Respiratory Tract Infection

Question 1

In which conditions is a viral throat swab used for diagnosis?

Answer 1

Influenza (A+B), RSV, metapneumovirus, rhinovirus, coronavirus, parainfluenza, adenovirus, enterovirus, parechovirus

Question 2

Strep throat:

• Exudate or transudate?
• Symptoms

Answer 2

• Exudate and pus

- Sore throat, dysphagia, dysphonia

Question 3

Tonsillitis:

• Signs and symptoms
• Treatment

Answer 3

• Swollen tonsils, erythematous, dysphagia, dysphonia

- Not all patients are treated, if recurrent consider tonsillectomy

Question 4

What is quinsy a complication of?

Answer 4

Tonsilitis

Question 5

Quinsy:

• Severity
• What is it?
• Presentation
• What can it cause?
• Management

Answer 5

• Life threatening
• Peri-tonsillar abscesses
• Drooling and pain in back of throat
• Can cause airway obstruction, retropharyngeal abscess, sepsis, glomerulonephritis and rheumatic fever
• IV antibiotics and drainage - beware of the internal carotid artery

Question 6

Epiglottitis:

• Severity
• What causes it?
• Presentation
• Treatment

Answer 6

• Life threatening complication of bacterial infection
• Common causes are strep. pneumonia, strep. progenies or staph. aureus
• Present with drooling since they cannot swallow
• Secure airway with endotracheal tube then urgent administration of IV antibiotics- ceftriaxone, vancomycin or clindamycin

Question 7

Coryza:

• What is it?
• Symptoms
• How is it spread?
• Complications

Answer 7

• Common cold - acute viral infection of the nasal passages
• Runny/blocked nose, often accompanied by sore throat, sometimes mild fever
• Spread by droplets and fomites
• Comlications - sinusitis and acute bronchitis

Question 8

Sinusitis:

• What is it often preceded by?
• Symptoms
• Viral/bacterial?
• How long does it last?
• Treatment

Answer 8

• Preceded by a common cold
• Purulent nasal discharge, frontal headache, retro-orbital pain, maxillary sinus pain, toothache
• Usually viral
• Resolves in 10 days
• Nasal decongestant, nasal steroids, pseudo-ephedrine

Question 9

Diphtheria:

• What is it?
• Main characteristic
• Why is it not seen in UK?

Answer 9

• Life threatening condition due to toxin production
• Characteristic pseudomembrane
• Not seen in UK due to vaccination