Upper Respiratory tract infection

Question 1

give some examples of URTIs?

Answer 1

rhinitis
tonsilitis
otitis media
pharyngitis
laryngitis
epiglottitis

Question 2

are the infectious agents of viral URTIs usually commensal?

Answer 2

no

Question 3

give examples of the few viruses that can be commensal

Answer 3

HSV

EBV

Question 4

what are the viral infective agents of URTIs?

Answer 4

adenovirus
influenza A and B
Para'flu I, II
RSV (respiratory cyncitial virus)
Rhinovirus

Question 5

what are the bacterial infective agents of URTIs?

Answer 5

H influenzae
M catarrhalis
Mycoplasma
S aureua
Streptococci B haemolytic - S pyogenes
alpha haemolytic- S pneumoniae

Question 6

when considering the natural history of a URTI what three questions are important to consider?

Answer 6

is the patient past their worst?
is the patient at their worst?
is the patient going to get worse?

Question 7

what is the most important thing to do to discover what stage in the natural history a URTI is at?

Answer 7

reviewing the patient, best way to do this is to ask the parent to review child and seek help if symptoms worsen

Question 8

what is rhinitis?

Answer 8

common cold

Question 9

does rhinitis require treatment?

Answer 9

it is self-limiting so often no

Question 10

what is rhinitis a prodrome to?

Answer 10

pneumonia
meningitis
septicaemia

Question 11

what is the observation when looking in a patient’s ear who has otitis media?

Answer 11

erythema- redness caused by increased blood flow

bulging drum

Question 12

should otitis media be treated?

Answer 12

it is self limiting so no antibiotics should be given as side affects are common. instead an analgesic should be given to relieve pain.

Question 13

what is the aetiology of otitis media?

Answer 13

primary viral infection. followed by a becterial infection

Question 14

what can be be the problem with treating tonsillitis/pharyngitis ?

Answer 14

it is hard to determine whether it is viral or bacterial

Question 15

how can you tell whether tonsillitis/pharyngitis is bacterial/viral?

Answer 15

throat swab

Question 16

what is the treatment for tonsillitis/ pharyngitis?

Answer 16

either nothing for viral or 10 days penicillin for becterial

Question 17

why must amoxycillin not be given to suspected tonsillitis/pharyngitis patients?

Answer 17

if it is glandular fever then it will cause a reaction which will cause a rash

Question 18

why is it very important to recognise the difference between croup and epiglottitis?

Answer 18

in children epiglottitis can be fatal

Question 19

which virus causes croup?

Answer 19

parainfluenza virus I

Question 20

which bacteria causes epiglottitis?

Answer 20

haemophilis influenzae type B

Question 21

what are the symptoms of croup?

Answer 21

• severe coryza (inflammation of mucous membranes causing large amount of mucous production)
• stridor
• hoarse voice
• “barking” cough

Question 22

what are the symptoms of epiglottitis?

Answer 22

stridor, drooling, pyrexia, blood pressure down, septic, painful swallowing, greater comfort when sitting up or leaning forward

Question 23

what is the treatment for croup?

Answer 23

oral dexamethasone , antinflammatory corticosteroid.

Question 24

what is the treatment of epiglottitis?

Answer 24

intubation and antibiotics