Upper Respiratory Tract Infection _احمد عبيد

Question 1

what’s the most common upper respiratory infection URTI ?

Answer 1

it’s the acute coryza (common cold)

Question 2

what’s the cause of the common cold ?

Answer 2

it’s highly infectious disease caused by viruses as rhino virus , corona virus , adeno virus
and there is 100 different antigen stairn of rhino virus

Question 3

what’s type of immunity of common cold?

Answer 3

short lived and virus specific

• viral specific immunity (Humoral Immunity: Virus and/or virus-infected cells can stimulate B lymphocytes to produce antibody (specific for viral antigens) Antibody neutralization is most effective when virus is present in large fluid spaces (e.g., serum) or on moist surfaces (e.g., the gastrointestinal and respiratory tracts).)
• Short-term immunity can be transferred passively from one. individual to another via antibody-containing serum; similarly, infants are protected by antibodies they receive from their. mothers (primarily before birth)

Question 4

how the infectivity of the common cold ?

Answer 4

infectivity from close personal contact in early stage and spread faciliated by the overcrowding and poor ventilation

Question 5

why it’s difficult to provide protection in common cold ?

Answer 5

because there are 100 strains of rhinovirus

Question 6

how much every individual can get common cold in a year ?

Answer 6

2-3 times in a year

Question 7

what’s the incidence among the age group ?

Answer 7

the incidence lessens (decrease) with age called accumulating immunity

Question 8

what’s the clinical features pf common cold ?

Answer 8

it’s cause mild systemic upset and prominent nasal symptoms as
- Tiredness
-Slight pyrexia, malaise
-sore nose & (sore throat) if involve pharynx.
-Sneezing & profuse, watery nasal discharge are followed by thick mucopurulent secretions which may persist for up to a week.
-Horse voice if (larynx) involve
complicated by a tracheitis or bronchitis, chest tightness & wheeze
Secondary bacterial infection occurs only in a minority of cases

Question 9

what’re the complications of the common cold ?

Answer 9

• complicated by a tracheitis or bronchitis, pnemonia (lower respirtory infection )chest tightness & wheeze
• Secondary bacterial infection occurs only in a minority of cases
• Sinusitis.
• otitis media, Hearing impairment

Question 10

what’re the mangments of the common cold ?

Answer 10

• Most do not require treatment.
• Analgesics & antipyretics for systemic symptoms.
• Nasal decongestant in some cases.
• Antibiotics not necessary in uncomplicated coryza.

Question 11

what’s the acute laryngitis ?

Answer 11

it’s Dry sore throat, Hoarse voice or loss of voice. Attempts to speak cause pain.
Initially, painful & unproductive cough.

-cause Stridor in children (croup) because of inflammatory oedema leading to partial obstruction of a small larynx

Question 12

what’s the cause of acute laryngitis ?

Answer 12

Often a complication of acute coryza

Question 13

what’re the complications of the acute laryngitis ?

Answer 13

Chronic laryngitis. tracheitis, bronchitis, pneumonia

Question 14

what’re the mangements of the acute laryngitis ?

Answer 14

• Rest voice.
• Analgesics for relief of discomfort and pyrexia.
• Steam inhalations may be of value
• Antibiotics not necessary in simple acute laryngitis

Question 15

what’s the influenza ?

Answer 15

an acute systemic viral infection that primarily affects the respiratory tract; it carries the mortality

Question 16

what’s the cause of influenza ?

Answer 16

orthomyxo virus group & exists in two main forms, A and B.

Question 17

what’re the types influenza ?

Answer 17

influenza A : world-wide pandemics, new antigenic variants at irregular intervals

Influenza B : localized outbreaks of milder nature

Question 18

what’s the epidermiology of influenza?

Answer 18

The most serious influenza pandemic occurred in:
-1918, more than 20 million deaths worldwide.

• 1957, a major shift in the antigenic make-up of the virus led to the appearance of influenza A2 type H2N2, which caused a world-wide pandemic.
• 1968 further pandemic occurred owing to the emergence of Hong Kong influenza type H3N2,
• A further pandemic is likely in the next few years.
• Recent concerns have focused on the H5N1 strain of influenza A which was previously confined to birds but can be contracted by humans who are in close contact with infected poultry.

Question 19

what’s the incubation period of the influenza?

Answer 19

The incubation period: usually 1–3 days

Question 20

what’s the clinical feature of the influenza ?

Answer 20

• illness starts abruptly with a fever, shivering and generalized aching in the limbs, severe headache, soreness of the throat, dry cough that can persist for several weeks.
• Diarrhoea occurs in 70% of cases of H5N1.
• prolonged period of debility and depression

Question 21

what’re the complication of the influenza?

Answer 21

• Secondary bacterial infection: Strep.pneumoniae , H. influenzae
• Secondary pneumonia caused by Staph. Aureus is rarer, but more seriousa mortality of up to 20%.
• Post infectious encephalomyelitis rarely occurs

Question 22

how to diagnosis the influenza?

Answer 22

+Laboratory diagnosis is not usually necessary, but a definitive diagnosis can be established by demonstrating:

1-a fourfold increase(x4) in the complement-fixing antibody

2-haemagglutinin antibody measured at onset and after 1–2 weeks by demonstrating the virus in throat or nasal secretions.

Question 23

what’re the treatments of the influenza?

Answer 23

• bed rest & paracetamol
• antibiotics to prevent secondary infection in those with: chronic bronchitis, cardiac& renal disease.
• Neuraminidase inhibitors :may help to shorten the duration of symptoms, if given within 48 hours

*oral oseltamivir (75 mg twice daily) or
* inhaled zanamivir (10 mg twice daily) for 5 days,
can reduce the severity of symptoms if started within 48 hours of onset

(Neuraminidase inhibitors block the neuraminidase enzyme. They are commonly used as antiviral drugs because they block the function of viral neuraminidases of the influenza virus, by preventing its reproduction by budding from the host cell.)

Question 24

when we give prophylaxis (vaccine )for the influenza?

Answer 24

_over 65 years of age

_younger people with chronic heart disease

_Chronic lung disease (including asthma)

_chronic kidney disease

_diabetes mellitus

_those who are immunosuppressed

_During pandemics: in key hospital and health service personnel

Question 25

how much the protection of the vaccine is effective ?

Answer 25

Protection by vaccines is effective only in up to70% of people, but only lasts for about a year.

Question 26

what’s the acute laryngo-tracheobronchitis ?

Answer 26

it’s croup diseaseالخناق
it starts as common cold then become Sudden paroxysms of cough accompanied by stridor &breathlessness with Contraction of accessory muscles and indrawing of intercostal spaces

if we don’t suspect this case it will lead to Cyanosis and asphyxia in small children

خارجي

Barking loud cough aggravated by crying and coughing when breath in
And anxiety
Fever

Question 27

what’re the complications of the acute laryngo-tracheobronchitis ?

Answer 27

-Asphyxia, Death.

-Super infection with bacteria, especially Strepts, pneumoniae &Staphy. aureus
Viscid secretions may occlude bronchi

Question 28

what’s the treatment of acute laryngo-tracheobronchitis ?

Answer 28

_Inhalations of steam and humidified air/high concentrations of oxygen.

_Endotracheal intubation or tracheostomy to relieve laryngeal obstruction & allow clearing of bronchial secretions

_intravenous antibiotic therapy for seriously ill patients.

_Maintain adequate hydration

Question 29

what’s the cause of the acute epigltitis ?

Answer 29

The infection is usually caused by bacteria(with Haemophilus influenzae)

Haemophilus influenzae (formerly called Pfeiffer’s bacillus or Bacillus influenzae) is a Gram-negative, coccobacillary,

Question 30

what’s the clinical feature of the acute epiglotitis ?

Answer 30

• Fever and sore throat, rapidly leading to stridor because of swelling of epiglottis and surrounding structures
• *Stridor and cough in absence of much hoarseness may distinguish acute epiglottitis from other causes of stridor

It’s called 4D in children
Dooling ,Dysphagia, Dyspnea,Dysphonia

Question 31

what’s the complication of the acute epiglositis

Answer 31

-Death from asphyxia which may be precipitated by attempts to examine the throat
So avoid using a tongue depressor or any instrument unless facilities for endotracheal intubation or tracheostomy are immediately available because it leads to increase the edema

Question 32

what’s the treatment of the acute epigltitis ?

Answer 32

Intravenous antibiotic therapy essential.
Other measures as for acute laryngo tracheo bronchitis as
_Inhalations of steam and humidified air/high concentrations of oxygen.

_Endotracheal intubation or tracheostomy to relieve laryngeal obstruction & allow clearing of bronchial secretions

_Maintain adequate hydration

Question 33

what’s the cause of acute bronchitis ?

Answer 33

Often follows acute coryza.

Question 34

what’s the clinical feature of the acute bronchitis ?

Answer 34

Initially irritating unproductive cough, retrosternal discomfort of tracheitis.
Chest tightness, wheeze and breathlessness when bronchi become involved.

Maybe viral or bacterial or smoking or pulation

Question 35

what’s the clinical feature of the trachitis ?

Answer 35

-causes pain on coughing with Sputum is initially scanty or mucoid.
After a day or so, sputum becomes mucopurulent, more copious & often blood-stained.

• its may associated with Acute bronchial infection with a pyrexia of 38-39°C &a neutrophil leucocytosis.

Question 36

what’s the most common cause of the bloody sputum ?

Answer 36

trachitis

Question 37

what’s the clinical feature treatment of the trachitis ?

Answer 37

Spontaneous recovery occurs over a few days