EXAM 1 Upper Respiratory Infections

Question 1

name the 7 URI syndromes

Answer 1

• cold
• URI
• bronchitis
• otitis (ear infection)
• sinusitis
• pharyngitis
• epiglottitis

Question 2

what are the etiologies of URIs?

Answer 2

• rhinoviruses
• coxsackie virus A
• influenza
• RSV
• coronavirus
• echovirus
• EBV
• parainfluenza
• HSV

Question 3

rhinoviruses and coxsackie virus A are collectively known as what?

Answer 3

enteroviruses

Question 4

are antibiotics useful for URIs?

Answer 4

no, because URIs have viral etiologies

Question 5

describe characteristics of URIs

Answer 5

• viral
  
  • most often transmitted from the hands
• lasts 7-10 days
• labels for syndromes suggest major site of symptoms, but much overlap

Question 6

describe pharyngitis

Answer 6

• sore throat
• mostly viral
  
  • more often viral in children than in adults
• bacterial causes
• immunosuppressed patients = unusual agents

Question 7

what are the bacterial causes of pharyngitis?

Answer 7

• group A strep (other strep)
• diptheria - not in the US
• pertussis
• gonococcus (gonorrhea)
• archanobacteria
• tularemia
• chlamydia
• anaerobes

Question 8

describe characteristics of group A strep

Answer 8

• sudden onset
• fever
• headache
• n/v/d
• pharyngeal inflammation - swollen tonsils
• discrete exudate
• tender cervical nodes
• age 5-15
• winter to spring
• exposure
• NOT cough, congestion, conjunctivitis

Question 9

describe otitis

Answer 9

• “ear infection”
• 84% of kids have 1 episode, 50% >4 episodes
• 50% viral
• bacteria: pneumo, H. flu, moraxella
• follows URIs
• ear pain/pulling
• 60% no fever
• antibiotics are of little value
  
  • treatment is drainage - more about the virus rather than the bacteria

Question 10

describe sinusitis

Answer 10

• more common in adults
• follows URIs
• mostly viral, but same bacteria as otitis
• facial pain, headache, upper teeth pain, opacity by transillumination
• x-rays not specific
• antibiotics of little value
  
  • drainage

Question 11

describe epiglottitis

Answer 11

• epiglottis swells, difficult to swallow
• infection - not a virus or a cold
• haemophilus influenzae
• dysphagia, drooling, stridor (sound when air is blocked)
• MEDICAL EMERGENCY
• lateral neck x-ray
• protect airway

Question 12

how do you diagnose URIs?

Answer 12

• throat culture (90-95%) or rapid test (80-90%)
• other diseases need aspirate to prove diagnosis
  
  • use only for complicated cases

Question 13

which URIs should be treated?

Answer 13

• group A strep and epiglottitis
• don’t treat others unless:
  
  • complicated course
  • immunosuppressed patient