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CPR Exam 4 > Habal: Colds, Otitis Media, Sinusitis > Flashcards

Habal: Colds, Otitis Media, Sinusitis Flashcards

1
Q

Which of the three is most commonly prescribed antibiotics in an office visit for children under 15 yo: UTI, Sinusitis, or Otitis Media?

A

Otitis Media

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2
Q

Which parts include the upper respiratory tract?

A

Nasal Cavity, Pharynx, Larynx (larynx tends to extend down to lower UT)

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3
Q

What are the more common ailments of the URT?

A

common cold, pharyngitis and tonsillitis, parotitis*, otitis* and sinusitis, acute epiglottis, oral cavity infections

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4
Q

Which parts include the lower respiratory tract?

A

Trachea, primary bronchi, lungs

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5
Q

What are the more common ailments of the LRT?

A

laryngitis* and tracheitis, diphtheria, whooping cough, bronchitis, bronchiolitis, pneumonia

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6
Q

The common cold is most often a _________ infection.

A

viral. inflammation –> cytokines released.

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7
Q

Common symptoms of the common cold?

A

nassal congestion, rhinorrhea, cough, fever (kids), last from day to 1-2 weeks

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8
Q

In the pathogenesis of the common cold, what receptors are effected?

A

HRV (human Rhinovirus) binds to three receptors: ICAM-I (major group), LDLR (minor group), and HRVC (unknown)

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9
Q

What does HRV target in the common cold?

A

epithelial cells in airways

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10
Q

In the pathogenesis of the common cold, what cytokines and chemokines are released?

A

cytokines: IFN-b, IFN-gamma, IL-1, IL-6, GM-CSF chemokines: CXCL10/IP-10, CCL5/RANTES, CXCL8/IL-8

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11
Q

In the pathogenesis of the common cold, for airway remodeling ________________ release _______________ which is involved in the breakdown of the extracellular matrix and contributes to remodeling/thickening of airways/thickening of the lamina reticularis.

A

fibroblasts/myofibroblasts; Matrix proteins (mainly MMP9: Matrix Metalloprotease Protein 9)

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12
Q

What are 4 common cold myths that have no conclusive evidence?

A

central heating dries out mucosa and you catch a cold; feed a cold/starve a fever; zinc is beneficial for treating/preventing; Vit C is beneficial for treating/preventing

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13
Q

3 main complications of the common cold?

A

otitis media, acute sinusitis, asthma

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14
Q

Common causes of the common cold?

A

Rhino Corona Entero Adeno >200 different viruses. 50% due to rhinoviruses and its >100 serotypes. 15-20% due to Coronaviruses (SARS, MERS). 2% due to Enteroviruses. 2% due to Adenoviruses.

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15
Q

What defines acute otitis media and what age group is it most commonly seen in?

A

acute inflammation of the middle ear resulting in ACCUMULATION OF FLUIDS within the middle ear space. 6-36 months (the eustachian tube is more open in babies)

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16
Q

**Describe the pathogenesis of acute otitis media.

A

An ANATOMIC or physiologic dysfunction of the auditory tube disrupts the drainage. (shorter and horizontal Eustachian tube in kids; supine position of infants when feeding –> reflux of pharyngeal content) –> FLUID accumulation –> BACTERIAL INFECTION

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17
Q

3 most common pathogens of acute otitis media?

A

Strep pneumo, H. influenza, Maroxella catarrhalis

18
Q

Describe how you would diagnose a patient with acute otitis media.

A

Symptoms: fever, chills, ear pain, ear drainage, irritability. Erythema of tympanic membrane. Fluid on otoscopy. (***if no fluid, it’s NOT otitis media.

19
Q

How would you manage your patient after giving a diagnosis of acute otitis media?

A

at ages 6-36 months, you can opt to “observe” and see if it goes away on its own. If no improvement: AMOXICILLIN If not responsive: AUGMENTIN, CEFTRIAXONE (also, topical analgesics, spray/drops)

20
Q

What is the most commonly effected sinus in acute sinusitis?

A

Maxillary (due to gravity)

21
Q

What includes the paranasal sinuses (which are commonly effected in acute sinusitis)?

A

FEMS: Frontal, Ethmoid, Maxillary, Sphenoid

22
Q

What is the duration of acute sinusitis? Subacute? Chronic?

A

10-30d; 30-90d; >90d

23
Q

What are symptoms of acute sinusitis?

A

inflammation of paranasal sinuses, congestion, mucus production, facial pain, headache, tooth pain, halitosis (bad breath)

24
Q

What is the gold standard for diagnosis of sinusitis?

A

sinus aspiration because it tells you the organisms (unlike xray, etc) BUT infrequently done becuase it has to be done by a specialist, it’s time consuming, invasive, and painful.

25
Q

What is the treatment for sinusitis?

A

(imaging not necessary to confirm dx in kids

26
Q

What are two factors that differentiate Strep pneumo from strep viridians?

A

strep pneumo is OPTOCHIN sensitive and BILE positive

27
Q

What are the clinical manifestations of strep pneumo?

A
  • Typical pneumonia (CAP, sudden onset, fever/cough/dyspnea/rusty color sputum) - Meningitis - Otitis Media and sinusitis
28
Q

Treatment for strep pneumo?

A

Penicillin, ampicillin, Tetracyclin and Doxycyclin If penicillin-resistant: fluroquinolones (levofloxacin) Pneumovac for people at risk (children, elderly, splenectomy)

29
Q

How would you identify H. influenza?

A

gram negative facultative anaerobe. Polysaccharide capsule (serotype B causes the majority of serious infections). Grows on HEATED BLOOD AGAR.

30
Q

What tests will you use to aid in teh dx of H. influenza?

A

Latex agglutination test; counterinnunoelectrophoresis; fluorescent antibody staining

31
Q

What are the clinical signs and manifestations of H. influenza?

A

Typable (Hib): infantile meningitis, epiglotitis, cellulites, pnemonia, +Quellung Non-typable: otitis media, sinusitis, bronchitis, conjunctivitis. Pleomorphic.

32
Q

Vaccine and treatment for H. influenza?

A

Vacc: Preventative DPT (combines Hib conjugate) Treatment: H. influenza is resistant to penicillin and chloramphenicol

33
Q

Picornaviridae are resistant to what levels of pH and thus can cause GI problems?

A

pH 3-9; so can survive in stomach acid

34
Q

List the geni of the family picornaviridae with their species.

A

Enteroviruses: PCCEE Poliovirus; Coxsackie A1-24; Coxsackie B 1-6; Enteroviruses 68-71; Echo 1-34 Rhinovirus: Human Rhinovirus 1-115 Heptavirus: Hepatitis A virus

35
Q

What is an important difference of rhinovirus from the others?

A

It can’t tolerate acid and this cannot survive in GIT. So no GI problems.

36
Q

How is Rhinovirus transmitted?

A

contact with respiratory secretions

37
Q

Is there a treatment or vaccine for rhinovirus?

A

No.

38
Q

What is the transmission for Coxsackie virus?

A

fecal-oral

39
Q

Vacc or tx for coxackie?

A

No.

40
Q

What are the complications of Coxsackie A?

A

HFM; Aseptic Meningitis; Herpangina

41
Q

What are the complications of Coxsacke B?

A

Pleurodynia; Myocarditis (LEADING CAUSE) and pericarditis ; HFM B2, B5; Juvenile diabetes

42
Q

Comparison chart of HFM, Herpangina, Conjunctivitis, and Pleurodynia

A

Coxsackie Virus Manifestations

CPR Exam 4 (23 decks)

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