Respiratory Tract Infections

Question 1

What does the term LRTI encompass?

Answer 1

Bronchitis
Bronchiolitis
Pneumonia

Question 2

What does the term URTI encompass?

Answer 2

Affect respiratory tract above the lungs:
Sinusitis
Pharyngitis
Tonsilitis
Laryngitis
Common cold

Question 3

List S/S of URTIs

Answer 3

Rhinitis
Cough
Fever
Sore throat
Earache
Wheeze

Question 4

List S/S of LRTIs

Answer 4

URTI S/S
Fever
Cough +/- vomiting
Breathing difficulties
Drowsiness

Question 5

For which conditions should a no prescribing or delayed antibiotics approach be used?

Answer 5

Acute otitis media
Acute sore throat/ pharyngitis/ tonsillitis, Common cold/ acute rhinosinusitis
Acute cough/ bronchitis.

Question 6

In which cases should an immediate antibiotic prescribing approach be considered for?

Answer 6

<2s with bilateral acute otitis media
Children with otorrhoea who have acute otitis media
Patients with acute sore throat/ pharyngitis/ tonsillitis when >,3 Centor criteria are present

Question 7

Describe the CENTOR criteria

Answer 7

Presence of tonsillar exudate
Tender anterior cervical lymphadenopathy or lymphadenitis
Fever
Absence of cough

Question 8

What does presence of 3 or more of the CENTOR criteria indicate?

Answer 8

40-60% chance sore throat is caused by Group A beta-haemolytic Streptococcus

Question 9

How long does acute otitis media typically last?

Answer 9

4 days

Question 10

How long does acute sore throat/ pharyngitis/ tonsillitis typically last?

Answer 10

1 week

Question 11

How long does the common cold typically last?

Answer 11

1.5 weeks

Question 12

How long does acute rhino sinusitis typically last?

Answer 12

2.5 weeks

Question 13

How long does acute cough/ bronchitis typically last?

Answer 13

3 weeks

Question 14

What is the most common cause of viral URTI?

Answer 14

Rhinoviruses

Question 15

Describe assessment for URTI

Answer 15

Examine throat, ears + cervical LNs
Resp. exam to r/o pneumonia, significant wheeze etc
Assess hydration status, esp. in young children + elderly
Basic obs - if significantly abnormal may need to consider ddx e.g. sepsis

Question 16

Which criteria may be helpful in assessing URTIs?

Answer 16

<5s: NICE fever traffic light system
FeverPAIN score: likelihood of Strep infection in adult with sore throat + guide decision making re abx usage

Question 17

List 5 complications of viral URTI

Answer 17

Sinusitis
Otitis media
Secondary bacterial infection e.g. pneumonia
Exacerbations of pre-existing resp conditions
Viral wheeze, bronchiolitis + croup in infants

Question 18

Name a condition that causes recurrent respiratory tract infections

Answer 18

Bronchiectasis