Upper respiratory tract infections

Question 1

What organism are the most common cause of upper respiratory tract infection?

Answer 1

viral (rhinovirus, influenza virus, coronavirus, adenovirus, parainfluenza virus)

Question 2

Presentation of flu

Answer 2

• fever
• dry cough
• sore throat
• coryzal symptoms (inflammation of the mucus membranes of nasal cavities) - runny nose, sneezing, discharge, cough, sore throat
• headache
• general malaise, eye pain, conjunctivitis

Question 3

Diagnosis of influenza?

Answer 3

clinical diagnosis

can perform viral PCR on throat swab etc.

Question 4

treatment for influenza

prevention

Answer 4

uncomplicated: paracetamol, antivirals only if high risk (obese, pregnant, >65 or <6)
complicated: oseltamivir or zanamivir stops release of virus replicating and spreading but in reality only stops about 1 day of illness duration.

prevention: flu jab

Question 5

Common infective organism causing pharyngitis

treatment for pharyngitis?

Answer 5

viral usually - adenovirus or rhinovirus. other causes include EBV or acute HIV infection.
Treatment = amoxicillin

Question 6

What infective organism would you suspect if a patient presented with sore throat, low grade fever and had an adherent membrane on the tonsils, pharynx or nasal cavity and lymphadenopathy?

Answer 6

Corynebacterium diphtheria

Question 7

Treatment for diphtheria?

Answer 7

pre-formed antibodies to the toxin and erythromycin or clarythromycin

Question 8

If a patient presents with tonsillar exudate, fever over 38, absence of a cough and tender cervical lymphadenopathy, is the infection more likely to be caused by bacteria or a virus?

Answer 8

Bacterial (centor criteria)

Question 9

What infection is this patient likely to have with these symptoms?
- dull, constant aching over the frontal or maxillary sinuses with tenderness and postnasal drip. Pain is worse on bending over. Ethmoid of sphenoid sinus pain felt deep in the midline at the root of the nose. Pain can last 1-2weeks.

Answer 9

Sinusitis

Question 10

What are the most common infective organisms of sinusitis?

Answer 10

strep pneumoniae

haemophilus influenzae

Question 11

bordatella pertussis is the causative organism of what condition?

Answer 11

whooping cough

Question 12

Clinical features of whooping cough

Answer 12

Catarrhal phase 1-2 weeks with rhinorrhoea, conjunctivitis, low grade fever
Paroxysmal phase 1-6 weeks with coughing spasms, inspiratory whoop, post ptussive vomiting and cough >14days

Question 13

treatment for whooping cough?

Answer 13

antimicrobials such as clarithromycin to eliminate the carriage
chemoprophylaxis of household contacts
vaccination at 2,3,4 months and 3-4yrs old.