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Cardiorespiratory 2 > Upper respiratory tract > Flashcards

Upper respiratory tract Flashcards

1
Q

what does the upper respiratory tract consist of

A

Upper respiratory tract includes the nasal cavity, pharyx and larynx

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2
Q

what are common URTIs

A
  • Common cold – rhinovirus, coronaviruses, adenoviruses, myxovirsues, echoviruses
  • Pharyngitis
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3
Q

what is more common bacteria or viruses for URTIs

A
  • Bacteria infections can drive URTI but the most common cold is virsues
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4
Q

what is the most common virus that causes the common cold

A

rhinovirus

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5
Q

how can the common cold be transmitted

A
  • Inhaling droplets in the air from sick people are major cause, due ot coughing sneezing or blowing their nose
  • Touching a surface contaminated with the virus and then touching your eyes nose or mouth
  • Inoculation of the mucosa lining of the upper airway
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6
Q

how long is the incubation time of the common cold

A
  • varies depending on the virus

- Rhinoviruses = 1-5 days and respiratory syncytial virus may incubate for 7 days

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7
Q

define incubation time

A

this is the time before the onset of symptoms

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8
Q

what are the symptoms of the common cold

A
  • Runny nose
  • Sore throat
  • Cough
  • Sneezing
  • Loss of appetite
  • Low grade fever
  • Watery eyes
  • Headache
  • Earaches
  • Nausea sensation
  • Rhinorrhoea (excess mucus filling in the nasal cavity) and nasal obstruction (mucosal lining) – major symptoms
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9
Q

what are the major symptoms of a common cold

A

Rhinorrhoea (excess mucus filling in the nasal cavity) and nasal obstruction (mucosal lining) – major symptoms

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10
Q

what leads to the feeling of congestion

A
  • Nasal obstruction – this results in swollen cells and swollen blood vessels, the swollen blood vessels lead to the feeling of congestion
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11
Q

describe the pathophysiology of the human rhinovirus infection

A
  • Airways are lined for the epithelial cells
  • upon inhlation of the HRV, this is recognized by TLR in this example it is TLR 3
  • binding to this leads to activation of a host of signalling mechanism this includes activation of the retinonic acid inducible gene-1-like receptor,
  • this signals mechanism inside the cell which leads to the secretion and release of pro- inflammatory mediates such as TNF alpha, IFN, CXCL8, some of these are chemokines which attract neutrophils,
  • APC cells happen, then there is a delayed immune signature of the B and T cells
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12
Q

what are the symptoms of inflammation

A
  • Swelling
  • Redness
  • Temperature
  • Pain
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13
Q

what two viruses are most popular for causing the common cold

A
  • rhinovirus

- RSV (respiratory syncytial virus)

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14
Q

how does the respiratory syncytial virus lead to the common cold

A

Viral Replication (major target epithelial cells)
→ Recognition via Toll-like (TLR) & retinoic acid-inducible gene-I-like (RIG-I) receptors
→ Cellular infection triggers pro-inflammatory mediators (e.g. TNF-alpha, IFN & CXCL8)
→ Triggers & activates Innate & Adaptive response

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15
Q

what is CXCL8

A

major chemokine that recruits neutrophils to the area

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16
Q

what does the neutrophils do in common cold

A

this leads to increased vascular permeability and increased mucus hypersection which causes rhinorrhea and nasal obstruction(major symptoms)

17
Q

how do viruses impede immune recognition

A
  • High glycosylation & structural variability of surface G-protein = impedes immune recognition
  • Viruses can not only change the cell surface marker but can release decoys as well (release of soluble G protein), this reduces the virus specific antibodies concentrations available for virus neutralisation
18
Q

what is high glycosylation when the virus impedes immune recognition

A

Dendritic cells recognize surface proteins, viruses are good at variability of surface G proteins and can change it quickly therefore this can make the immune system redundant and unable to fight you this is high glycosylation

19
Q

what is the impact of rhinovirus infections on people with asthma

A
  • 50-80% of asthma exacerbations

- Factors favouring HRV infection severity in allergic conditions

20
Q

what are you more likely to get an asthma exacerbation when you have a cold

A

Asthma (state of heightened immune & inflammatory response)
→ ↑ cytokine release (e.g. IL-4, -5, -10 & -13)
→ ↑intracellular adhesion molecule (ICAM-1, major HRV receptor)
→ more susceptible to HRV infection

21
Q

how is COPD effected by virus causing the common cold

A

Viral infections may account for 60-80% of COPD exacerbations
- Worsening on resp symptoms – change in medication
- Increase in disease progression and hospitalization – this can lead to death
- Increased airway inflammation, worsening hyperinflation, lung function decline
Nasopharyngitis

22
Q

what are the viral pathogens that cause COPD exacerbations

A

RV, Respiratory Syncytial Virus & Influenza virus

23
Q

how do you prevent nasophayngitis from spreading

A
  • Decrease infection risk
  • Wash hands frequently
  • Avoid contact with viral particles
  • Avoid touching you eyes with contaminated hands
  • Use disposable tissues
  • Use instant hand sanitizers to stop the spread of germs
  • Avoid touching your nose
24
Q

how long does nasophayrngitis last for

A
  • Duration up to 14 days, symptomatic 7-11 days
25
Q

what are the symptoms of nasopharygitis

A
  • Fever, sneezing, and sore throat typically resolve early whereas cough and nasal discharge are among the symptoms that last longest
26
Q

how do you mange nasopharyngitis

A
  • Nasal irrigation – clear pollutants and thin mucus
    Nasal and or systemic steroids – reduce swelling
    Decongestatns
27
Q

how do decongestants work

A
  • Site of action – blood vessels surrounding nasal sinuses
  • Mechanism – alpha 1 adrenoreceptor agonist
  • Pharmacological effect – vasoconstriction
  • Decongestants reduce swelling of blood vessels around the sinuses and this reduces the congestion in the nose
  • Alpha 1 agonist leads to vasoconstriction of the nasal blood vessels, this leads to a broad nasal pathway which leads to decongestion
28
Q

what is pharyngitis

A
  • This is a sore throat
  • Pharyngeal and tonsillar tissue may look edematous or be ulcerated
  • There is significant inflammation of the tonsils and there is also tonsillar exudate
29
Q

what are the two scores used in the sore throat assessment

A
  • fever pain score

- centor score

30
Q

name the categories for the fever pain score

A
  • If the person has fever above 38 degrees
  • Purulence
  • Attend within 3 days or less
  • Severly inflamed tonsils
  • No cough or coryza
31
Q

name the categories for the centor score

A
  • Tonsillar exudate
  • Tender anterior cervical lymphadenopathy or lymphadenitis
  • History of fever greater than 38 degrees
  • No cough
32
Q

how do you use the fever pain score and the centor score to work out if the patient should have an antibiotic or not

A

Fever pain is 0 or 1 do not offer antibiotic
Centor score 0 1 or 2 do not offer an antibiotic
Advice that sore throat can last around 1 week and to manage symptoms with self-care
Fever PAIN score 2 or 3 consider no antibiotic or a backup antibiotic prescription
FeverPAIN score 4 or 5 – consider an immediate antibiotic or a backup antibiotic prescription
Centore score 3 or 4 – consider an immediate antibiotic or a back up antibiotic prescription

33
Q

what is the first line therapy and alternative first choices for pharyngitis

A

First line therapy
- Phenoxymethylpenicillin – 500mg four times a day or 1000mg twice a day for 5 to 10 days
Alternative first choice
- Clarithromycin – 250mg to 500mg twice a day for 5 days
- Erythromycin – 250mg to 500mg four times a day or 500mg to 1000mg twice a day for 5 days

34
Q

what is the leading cause of nasopharyngitis (common cold)

A

human rhinovirus

Cardiorespiratory 2 (43 decks)

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