Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FAMILY MEDICINE > Upper Respiratory Infection > Flashcards

Upper Respiratory Infection Flashcards

1
Q

Name some specific microbes/viruses that can cause acute bronchitis

A

influenza, parainfluenza, adeno, rhino, mycoplasma pneumonia and chlamydia pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common presentation of acute bronchitis

A 
cough productive of purulent sputum (MOST COMMON)
fever
malaise
rhinorrhea
nasal congestion
sore throat
wheezing
dyspnea
chest pain
myalgias/arthralgias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Typical physical exam findings for acute bronchitis

A

non-specific and usually UNREMARKABLE

lung exam can show rales, rhonchi, or wheezes occasionally

make sure to note fever, tachypnea, tachycardia, BP abnormalities and to pulse ox in more severe symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Factors more indicative of pneumonia

A

prolonged fever, tachycardia, tachypnea, hypotension, signs of consolidation on lung exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What to do to confirm dx if suspecting pneumonia?

A

chest radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long does acute bronchitis usually last?

A

nearly always self limited in otherwise healthy individual

most lasts less than 2 weeks, some cases cough up to 2 months or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment for acute bronchitis

A

bronchodilator therapy, antitussives (dextromethorphan and codeine)

antibiotics limited effectiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common cause of chronic cough in healthy, non smokers with normal chest xray

A

upper airway cough syndrome (UACS)

encompasses variety of conditions (like allergic rhinitis or bacterial sinusitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How to subdivide rhinosinusitis?

A

acute (12 weeks)

recurrent (4 or more per year with interim resolution of symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When to think bacterial sinusitis vs viral sinusitis?

A

viral usually is gone in 7-10 days…

if patient has symptoms that persist longer than this, consider bacterial (>7 adults and>10 for children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms of sinusitis

A

purulent nasal discharge, maxillary tooth/facial pain, unilateral maxillary sinus tenderness, worsening of symptoms after initial improvement + other syptoms similar to other URI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Organisms most commonly responsible for bacterial sinusitis?

A

s pneumo, h influenza, and moraxella catarrhalis (esp in children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

First line treatment for bacterial acute sinusitis

A

amoxicillin or trimeth-sulfa 10-14 day regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Second line antibiotics for acute sinusitis

A

augmentin (amox-clauvanic acid), 2/3rd gen cephalosporin), fluroquinolones, second generation macrolides (azithro, clarithrymycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can be used in addition to antibiotics for adjunctive treatment of sinusitis

A

oral/topical decongestants, NSAIDS all for symptomatic relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What comprises the majority of etiologies of pharyngitis?

A

VIRAL, self limited

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When someone comes to you with sore throat, what serious conditions to rule out first?

A

GAS infection (strep throat), peritonsillar abscess, epiglottitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Some bacterial causes of pharyngitis in teens

A

mycoplasma pneumoniae, chlamydia pneumoniae, arcanobaacterium haemolyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Findings frequently associated with GAS infection

A

abrupt onset sore throat, cervical lymphadenopathy, absence of cough, fever greater than 100.4, tonsillar exudate (not specific)

think CENTOR criteria

GAS can also cause scarlitinoform rash (red, sandpaper like)

20
Q

What other virus presents similarly to GAS infection

A

Epstein barr (infectious mononucleosis)

21
Q

features of Epstein Barr virus infection

A

hepatospenomegaly/generalized adenopathy
atypical lymphocytes on blood smear
presdisposition to splenic rupture (tell patients to avoid sports)

22
Q

stridor, drooling, toxic appearance, patient somtimes leaning forward on outstretched arms (tripod)

A

epiglottitis

23
Q

How to treat epiglottitis

A

emergently secure airway (via intubation/cricothyroidotomy)

24
Q

swelling, associated tonsil pushed toward the midline with contralateral deviation of uvula

A

peritonsillar abscess

25
Q

What is peritonsillar abcess associated with

A

complication of streptococcal pharyngitis or initial complaint of sore throat with trismus (pain with chewing)

26
Q

what to do if suspect peritonsillar abscess

A

immediate referral for surgical drainage of abcess

27
Q

gold standard for GAS infection diagnosis

A

throat culture! but can take 24-48 hours to come back

28
Q

quick way to diagnose GAS

A

rapid antigen testing (highly specific but lower sensitivity than throat culture)

positive = prompt antibiotic treatment
negative = do throat culture
29
Q

Rare, but serious complications of untreated GAS infection

A

RHEUMATIC FEVER, glomerulonephritis (poststreptococcal), toxic shock syndrome, peritonsillar abscess, meningitis, bacteremia

30
Q

T/F: postglomerulornephritis can occur even if patient was given appropriate antibiotic treatment

A

TRUE

31
Q

treatment for GAS pharyngitis

A

PENICILLIN (10 day course) IM or oral

32
Q

chronic cough, inflammation/hyperactivity of airway, chest tightness, exacerbation by particular triggers, improved with bronchodilators

A

asthma

33
Q

cough gets worse in supine position, heartburn, increased symptoms after meals

A

GERD

34
Q

how to dx GERD

A

24 hours esophageal ph monitoring (but clinical diagnosis is more common)

35
Q

easily overlooked cause of nonproductive cough

A

ACE-inhibitor related cough

36
Q

When can ACE inhibitor cough present?

A

1 week to 6 months after initiation of therapy

37
Q

how to treat ACE inhibitor cough

A

discontinue med, check back in 4 weeks at the earliest, may use ARB as alternative

38
Q

inflamed, swollen external ear canal, exudates/discharge, tympanic membrane may or may not be involved

A

OTITIS EXTERNA (OE)

39
Q

pathogens that can cause OE

A

staph, strept, pseudomonas (“swimmer’s” ear from pools/bathtubs)

40
Q

What condition puts patients at risk for invasive external otitis (malignant OE) by pseudomonas

A

DM

41
Q

How does otitis media usually present?

A

usually seen in kids
fever, ear pain, tinnitus, vertigo, swollen TM (decreased motility or fluid behind TM is diagnostic), red TM

MOST CASES ACUTE OM RESOLVE SPONTANEOUSLY

42
Q

bacterial pathogens commonly seen in OM

A

s pneumo, moraoxella catarrhalis, h influenzae

43
Q

If patient has prolonged, severe OM, what a/b to give?

A

amoxicilin!

alt: amoxicillin-clavulanic acid (augmentin), bactrim or cephalosporin

44
Q

CENTOR criteria = ?

A

1 point for each

age between 3-14
tonsillar exudate/swelling
fever greater than 100.4
absence of cough
cervical lymphadenopathy

minus point for age over 45

45
Q

CENTOR criteria treatment score

A

0-1 no further testing no antibiotics
2-3 rapid antigen testing or throat culture, if positive treat with antibiotics
4 or more - empirically treat with antibiotics

FAMILY MEDICINE (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions