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Internal medicine > Upper respiratory tract infection and sneezing > Flashcards

Upper respiratory tract infection and sneezing Flashcards

1
Q

Upper respiratory tract is above the

A

vocal cords

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2
Q

The upper respiratory tract consists of

A

nose
paranasal sinuses
pharynx
larynx

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3
Q

functions of the upper respiratory tract:

A

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

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4
Q

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

A 
common cold (rhinosinusitis)
sinusitis
pharyngitis/tonsillitis
laryngitis
tracheobronchitis
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5
Q

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

A

1 - 3 days

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6
Q

the duration of URTIs symptoms is usually _ - _ days

A

7 - 10 days

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7
Q

URTIs usually occur during ___ months

A

cold

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8
Q

why do URTIs usually happen in winter?

A

cuz in cold weather ppl overcrowd inside buildings

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9
Q

mean frequency of URTIs in adults and in children

A

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

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10
Q

what causes repeated circulation of URTIs in the community?

A

antigenic variation of hundreds of respiratory viruses

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11
Q

name 3 ways URTI pathogens are transmitted

A

aerosol
droplet
direct contact

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12
Q

Sinusitis and acute bronchitis are often preceded by a

A

common cold

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13
Q

factors predisposing to URTIs

A 
allergic rhinoconjunctivitis
nasal septum deviation
immunodeficiency
cocaine abuse
smoking or second-hand smoke 
travel
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14
Q

how many viruses cause common cold?

A

200

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15
Q

definition of a common cold

A

a viral infection of the upper respiratory tract

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16
Q

Typical viral agents that cause URTIs:

A 
rhinoviruses
coronaviruses
adenoviruses
coxsackieviruses
influenza and parainfluenza viruses
human metapneumovirus
respiratory syncytial virus (RSV)
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17
Q

Bacteria that cause URTIs:

A

Group A, C and G streptococci -pharyngitis
Streptococcus pneumonia

Chlamydia
Neisseria gonorrhoeae

Corynebacterium diphtheriae
Bordetella pertussis or Bordetella Parapertussis

Mycoplasma
Haemophilus influenzae
Moraxella catarrhalis

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18
Q

Symptoms of URTIs

A 
sneezing
coughing
chills
cold
headache
backache
sore throat
snot (runny nose)
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19
Q

symptoms of common cold

A 
nasal congestion
mucopurulent nasal discharge
sneezing
sore throat
halitosis
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20
Q

signs of common cold

A

low-grade fever
nasal vocal tone
inflamed nasal mucosa

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21
Q

symptoms of sinusitis

A

unilateral facial pain
maxillary toothache
headache
purulent nasal discharge

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22
Q

signs of sinusitis

A

swelling, redness, and tenderness over the affected sinus

abnormal transillumination

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23
Q

symptoms of pharyngitis

A 
sore throat
odynophagia or dysphagia
fever
no cough
halitosis
24
Q

signs of pharyngitis

A 
pharygneal erythema & exudate
palatal petechiae (donut lesions)
tender anterior cervical lymphadenopathy
scarlatiniform rash
herpangina
tonsillar hypertrophy
25
Q

symptoms of laryngitis

A 
hoarsness
voiselessness
dry cough
odynophagia or dysphagia
halitosis
26
Q

signs of laryngitis

A

low-grade fever
cervical lymphadenopathy
inspiratory stridor
tachypnoea

27
Q

URTIs can progress to

A 
otitis media
bronchitis
bronchiolitis
pneumonia
sepsis
meningitis
intracranial abscess         ....and other infections
28
Q

complications of untreated group A streptococcal pharyngitis

A

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

29
Q

complications of sinusitis

A

orbital cellulitis
subperiosteeal abscess
orbital abscess
frontal & maxillary osteomyelitis

30
Q

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

A 
influenza
corona
group A streptococcal pharyngitis
infectious mononucleosis
pertussis
pneumonia
31
Q

diagnostic investigation for influenza:

A

pharyngeal swab for PCR

32
Q

diagnostic investigation for coronavirus:

A

nasal and pharyngeal swab for PCR

33
Q

diagnostic investigation for group A streptococcal pharyngitis:

A

pharyngeal swab for rapid antigen detection test

34
Q

diagnostic investigation for mononucleosis:

A

mononucleosis spot test in blood

35
Q

additional symptoms of mononucleosis

A

hepatosplenomegaly

lymphocytosis

36
Q

diagnostic investigation for pertussis:

A

nasopharyngeal swab for serology or PCR

37
Q

DDx for URTIs

A 
influenza
allergic rhinoconjunctivits
acute thyroiditis
Gastro-oesophageal reflux
Granulomatosis with polyangiitis
Asthma
38
Q

The definition of influenza-like illness is

A

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

39
Q

allergic rhinoconjunctivitis is characterised by

A

edema of conjunctiva
itchy eye
increased lacrimation
symptoms of rhinitis

40
Q

Acute thyroiditis can present as sore throat

how do u check if sore throat is cuz of thyroid or URTI?

A

thyroid hormone & thryoid autoantibody test

US and radioactive iodine uptake

41
Q

GERD can clinically present as which 2 URTIs?

A

laryngopharyngitis and/or tracheobronchitis

42
Q

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

A

EGD

43
Q

Granulomatosis with polyangiitis should be considered in who?

A

patients with sinusitis not responding to therapy

44
Q

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

A

Granulomatosis with polyangiitis

45
Q

how to differentiate between granulomatosis with polyangiitis and sinusitis?

A

Classic antineutrophil cytoplasmic antibodies and biopsy are key to diagnosis.

46
Q

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

A

asthma

47
Q

URTI treatment

A

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)
48
Q

URTI indications for antibiotic treatment

A

Group A streptococcal pharyngitis
Bacterial sinusitis
Pertussis

49
Q

group A streptococcal pharyngitis antibiotic treatment:

A

oral penicillin or macrolide for 10 days

50
Q

how do u know a sinusitis is bacterial not viral?

A

when it doesn’t resolve within 7 days

51
Q

bacterial sinusitis antibiotic treatment:

A

aminopenicillin +/- a β-lactamase inhibitor
2nd/3rd generation cephalosporins
macrolides
trimethoprim-sulfamethoxazole

for 7–10 days

52
Q

pertussis antibiotic treatment:

A

macrolides
erythromycin
trimethoprim-sulfamethoxazole
doxycyclin

for 7 days

53
Q

2 most prevalent respiratory pathogens

A

rhinoviruse and respiratory syncytial virus (RSV)

54
Q

How to prevent URTIs (2 things)

A

frequently wash or disinfect hands

vaccine

55
Q

2 URTI vaccines that were very effective in controlling disease

A

Haemophilus influenzae type B (Hib) vaccine

Pneumococcal vaccine

Internal medicine (7 decks)

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