Upper respiratory tract infection

Question 1

1)Definition of otitis media
2)pathophysiology
3)clinical manifestation
4)which pathogen is involved
5)how to diagnose
6)treatment
7)prevention

Answer 1

1)infection of middle ear(may be chronic or acute)
2)viral infection, and allergic rhinitis in upper respiratory tract cause inflammation of eustachian tube and than obstruction reduce drainage of the middle ear
3)ear pain, fever ,erythematous and bulged tympanic membrane which can rupture, may cause meningitis , hear lose or lateral and cavernous sinus thrombosis
4)S.pneumoniae, H.infulenzae, m. catarrhalis,
rhinovirus, RSV, coronavirus
5)otoscope, and tympanocentesis for reduce pressure and observe specimen
6)amoxicillin(clavulanic acid if resistance )+ nasal decongestant
7)antibiotic+ ventilating tube

Question 2

1)Definition of sinusitis
2)Pathophysiology
3)Why maxillary sinus is involved frequently?
4)Clinical manifestation
5)Which pathogen cause sinusitis?
6)how to diagnose?
7)Treatment

Answer 2

1)Inflammation of paranasal sinuses
2)Infection or allergy cause inflammation(impaired mucociliary
clearence) and blockage of orifice, this cause stasis of sinuses, stasis lead to bacterial infection
3)Due to gravity induced movement is reduced
4)fever, face of sinus pain, intracranial problems
5)all bacteria which cause otitis media and staphylococcus aureus(superinfection), immunocompromised and diabetes- mucor and aspergillus
6)clinical manifestation plus CT
7)Mild case don not need antibiotic but in severe case amoxicillin(resistance clavulanic acid), nasal decongestants and intranasal corticosteroid

Question 3

1)Definition of pharyngitis
2)Clinical manifestation
3)Pathogen
4)Diagnosis
5)Treatment

Answer 3

1)inflammation of throat primarily caused by viruses but in rear cases it may caused by streptococcus pyogenes(rheumatic fever)
2)fever, sore throat, typical upper respiratory tract symptoms, erythema on throat and tonsils, anterior lymphadenopathy, exudate on tonsils, GAS cause petechiae on palate
3)Bacteria -most severe -streptococcus pyogenes, than s.aureus, N.gonorrhea(child sexual abuse), chlamydia pneumonia, Corynebacterium diphtheria, fusobacterium necrophorum(jugular vein thrombophlebitis which can cause septic emboli in lungs), mycoplasma pneumoniae,
Most cases of viral infection is respiratory viruses and in some situation there are another viruses
4)priority is GAS because of its complication and reliable treatment , we take throat culture.
5)In case of GAS penicillin or amoxicillin, if there is penicillin induce allergy we use erythromycin

Question 4

1)Definition of croup
2)pathogens
3)Disease
4)Diagnosis
5)treatment

Answer 4

1)laryngotracheobronchitis
2)Most common parainfluenza virus and rare influenza and RSV
3)Stridor and airway obstruction
4)By x-ray
5)Dexamethasone with or without epinephrine

Question 5

1)Definition of laryngitis
2)Clinical manifestation
3)pathogens
4)Diagnosis and treatment

Answer 5

1)vocal cord inflammation
2)Difficult to speak
3)viruses and bacteria which cause upper respiratory infection
4)Clinically and treatment is hydration and voice rest

Question 6

1)Definition of epiglottitis
2)Clinical manifestation
3)pathogens
4)Diagnosis
5)Treatment
6)prevention

Answer 6

1)inflammation of epiglottis
2)Odynophagia, dysphagia and airway obstruction
3)H.influenzae most common and rarely s.aureus, s.pyogens and s.pneumoniae
4)Clinically and with lateral x-ray thumb thing
5)ceftriaxone, corticosteroids and adequate airway maintained
6)vaccine and rifampin with close contact