Head and Neck Infections

Question 1

Term

Answer 1

Definition

Question 2

What are the most common viruses that cause pharyngitis?

Answer 2

Adenoviruses (pharyngoconjunctival fever), influenza, cold viruses (rhinoviruses, coronaviruses)

Question 3

What is the most common bacteria that causes pharyngitis?

Answer 3

Streptococcus pyogenes

Question 4

What are the most common viruses that cause otitis media?

Answer 4

RSV, rhinoviruses, adenoviruses, influenza

Question 5

What is the most common bacteria that causes otitis media?

Answer 5

Streptococcus pneumoniae

Question 6

What is a common infection that is a complication of untreated otitis media? What bacteria causes this infection?

Answer 6

Mastoiditis, where the air cells are infected, usually by H. influenzae

Question 7

What are the most common bacteria that cause sinusitis?

Answer 7

S. pneumonia, H. influenzae, M. catarrhalis

Question 8

What is one of the most serious common complications of sinusitis?

Answer 8

Orbital cellulitis caused by Streptococcus spp., usually S. aureus and S. pneumonia; bacteria, because of edema, are able to move through the lamina papyracea (the thin bones separating the sinuses and orbit)

Question 9

What structures make up the URT and the LRT?

Answer 9

Division is vocal vords; upper respiratory tract (URT) is the nasal cavity, nasopharynx, oropharynx, larynx; lower respiratory tract (LRT) is the trachea, bronchi, bronchioles, lung

Question 10

Name the syndrome and most common viruses infecting the nasal cavity.

Answer 10

Rhinitis (common cold); rhinovirus, coronavirus

Question 11

Name the syndrome and most common viruses infecting the nasopharynx, oropharynx, or larynx.

Answer 11

Pharyngitis (sore throat) or laryngitis; adenovirus or parainfluenza virus

Question 12

Name the syndrome and most common viruses infecting the trachea or bronchi.

Answer 12

Laryngotracheobronchitis (croup); parainfluenzavirus; common in children, listen for the barking cough

Question 13

Name the syndrome and most common viruses infecting the bronchi.

Answer 13

Brochitis; parainfluenza virus, influenza, adenovirus, metapneumovirus, RSV, coronavirus; watch for heavy productive cough with purulent sputum

Question 14

Name the syndrome and most common viruses infecting the bronchioles.

Answer 14

Brochiolitis; RSV, influenza, metapneumovirus, adenovirus; very severe in infants because of small bronchiole size

Question 15

Name the syndrome and most common viruses infecting the alveoli.

Answer 15

Pneumonia; (all respiratory viruses) influenza, rhinovirus, parainfluenzavirus, metapneumovirus, RSV, SARS, MERS, coronavirus, adenovirus

Question 16

How are bacterial and viral respiratory pneumonias distinguished radiographically?

Answer 16

CXR shows viral pneumonias to be diffuse and bilateral while bacterial pneumonias are more focal with demarcated areas of opacity representing filled alveoli

Question 17

Which respiratory viruses are RNA and which are DNA?

Answer 17

All are RNA except for adenoviruses

Question 18

Describe the seasonality of respiratory viruses.

Answer 18

Most peak in the winter (e.g. RSV), except for parainfluenzavirus (late fall) and adenovirus (year round)

Question 19

Describe the Baltimore classification, the family, and the structure of the rhinovirus.

Answer 19

(+) sense RNA virus; Picornaviridae; naked capsid

Question 20

Describe the Baltimore classification, the family, and the structure of the coronavirus.

Answer 20

(+) sense RNA virus; Coronaviridae; enveloped, which makes it susceptible to detergents; includes SARS and MERS

Question 21

Describe the Baltimore classification, the family, and the structure of the adenovirus.

Answer 21

dsDNA virus; Adenoviridae; naked capsid, but can survive and invade the GI tract through its binding of tight junction proteins

Question 22

Describe the Baltimore classification, the family, and the structure of the parainfluenzavirus.

Answer 22

(-) RNA virus; Paramyxoviridae; buds out of the apical cell so it doesn’t cause cell lysis, but the increased epithelial turnover causes swelling

Question 23

Describe the Baltimore classification and the family of RSV.

Answer 23

(-) RNA virus; Paramyxoviridae;

Question 24

What are the two important surface proteins of RSV?

Answer 24

G-protein attaches to host and F-protein fuses the viral envelope to the host cell membrane

Question 25

How does RSV evade the immune system?

Answer 25

The glycosylation of G-protein is hard for Ig to bind to, and soluble G-protein consumes Ig; RSV also infects DCs, hampering the immune response

Question 26

What are the common clinical manifestations of adenovirus?

Answer 26

Pharyngitis, laryngitis

Question 27

What are the common clinical manifestations of parainfluenzavirus?

Answer 27

Laryngotracheobronchitis, croup (look for the steeple sign, or subglottic stenosis on the radiograph)

Question 28

How does RSV cause bronchiolitis?

Answer 28

Increased vascular flow, permeability, and mucus production after respiratory epithelial cell infection causes tachypnea, cough, respiratory distress with retractions, and wheezing

Question 29

Which major virus is most similar to metapneumovirus?

Answer 29

RSV