Overview Of URIs And LRIs Flashcards
Fever in viruses
Almost always cause fevers in children
May or may not (usually not) causes fevers in adults
most viruses are also self-limiting, but there are exceptions
Secondary bacterial infections
Caused as a complication of atrial infection
- usually has to do with over production fo mucus and/or making the host body a reasonable environment for a bacteria infection to occur
- remember that bacterial infections like overproduction of mucus since hiding in mucus makes it harder to be spotted by the immune system*
Often starts when the cold symptoms (virus) peak or are just resolving.
Upper vs lower tract review
Upper: everything above the larynx and including larynx
Lower: every thing trachea and below
Otitis externa/swimmers ear
Infection for he external ear canal
- CC = ear pain, especially when palpating the tragus or moving the external ear manipulation
Tympanic membrane will look swollen apon exam
Risks:
- being a swimmer
- inserting anything into the ears
Otitis media
Infection in the middle ear
- CC: generalized ear pain that may include a fever and/or sound dulling
- no tragus tenderness thou
Often caused by a bacterial infection secondary to viral infections
- more common in children and usually unilateral
Upon exam, the tympanic membrane will look yellow/white and vascular as well as swollen or retracted
Can cause tympanic rupture if not treated
also can cause (most resolve on its own however, except young children)
- mastoiditis
- meningitis
Risks:
- having a chronic viral infection
Rhinitis
Inflammation and congestion of the nasal cavity/ nasopharynx that blocks eustachian tube
- causes the middle ear pressure to not be Able to equalize and causes ear pain in the process
CC: runny nose w/ ear pain
- no tragus tenderness though
- tympanic membrane is normal looking
Viral rhinitis (cold)
Generalized virus that infects the upper respiratory tracts (But not the nasal mucosa
CC: cold symptoms
- nasal congestion
- sore throat
- cough
- headache
- usually no fever
- lasts <10 days
- nasal discharge is normal looking
Viral sinusitis
Generalized virus that infects the upper respiratory tract as well as the nasal mucosa and sinuses
CC: runny nose and congestion w/ generalized cold symptoms
- nasal discharge is usually green/yellow
- bilateral or unilateral facial pain along the sinuses (especially frontal and maxillary)
- upper tooth pain may present and is usually diagnostic
- no fever usually
- lasts <10days
Bacterial sinusitis
Bacteria induced inflammation of the sinuses and nasal mucosa
CC: runny nose and congestion w/ the exact same symptoms as viral sinusitis
- often unilateral pains
- IS A FEVER
- also lasts > 10days
- usually results after a viral URI
Generalized Viral pharyngitis (cold)
Generalized virus that infects the throat specifically
CC: cold symptoms and sore throat
- nasal congestion
- sore throat
- cough
- headache
- usually no fever
- lasts <10 days
- nasal discharge is normal looking
- no tonsillar exudate
- no lymphadenopathy
Thrush
White plaques on the oral mucosa that are friable (destroyable) w/ red bases
- usually accompanies viral infections or bacterial infections
- more common in young or immunosupression patients
- often asymptomatic
Viral pharyngitis herpangina (hand/foot/mouth disease)
Herpes virus that infects the throat specifically (coxsackie virus)
CC: cold symptoms and sore throat similar to viral pharyngitis except:
- there IS a FEVER
- often oral painful lesions (similar to thrush/ulcerations)
- if it is hand/foot disease, will also show lesions on the hands/feet (looks like a sunburn peeling off
Viral pharyngitis caused by HIV
HIV viruses that infects the throat
CC: same symptoms as viral pharyngitis except:
- PRODUCES FEVER
- painful oral ulcers are also present
- lymphadenopathy present
- GI symptoms may also be present
- usually history of high-risk sex or IV drug use (but this isnt diagnositic)
Viral pharyngitis caused by Mononucleosis or Epstein Barr virus (MONO)
EBV viruses infect the throat
CC: produces the following
- produces FEVER
- tonsillar exudate (white splotches is present
- prolonged fatigue
- lymphadenopathy (in posterior auricular and posterior cervical)
- if untreated or long time infected, causes spleen issues (possible rupture of the spleen if playing contact sports)
- NO COLD SYMPTOMS
Streptococcal pharyngitis (strep throat)
Step induced infection of the throat
CC: need 3 out of 4 of the following
- Fever
- White tonsillar exudate (similar to mono)
- lymphadenopathy in the anterior submandibular, anterior cervical and tonsills
- NO COUGH
- NO COLD SYMPTOMS
- note can be self-limiting, problem is it can cause the following if chronic*
- rheumatic fever
- glomerulonephritis
- peritonsillar abscess
- bacteremia
Viral laryngitis
Generalized viral infection of the larynx
CC: hoarse or muffled voice
- no fever
- May present w/ generalized cold symptoms
- lasts <10days
Croup
CC: hoarse voice
- FEVER PRESENT
- usually younger children
- “barking cough”
- inspiratory stridor (w/ possible Expiratory stridor as well)
- symptoms are worse at night and better in cold/humid areas
- self-limiting and lasts 3-7 days
Most commonly caused by parainfluenza viruses
Peritonsillar cellulitis/ abscesses
CC: hoarse or muffled voice w/ the following
- FEVER present
- sore throat (usually only on one side)
- cellulitis w/ tonsillar swelling
- abscesses that are unilateral usually around the uvula (uvula will physically be pushed away from the abscess)
Epiglottis
CC: hoarse of muffled voice
- FEVER present
- respiratory distress obvious
- drooling
- dysphasia
- tripod positioning when trying to breath
- often seen in children especially those not vaccinated for flu
- is a medical emergency
Viral bronchitis
Generalized viral Infection of the bronchi
Cc: coughing
- no fever
- generalized col symptoms
- self limiting and lasts <10 days ( cough can last longer though)
Bronchiolitis
Usually respiratory syncytial virus infections of the bronchioles
- usually in children but can infect adults also
CC: cough
- FEVER present
- nasal discharge
- dysphagia
- wheezing and sometimes rales
- hypoxic/cyanosis may be present
- self limiting for 2-3 weeks w/ supportive care (although you must monitor kids since it can get really bad)
Pertussis/whooping cough
Pertussis infection that is life-threatening in children
CC: 3 phases
1) catarrhal phase (1-2 weeks)
- cold-like symptoms
- low grade fever may or may not be present
2) paroxysmal (10 weeks if left untreated)
- intense “whooping cough” episodes
- inspiratory “whoop” (similar to stridor) sound
- vomiting after coughing (may or may not be present)
- no fever
- cyanosis/ apnea in kids (deadly)
3) convalescent (12 weeks if untreated)
- coughing w/ no severe symptoms
Influenza
Most common cause of coughing at all ages
- seasonal usually peaking in winter
CC: cough
- FEVER present
- rapid onset of all symptoms (less than 1 day usually)
- cold-like symptoms
- tachycardia/tachypnea
- severe fatigue (usually wont want to get ready for the day)
- Lungs usually are normal but can show rales diffusely
- No dyspnea
- no vomiting or diarrhea (is stomach flu if present, completely different)
- no xray findings
must recognize this since if not can lead to pneumonia or acute respiratory distress syndrome
COVID-19
- severe acute respiratory syndrome SARS-CoV-2
Similar to influenza symptoms
Differences include
- varying symptoms
- dyspnea is present
- GI symptoms are likely (diarrhea)
- high risk of viral pneumonia (higher than flu)
- no xray findings
because of unknown, risk of exposure is taken heavily into account
Mortality is 15x higher than flu
- older adults are the highest risk
- immunosuppressive or comorbitities increase chance also
- children, unlike flu, are very unlikely to develop bad symptoms
Bacterial pneumonia
Multiple subtypes (can be hospital or community acquired)
CC: generalized symptoms include
- FEVER
- chest pain
- dyspnea
- Tachycardia/tachypnea
- unilateral lung abnormalities
- chest xray shows unilateral diffuse edema
- more common in elderly and immunocompromised patients and smokers
Often occurs secondary to a viral URI
Tuberculosis (TB)
Common among people in poverty or immunocompromised populations
Primary TB is usually asymptomatic
Reactivating TB CC: coughing that gets worse - prolonged fever - night sweats - weight loss - hemoptysis May be present
