovent)
  7. Intranasal cromolyn sodium
  8. Antitussives: dextromethorphan, codeine
  9. Expectorants: Guafenesin
  10. Analgesics: NSAIDS, acetaminophen
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16
Q
A
17
Q

What would be the differential diagnosis for the common cold?

A
  • Allergic Rhinitis
  • Bacterial pharyngitis / tonsillitis
  • Acute bacterial rhinosinusitis
  • Influenza
  • Acute bronchitis
  • Asthma exacerbation
  • Pneumonia
  • Infectious mono
  • Pertussis

**any respiratory infection can be in the Ddx*