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PR3151_Final Exam > Upper Respiratory Tract Infection > Flashcards

Upper Respiratory Tract Infection Flashcards

1
Q

What are the risk factors for URTI?

A
  • contact with young children
  • lack of personal / hand hygiene
  • chronic respiratory diseases e.g. asthma, allergic rhinitis
  • smoking
  • immunocompromised
  • anatomical anomalies
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2
Q

What is the clinical presentation of a Common Cold?

A

Low grade temperature, rhinorrhea, nasal blockage, sneezing, productive cough, headache, body ache

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3
Q

What are the common pathogens causing common cold?

A

Rhinovirus, Coronavirus

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4
Q

What are the monitoring points for Common Cold?

A
  • most will recover in 7 to 10 days
  • see doctor if symptoms get better then worsen
  • cough may last 2-3 weeks
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5
Q

What is the clinical presentation for Influenza?

A

Fever, chills, headache, myalgia, malaise, anorexia, confusion (elderly), sore throat, dry cough, nasal discharge

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6
Q

What is the recommended regimen for the treatment of influenza?

A

PO Oseltamivir 75mg BD x 5d

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7
Q

When should oseltamivir be initiated for hospitalised / high-risk / severe patients?

A

Best within 48H, up to 5 days

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8
Q

When should oseltamivir be initiated for outpatient?

A

within 48H

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9
Q

What is the MoA of oseltamivir?

A

Neuraminidase inhibitor, prevents protein cleavage and release of new virus

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10
Q

What are the side effects of oseltamivir?

A

Headache, mild N/V

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11
Q

What are the monitoring points for influenza?

A
  • will have symptoms for a week
  • see doctor if no improvement in 10 days / symptoms get better then worsen
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12
Q

What is the clinical presentation of pharyngitis?

A

Fever, swollen and tender lymph nodes, sore throat, erythema and inflammation of pharynx and tonsils (with or without patchy exudates)

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13
Q

What is the modified centor criteria for s. pyogenes pharyngitis?

A

Fever > 38c
Swollen lymph nodes
Tonsillar exudates
Absence of cough
3-14yo +1 / 15-45yo +0 / >45 -1
0-1: unlikely bacterial
2-3: culture
4-5: likely bacterial, treat

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14
Q

What are the complications of s. pyogenes pharyngitis?

A
  • acute rheumatic fever (prevented by abx)
  • acute glomerulonephritis (not prevented by abx)
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15
Q

What are the first-line treatment regimens for s. pyogenes pharyngitis?

A

PO penicillin V 250mg Q6H
PO amoxicillin 500mg Q12H

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16
Q

What are the treatment regimens for s. pyogenes pharyngitis for patients with penicillin allergy?

A

Mild
- PO Cephalexin 500mg Q12 (x in amoxicillin allergy)
- PO Cefuroxime 250mg Q12
Others
- azithromycin 500mg OD
- clarithromycin 500mg Q12
- clindamycin 300mg Q8H

17
Q

What is the treatment duration for s. pyogenes pharyngitis?

A

x 10d (5d for azithromycin)

18
Q

What is the pathogenesis of acute bacterial rhinosinusitis?

A

Viral URTI -> sinus obstruction, trapping of bacteria -> infection

19
Q

What are the symptoms of acute rhinosinusitis?

A

facial pain, purulent nasal discharge, nasal congestion, decreased sense of taste and smell, headache, cough, ear fullness, bad breath, dental pain

20
Q

When should a patient presenting with rhinosinusitis symptoms be referred to the emergency department?

A

Signs of spread to orbits / CNS
- limited ocular movements
- acute vision changes
- unilateral weakness
- confusion

21
Q

What are the pathogens responsible for bacterial rhinosinusitis?

A

Main
- h. influenzae
- s. pneumoniae
others
- s. pyogenes
- moraxella catarrhalis
- anaerobes

22
Q

When should antibiotics be initiated for patients presenting with rhinosinusitis symptoms?

A

> = 1 of the following
- symptoms for > 10 days without improvement
- severe symptoms: fever > 39c, purulent nasal discharge, facial pain for >=3 consecutive days
- initial improvement -> worsening

23
Q

What are the first-line treatment regimens for bacterial rhinosinusitis?

A

PO amoxicillin 500mg Q8H
PO amox-clav 625mg Q8H

24
Q

What are the treatment regimens for bacterial rhinosinusitis in patients with penicillin allergy?

A

non-severe: PO cefuroxime 500mg Q12H
PO levofloxacin 500mg OD or moxifloxacin 400mg OD

25
Q

What is the duration of treatment for bacterial rhinosinusitis?

A

x 5-7d

PR3151_Final Exam (8 decks)

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