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Clinical Medicine II > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

URI

  • __ most common primary diagnosis in ambulatory visits in 2001
  • __ most common acute illness in US
  • majority are __ in etiology
  • difficult to differentiate between viral and bacterial illness due to __
A
  • 3rd
  • # 1
  • viral
  • overlap of signs and symptoms
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2
Q

URI

  • __ diagnosis for prescribing __ on an outpatient basis despite mostly viral in etiology (~__%)
  • this has led to __
  • most URIs are self-__ and self-__
A
  • leading; antibiotic; 75%
  • bacteria resistant to antibiotics
  • diagnosed; treated
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3
Q

Common Cold: Epidemiology

  • the common cold is the general term for an UPI that has __
  • in an average year, every person in the US has __ URIs
A
  • no prominent localizing features (when a specific localizing symptom is present, the diagnosis is made based on location: pharyngitis, sinusitis, bronchitis)
  • 2-4
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4
Q

Common cold: epidemiology

  • incidence peaks during the __, __ from person to person, and __ with age
  • URI is a leading reason for __
  • DESPITE THE FACT TAHT URIS ARE NEARLY ALWAYS CAUSED BY __, APPROX. __% OF MEDICAL PROVIDER VISITS FOR URTIS RESULT IN AN __ PRESCRIPTION
A
  • fall and winter; varies considerably; declines
  • consultation with health care providers and of missed work days (in 1998, 25 million individuals received care for URI and 20 million days were missed from work)
  • VIRUSES; 30%; ANTIBIOTIC
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5
Q

common cold: pathophysiology

URIs are nearly always caused by __

A

viral infection of the anterior nasal mucosa

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6
Q

common cold: pathophysiology

virus reaches nasal epithelium via

A
  1. aerosol spread

or

  1. direct contact with infectious secreation on the skin or other surfaces
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7
Q

common cold: pathophysiology

viral replication within __

A
  1. epithelial cells

or

  1. oral, nasal, and upper respiratory mucosa
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8
Q

common cold: pathophysiology

viral replication triggers __ leading to __ symptoms

A

cytokine mediated inflammatory reactions; typical cold

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9
Q

common cold: pathophysiology

symptoms begin about __ days after viral __

A

2-8; inoculation

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10
Q

common cold: microbiology

__ infection is the main cause of URI and peaks in the __

A

rhinovirus; autumn

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11
Q

common cold: microbiology

the majority of transmission of rhinovirus occurs via __ and is transferred from __, from where the viruses then migrate to the

A
  • fomites
  • fromites via the hands to the nose, eyes, or mouth
  • nasopharynx
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12
Q

common cold: microbiology

experimental infection has demonstrated that __% of individulas who are infected develop symptoms, some as early as __ hours after exposure

A
  • 75%
  • 10
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13
Q

common cold: microbiology

shedding of viral particles peaks __ after infection, but may continue at low levels for __

A
  • 2 days
  • 1-3 weeks
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14
Q

viruses associated with the common cold

rhinovirus (>100 serotypes): percentage of cases and seasonal peak

A
  • 30-50%
  • fall and spring

>100 antigenically different types, adenovirus has 47, therefore, large number of reinfections with them; due to rapid mutations on the surface of the virus

spread via direct contact with infected respiratory secretions: hand-hand, hand-face (also RSV, adeno, influenza: note overlaps)

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15
Q

viruses associated with the common cold

coronavirus: percentage of cases and seasonal peak

A
  • 10-15%
  • mid-winter
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16
Q

viruses associated with the common cold

influenza: percentage of cases and seasonal peak

A
  • 5-7%
  • winter
  • only 3 serotypes; large number of reinfections due to rapid mutations on the surface of the virus

spread via direct contact with infected respiratory secretions: hand-hand, hand-face (also RSV, adeno, rhinovirus: note overlaps)

17
Q

viruses associated with the common cold

RSV: percentage of cases and seasonal peak

A
  • 5%
  • winter

spread via direct contact with infected respiratory secretions: hand-hand, hand-face (also influenza, adeno, rhinovirus: note overlaps)

18
Q

viruses associated with the common cold

parainfluenza virus: percentage of cases and seasonal peak

A

<5%

-winter

19
Q

viruses associated with the common cold

adenovirus: percentage of cases and seasonal peak

A

<5%

year round

>100 antigenically different types, adenovirus has 47, therefore, large number of reinfections with them; due to rapid mutations on the surface of the virus

spread via direct contact with infected respiratory secretions: hand-hand, hand-face (also RSV, influenza, rhinovirus: note overlaps)

20
Q

viruses associated with the common cold

metapneumovirus

A

5%

late winter and early spring

21
Q

viruses associated with the common cold

bocavirus

HMPV

others

A
  • HMPV affects kids; peaks 1-2 mos after RSV
  • Bocavirus also found mainly in children
  • can have reinfections with virus due to (1) antigenic shift, (2) incomplete induction of immunity, or (3) waning immunity
  • HMPV and bocavirus in category of emerging viruses, discovered in 2002 and 2005 respectively
22
Q

common cold: clinical features

mild, self-limited illness characterized by 1 or more of the following (7 things)

A
  1. nasal congestion and discharge: clear to yellow-green
  2. sneezing
  3. coughing
  4. hoarseness or sore throat
  5. headache
  6. sinus pressure
  7. malaise
23
Q

common cold: clinical features

these symptoms are usually not present

A

-constitutional symptoms like myalgias and arthalgias are not prominent

fever is uncommon in adults (usually NO fever)

24
Q

common cold: clinical course

within __ the sore throat usually resolves and the rhinorrhea becomes __, which results from __

A
  • 2-3 days
  • more purulent, appearing thick and yellow to green
  • this change in nasal discharge results from recriutment of leukocytes, and is a natural part of the progression of a viral URI (PURULENT SPUTUM AND PHLEGM ARE NOT ASSOCIATED WITH BACTERIAL INFECTION OR RISK FOR BACTERIAL INFECTION)
25
Q

common cold: clinical course

other associated symptoms (5)

A
  1. headache
  2. hoarse voice
  3. malaise
  4. laryngitis
  5. lethargy
26
Q

common cold: clinical course

symptoms usually peak within __ days and resolve over __ days

A

2-3 days

5-10 days

27
Q

21312

A

21

28
Q
A

Clinical Medicine II (1 decks)

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