T6 - L3 Clinical respiratory infections Flashcards
(36 cards)
what makes up the upper respiratory tract?
- mouth
- sinuses
- nose
- pharynx
- larynx
what makes up the lower respiratory tract?
- trachea
- bronchi
- bronchioles
- lungs
what is Pharyngitis?
nflammation of the back of the throat (pharynx), resulting sore throat & fever
what is Acute tonsillar pharyngitis?
symmetrically inflamed tonsils and pharynx (+/- fever +/-
headache)
(Severe infection: patient has marked systemic symptoms of infection and/or
unable to swallow).
what is the Centor criteria?
a set of criteria which may be used to identify the likelihood of a bacterial infection
criteria are: • Tonsillar exudate • Tender anterior cervical lymphadenopathy • Fever over 38°C • Absence of cough
If 3 or 4 of Centor criteria are met, the positive predictive value is 40% to 60%. The absence
of 3 or 4 of the Centor criteria has a fairly high negative predictive value of 80%.
how is the Fever PAIN Criteria scored?
Score 0-1 - no antibiotic
Score 2-3 - 3 days delayed antibiotic
Score 4-5 - Immediate antibiotic only if severe; otherwise 48 hours delayed antibiotic.
what is the Fever PAIN Criteria?
• Fever in the last 24 hours • Purulence • Attend rapidly under 3 days • Inflamed tonsils • No cough or coryza • Plus additional parameters to help prescribers determine the severity of the sore throat.
what infections would you do for an acute sore throat?
No routine investigations,
unless infectious mononucleosis is suspected
what is Infectious mononucleosis?
- glandular fever
- Epstein-Barr virus (EBV)
what is Infectious mononucleosis also known as?
glandular fever
- Epstein-Barr virus (EBV)
Infectious mononucleosis often presents with a triad of what 3 symptoms?
- fever
- tonsillar pharyngitis
- cervical lymphadenopathy
what is Epiglottitis?
inflammation of structures above the glottis.
- Almost always caused by bacterial infection.
- most commonly Haemophilus influenzae type b
what investigations would you do if you suspected Epiglottitis?
- blood cultures
- epiglottic swabs
how do you manage Epiglottitis?
- IV antibiotics (usually 3rd generation cephalosporin)
* Analgesia
what is Otitis externa (OE)?
inflammation of the external ear canal presenting with a
combination of: otalgia, pruritus and non mucoid ear discharge.
what is otalgia?
ear pain
what is pruritus?
severe itichng
what are risk factors for Otitis externa (OE)?
- Swimming (or other water exposure)
- Trauma (e.g. ear scratching, cotton swabs)
- Occlusive ear devices (e.g. hearing aids, ear phones)
- Allergic contact dermatitis (e.g. due to shampoos, cosmetics)
- Dermatologic conditions (e.g. psoriasis).
what is the most common cause for Acute Otitis externa (OE)?
Pseudomonas aeruginosa
&
Staphylococcus aureus
what investigations would you do for Acute Otitis externa (OE)?
- ear swab
- pus sample (culture)
- blood culture is systemically unwell
what is the non-antimicrobial management for Acute Otitis externa (OE)?
- Remove pus and debris from ear canal
* Analgesia
what is the antimicrobial management for Acute Otitis externa (OE)?
- Topical agents for mild-moderate
* Topical plus systemic antibiotic such as flucloxacillin for severe AOE
what is Malignant (necrotising) external otitis?
external otitis occurs when external otitis spreads to the skull base
(soft tissue, cartilage, and bone of the temporal region and skull).
- commonly diabetic or immunocompromised patients
what is otorrhoea?
discharge of abnormal material through ear canal
