Upper Respiratory Infections

Question 1

Syndromes

Answer 1

Cold
URI 
Bronchitits
Oititis
SInusitis
Pharyngitis
Epiglottitis

Question 2

Etiologies of URIs

Answer 2

Rhinoviruses (common cold, bell curve progression)
Coxsackie virus A 
Influenza (flu, hits 110% on day 1, no progression)
Coronavirus
Adenovirus
Echovirus
EBV
Parainfluenza
HSV

Question 3

Characteristics of URIs

Answer 3

VIRAL
last 7-10 days
nasal congestion, cough

Question 4

Pharyngitis

Answer 4

sore throat
usually viral
college students
Immunosuppresed patients = unusual agents

Grp A Strep, diphtheria, pertussis (whooping), gonococcus, archanobacteria,
tularemia, chlamydia, anaerobes***

Question 5

Group A Strep

Answer 5

Sudden onset
fever
headache
nausea, vomit
pharyngeal inflam
discrete exudate
tender cervical nodes
ages 5-15**
winter to spring
exposure 
NO cough, congestion, conjunctivitis

Question 6

Oititis

Answer 6

84% kids 1 episode, 50% >4
50% viral

pneumo, H flu, moraxella

after URIs
ear pain pulling
60% no fever
antibiotics little value

can treat with lesion to tympanic mem

Question 7

Sinusitis

Answer 7

adults
after URIs
usually viral
can cause tooth pains
facial pain, opacity by transillumination
x-rays not specific

pneumo, H flu, moraxella

antibiotics little value

Question 8

Epiglottitis

Answer 8

Haemophilis influenzae (vaccine against)

Dysphagia, drooling, stridor (hear breathing)

Protect airway, kids can die from this
Lateral neck x-ray (thumb sign)

Question 9

Diagnosis URIs

Answer 9

Throat culture w 90-95% sensitivity or rapid test 80-90%

Other diseases need aspirate (complicated cases)

In kids always culture but for adults can usually trust rapid test

Question 10

Treatment of URIs

Answer 10

Treat Group A and epiglottitis with antibiotics

Don’t treat others unless complicated case or immunosuppressed

Question 11

Effect of antibiotic

Answer 11

No effect on sinusitis, otitis, or acute bronchitis