Upper respiratory tract infection and sneezing Flashcards by Darya Mokri

Upper respiratory tract is above the

vocal cords

How well did you know this?

Not at all

Perfectly

The upper respiratory tract consists of

nose
paranasal sinuses
pharynx
larynx

How well did you know this?

Not at all

Perfectly

functions of the upper respiratory tract:

breathing
speaking
warm air
clean air (mucous membrane traps foreign particles like smoke & other pollutants)

How well did you know this?

Not at all

Perfectly

most common upper respiratory tract infections (from most to least common)

common cold (rhinosinusitis)
sinusitis
pharyngitis/tonsillitis
laryngitis
tracheobronchitis

How well did you know this?

Not at all

Perfectly

the onset of symptoms of URTIs usually begins after how many days of exposuer to a microbe?

1 - 3 days

How well did you know this?

Not at all

Perfectly

the duration of URTIs symptoms is usually _ - _ days

7 - 10 days

How well did you know this?

Not at all

Perfectly

URTIs usually occur during ___ months

cold

How well did you know this?

Not at all

Perfectly

why do URTIs usually happen in winter?

cuz in cold weather ppl overcrowd inside buildings

How well did you know this?

Not at all

Perfectly

mean frequency of URTIs in adults and in children

adults: 2 - 4 episodes per year
children: more than adults

How well did you know this?

Not at all

Perfectly

what causes repeated circulation of URTIs in the community?

antigenic variation of hundreds of respiratory viruses

How well did you know this?

Not at all

Perfectly

name 3 ways URTI pathogens are transmitted

aerosol
droplet
direct contact

How well did you know this?

Not at all

Perfectly

Sinusitis and acute bronchitis are often preceded by a

common cold

How well did you know this?

Not at all

Perfectly

factors predisposing to URTIs

allergic rhinoconjunctivitis
nasal septum deviation
immunodeficiency
cocaine abuse
smoking or second-hand smoke 
travel

How well did you know this?

Not at all

Perfectly

how many viruses cause common cold?

200

How well did you know this?

Not at all

Perfectly

definition of a common cold

a viral infection of the upper respiratory tract

How well did you know this?

Not at all

Perfectly

Typical viral agents that cause URTIs:

rhinoviruses
coronaviruses
adenoviruses
coxsackieviruses
influenza and parainfluenza viruses
human metapneumovirus
respiratory syncytial virus (RSV)

How well did you know this?

Not at all

Perfectly

Bacteria that cause URTIs:

Group A, C and G streptococci -pharyngitis
Streptococcus pneumonia

Chlamydia
Neisseria gonorrhoeae

Corynebacterium diphtheriae
Bordetella pertussis or Bordetella Parapertussis

Mycoplasma
Haemophilus influenzae
Moraxella catarrhalis

How well did you know this?

Not at all

Perfectly

Symptoms of URTIs

sneezing
coughing
chills
cold
headache
backache
sore throat
snot (runny nose)

How well did you know this?

Not at all

Perfectly

symptoms of common cold

nasal congestion
mucopurulent nasal discharge
sneezing
sore throat
halitosis

How well did you know this?

Not at all

Perfectly

signs of common cold

low-grade fever
nasal vocal tone
inflamed nasal mucosa

How well did you know this?

Not at all

Perfectly

symptoms of sinusitis

unilateral facial pain
maxillary toothache
headache
purulent nasal discharge

How well did you know this?

Not at all

Perfectly

signs of sinusitis

swelling, redness, and tenderness over the affected sinus

abnormal transillumination

How well did you know this?

Not at all

Perfectly

symptoms of pharyngitis

sore throat
odynophagia or dysphagia
fever
no cough
halitosis

signs of pharyngitis

pharygneal erythema & exudate
palatal petechiae (donut lesions)
tender anterior cervical lymphadenopathy
scarlatiniform rash
herpangina
tonsillar hypertrophy

symptoms of laryngitis

``` hoarsness voiselessness dry cough odynophagia or dysphagia halitosis ```

signs of laryngitis

low-grade fever cervical lymphadenopathy inspiratory stridor tachypnoea

URTIs can progress to

``` otitis media bronchitis bronchiolitis pneumonia sepsis meningitis intracranial abscess ....and other infections ```

complications of untreated group A streptococcal pharyngitis

Acute rheumatic fever (ARF) Acute glomerulonephritis Peritonsillar abscess toxic shock syndrome

complications of sinusitis

orbital cellulitis subperiosteeal abscess orbital abscess frontal & maxillary osteomyelitis

diagnosis of URTIs is clinical, diagnostic investigations are only done when there is suspicion of

``` influenza corona group A streptococcal pharyngitis infectious mononucleosis pertussis pneumonia ```

diagnostic investigation for influenza:

pharyngeal swab for PCR

diagnostic investigation for coronavirus:

nasal and pharyngeal swab for PCR

diagnostic investigation for group A streptococcal pharyngitis:

pharyngeal swab for rapid antigen detection test

diagnostic investigation for mononucleosis:

mononucleosis spot test in blood

additional symptoms of mononucleosis

hepatosplenomegaly | lymphocytosis

diagnostic investigation for pertussis:

nasopharyngeal swab for serology or PCR

DDx for URTIs

``` influenza allergic rhinoconjunctivits acute thyroiditis Gastro-oesophageal reflux Granulomatosis with polyangiitis Asthma ```

The definition of influenza-like illness is

fever (>38.5°C) + cough / sore throat / headache / muscle ache.

allergic rhinoconjunctivitis is characterised by

edema of conjunctiva itchy eye increased lacrimation symptoms of rhinitis

Acute thyroiditis can present as sore throat how do u check if sore throat is cuz of thyroid or URTI?

thyroid hormone & thryoid autoantibody test | US and radioactive iodine uptake

GERD can clinically present as which 2 URTIs?

laryngopharyngitis and/or tracheobronchitis

to differentiate between GERD and laryngopharyngitis / tracheobronchitis, we should do:

EGD

Granulomatosis with polyangiitis should be considered in who?

patients with sinusitis not responding to therapy

if a patient with sinusitis is not responding to therapy, they could have _____

Granulomatosis with polyangiitis

how to differentiate between granulomatosis with polyangiitis and sinusitis?

Classic antineutrophil cytoplasmic antibodies and biopsy are key to diagnosis.

if cough (from what u thought was URTI) doesn't resolve >3 weeks, it could be

asthma

URTI treatment

usually no treatment ``` drink water maybe zinc, vit C, echinacea NSAIDs (for fever, HA, malaise) antibiotics (only in specific cases) Nasal decongestants (for rhinitis and sinusitis symptoms) topical nasal steroids (for sinusitis) neuraminidase inhibitors (for influenza) ```

URTI indications for antibiotic treatment

Group A streptococcal pharyngitis Bacterial sinusitis Pertussis

group A streptococcal pharyngitis antibiotic treatment:

oral penicillin or macrolide for 10 days

how do u know a sinusitis is bacterial not viral?

when it doesn't resolve within 7 days

bacterial sinusitis antibiotic treatment:

aminopenicillin +/- a β-lactamase inhibitor 2nd/3rd generation cephalosporins macrolides trimethoprim-sulfamethoxazole for 7–10 days

pertussis antibiotic treatment:

macrolides erythromycin trimethoprim-sulfamethoxazole doxycyclin for 7 days

2 most prevalent respiratory pathogens

rhinoviruse and respiratory syncytial virus (RSV)

How to prevent URTIs (2 things)

frequently wash or disinfect hands | vaccine

2 URTI vaccines that were very effective in controlling disease

Haemophilus influenzae type B (Hib) vaccine | Pneumococcal vaccine