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PR3151 Revision > IC15 URTI > Flashcards

IC15 URTI Flashcards

1
Q

What are the risk factors to developing URTI? (8)

A
  1. Close contact with kids
  2. Lack of personal or hand hygiene
  3. Immunocompromised patients (CF, HIV, corticosteroids, splenectomy, transplant)
  4. Smoking
  5. Facial dysmorphia
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2
Q

What are some of the options for symptomatic relief for URTIs? (5)

A

paracetamol/NSAIDs
nasal decongestants
normal saline nasal irrigation
cough suppressants/expectorants
warm water, tea honey

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3
Q

What signs and symptoms does the common cold present with?

A

Low grade fever, rhinorrhea, nasal blockage, sneezing, productive cough, body aches

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4
Q

What are the two key features of common cold presentation?

A

Lack of high fever
Clear bilateral lungs on auscultation

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5
Q

Are diagnostics required for the common cold?

A

No

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6
Q

Should antibiotics be used for the common cold?

A

No

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7
Q

How should you counsel patients with the common cold?

A

Abx will make no difference or worsen symptoms, initiating will take 1-2 weeks. Best to go for symptomatic relief

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8
Q

Should a patient presenting with greenish-yellow sputum in common cold be started on antibiotics?

A

Nasal discharge changing colour is normal and NOT an indication of bacterial infection, so no.

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9
Q

What s/sx does influenza present with?

A

Fever, chills, headache, malaise, myalgia, dry cough, confusion in elderly

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10
Q

How should diagnosis be made in influenza? (2)

A

Nasopharyngeal swab or aspiration

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11
Q

How can nasopharyngeal swabs or aspiration samples be tested for in influenza? (2) (hint: think CEH)

A

EIA or PCR

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12
Q

Who are the high risk groups that for influenza? (5)

A
  1. Kids below 5 years old
  2. Pregnant women or within 2 weeks postpartum
  3. Patients in nursing homes or LT-care facilities
  4. Obese BMI >=40
  5. Patients with chronic medical conditions (eg. COPD, HF, CKD, DM, immunocompromised)
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13
Q

What are the types and subtypes of influenza?

A

Influenza A - H1N1 and H3N2 (haemagglutinin and neuraminidase)

Influenza B - B/Victoria and B/Yamagata

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14
Q

Within when should oseltamivir be started in high risk patients?

A

Best within 48h, if not within 5 days maximum

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15
Q

How does oseltamivir work

A

Neuraminidase inhibitor, interferes with protein cleavage

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16
Q

Who are high risk patients in which oseltamivir be started? (3)

A
  1. hospitalised
  2. high complication risk
  3. severe or complicated illness
17
Q

What is the dosing for antiviral therapy in influenza?

A

PO Oseltamivir 75mg BD x 5 days
(requires adjustment in renal impairment CrCl < 60ml/min)

18
Q

What are the s/sx for bacterial pharyngitis?

A

Sore throat with tonsillar exudates, fever and cervical lymphadenopathy

19
Q

What bacteria causes pharyngitis?

A

Strep. pyogenes (same as SSTI)

20
Q

What are the components of the modified centor criteria?

A
  1. Fever > 38ºC
  2. Tonsillar exudate
  3. Absence of cough
  4. Swollen and tender lymph nodes
  5. Age (plus 1pt for 3-14, minus 1pt for above 45yo)
21
Q

What is the centor criteria used for?

A

In pharyngitis, to tell us when to test and treat

22
Q

Explain what the different points mean in the centor criteria

A

0-1 points: do not test or treat

2-3 points: test for S. pyogenes and treat if positive

4-5 points: highly likely, start empiric treatment

23
Q

What is the first-line treatment for pharyngitis?

A

PO Penicillin V 250mg QDS x 10 days
PO Amoxicillin 500mg BD x 10 days

24
Q

What are treatment options for pharyngitis in a patient with penicillin allergy? (hint: PM)

A

PO Cephalexin 500mg BD x 10 days
PO Clindamycin 300mg TDS x 10 days
PO Azithromycin 500mg OD x 5 days
PO Clarithromycin 250mg BD x 5 days

25
Q

What is the duration of treatment for pharyngitis?

A

10 days
5 days for macrolides as they concentrate well in the tonsils

26
Q

What are the s/sx that sinusitis present with? (hint: i alw get this)

A

Purulent nasal discharge, facial pain, fever, nasal congestion and obstruction, reduced taste/smell, headache, ear fullness or pressure

27
Q

What red flag symptoms can sinusitis present with?

A

Limited ocular movement, acute vision changes, unilateral weakness

Refer to ED, may have spread to orbits or CNS

28
Q

What are the 2 most common pathogens (and others) that sinusitis presents with?

A

Common: Strep pneumo, H. influenzae
Others: Strep pyogenes, Moraxella catarrhalis, GP anaerobes

29
Q

When to treat sinusitis? (3)

(hint: treat if any ONE of the following)
(hint: this was during one of the CT cases)

A
  1. symptoms persisting for more than 10 days without clinical improvement
  2. severe sx (fever > 39ºC, purulent nasal discharge, facial pain for > 3 days)
  3. worsening sx (new onset fever, headache, increased discharge) after initial improvement for > 3 days
30
Q

What is the first-line treatment for sinusitis?

A

PO Amoxicillin 500mg TDS x 5-7 days
PO Amoxicillin-clavulanate 625mg TDS x 5-7 days

31
Q

What treatment options are there for sinusitis in penicillin allergy?
(hint: SF)

A

PO Cefuroxime 500mg BD
PO Levofloxacin 500mg OD
PO Moxifloxacin 400mg OD

32
Q

How long should sinusitis be treated for?
(hint: sinusitis is a shorter word than pharyngitis)

A

5-7 days

PR3151 Revision (7 decks)

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