Respiratory Tract Infection (Respiratory) Flashcards
What is the clinical presentation of influenza?
High fever, abrupt onset, malaise, myalgia (joint pain), headache, cough, prostration.
What is the aetiology of influenza?
Influenza A+B, flu like illnesses e.g. parainfluenza, haemophilus influenza (secondary invader).
What tube colour should you use for viral media throat swabs and what technique does the lab use?
Red top, uses PCR so is incredibly sensitive.
What are the symptoms of strep throat?
Exudate, pus (most obvious sign it is bacterial), sore throat, dysphagia, dysphonia.
What are the symptoms of tonsillitis?
Swollen tonsils, erythematous, dysphagia, dysphonia (difficulty speaking), recurrent, tonsillectomy can be done but not often.
What is quincy and how can it be treated?
Complication of tonsillitis, it is a tonsillar abscess, can be drained (beware internal carotid artery).
Who does epiglottitis affect most often and what complication can arise from this?
Kids (have small larynx), can occlude airway, call anaesthetist to put a tube in and give IV antibiotics.
What is the common cold called and how is it spread?
Coryza, spread by droplets and fomites.
What are sometimes complications of the common cold?
Sinusitis and acute bronchitis.
What are the common viruses causing the common cold?
Adenovirus, rhinovirus, respiratory syncytial virus.
What types of pain can sinusitis cause?
Frontal headache, retro-orbital pain (behind eyes), maxillary sinus pain, toothache, discharge.
What about lymphatic drainage makes sinusitis potentially very bad?
Drainage of this area of the face drains to the brain, which is why it can be very bad.
What is acute sinusitis often preceded by and what type of discharge does it cause?
Common cold, purulent nasal discharge.
What is the treatment of sinusitis?
Mostly-viral aetiology so usually self-limited, resolves in 10 days, some need antibiotics.
What makes diptheria life threatening?
Toxin production.
What is the characteristic of diptheria and why is it not commonly seen in the UK?
Pseudo-membrane, due to vaccination.
What is acute bronchitis preceded by?
Common cold.
What are the clinical features of acute bronchitis?
Productive cough, fever (minority), normal chest exam, normal CXR, may have a transient wheeze.
What is the treatment for acute bronchitis?
Usually self-limiting, antibiotics not-indicated, can lead to significant morbidity in patients with chronic lung disease.
What are the incubation times for viruses in URTIs?
Rhinoviruses: 1-5 days, group A streptococci: 1-5 days, infleunza and parainfluenza: 1-4 days, RSV: 7 days, pertussis: 7-21 days, diptheria: 1-10 days, epstein-barr virus (glandular fever): 4-6 weeks.
What may an acute exacerbation of COPD be preceded by?
A URTI (increased sputum production, increased sputum purulence, more wheezy, breathless).
How would you manage an acute exacerbation of COPD?
Antibiotic e.g. doxycycline or amoxicillin, bronchodilator inhalers (exacerbations sometimes occur because they don’t take their medicine), short course of steroids in some cases.
When should you refer someone with an exacerbation of COPD to hospital?
If there is evidence of respiratory failure or if they are not coping at home.
How would an exacerbation of COPD be managed in hospital?
Same as at home but measure arterial blood gases, CXR to look for other diseases, give oxygen if hypoxaemic.
