Upper resp infections Flashcards
how many colds do people get/year
adults - 2-5
kids 6-8
what causes colds
viruses - 200 types- corona, rhino etc
presentaion of cold
intial - sore throat malaise
1-2 days - nasl congestion/discharge
duration - peak 3-4 days, resolve 7-10 days
Tx for colds
NOT antibiotics
- topic decongestant for 3 days max
- topical Atrovent - over 6 yo
codeine syrups not reccomended
what is acute sinusitis
inflammation of paranasal sinuses
clinical course of sinusitis
initial - URI followed by persistence >7 days or worsening after 5
followed by - purulent or bloody discharge AND pain
other Sx - headaches, cough, pain worse on bending
duration
microbiol of sinusitis
mostly viral
some bact. - strep pneumoniae, Haem. influenzae
key to diagnosis of acute bact. sinusitis
PODS = 2 of P - pain facial pain O - nasal obstruction D - purulent Discharge S - hyponosomia - less SMell
when to use ABs in rhinosinitis
persistence >7 days or worsening after 5
what is effect of ABs in sinusitis
with AB 77% improve, 60% without - most improve without!!
main AB for sinusitis
amoxicillan
adjuvent Tx of sinusitis
- analgesia
- decongestnats
- nasal irrigation
- steam inhalation
- nasal steroids NOT helpful
when to refer sinusitis to specialist
- anatomic abnormalities
- complications
- 4+ per year
- not repsonding to meds
microbio of pharyngitis
viral 50-80%
group A strep in 5-36%
what is epi of strep pharyngitis
late fall to early spring
- 5 -12 year olds most common
- contact transmission
clinical course of strep throat
- sore throat, fever, tonsillar erethyma
- usually self limited
why treat strep throat
prevent rheumatic fever and peri-tonsillar abscess
2 tests for strep
- throat swab and culture - gold stnadard - 48 hrs
2. rapid antigen detection test - 15min - sens only 80%
treat of strep
penicillin - if allergic erythromycin
what is hand foot and mouth
coxsackie virus - mild, but causes skin lesions
when to remove tonsils
- 6 episodes tonislitis per year
- recurrent absceses
- very alrge tonsils
cause of mono
eprstein barr virus
Sx of mono
sore throat, fever, lymphadenopathy
tests for mono
mono spot for IgM ABs
CBC for lymphocytosis
complications of mono
neuro, upper airway obstruciton, speen rupture
3 other causes of phayngitis
- gonococcal
- oral thrush
- lemierre’s
what is croup
term used to describe laryngeotracheitis
when to worry about croup
- drooling
- dysphagia
- toxic appearance
what is acute bronchitis
acute resp infection manifested primarily by cough with ror without phlegm
cause of bronchitis
90% viral - self limiting
what is treatment of acute bronchitis
not ABs - rule out asthma and COPD
