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CR2 > Upper Respiratory Tract Infections > Flashcards

Upper Respiratory Tract Infections Flashcards

1
Q

What is the most common cause of URTIs

A

Viruses

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2
Q

What are the most common type of common cold

A

Rhinoviruses

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3
Q

How are rhinoviruses transmitted

A

Inhaling droplets from sick people sneezing, coughing, or blowing nose
Touching contaminated surface then eyes nose or mouth

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4
Q

How long is the usual incubation time for a rhinovirus

A

1-5 days

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5
Q

How do viruses act on upper respiratory tract cells

A

Bind -> release genetic material into cell -> genetic material replication and protein transcription -> packaging into viruses -> new viruses released

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6
Q

Rhinorrhea

A

Excess mucus filling nasal cavity

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7
Q

What is nasopharyngitis usually referred to as

A

Common cold

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8
Q

2 main common cold symptoms

A

Rhinorrhea
Nasal obstruction

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9
Q

Which receptors on airway epithelial cells recognise human rhinovirus and respiratory syncytial virus

A

Toll like receptors
Retinoic acid inducable gene-1-like receptors

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10
Q

What do airway epithelial cells do when human rhinovirus infection or respiratory syncytial virus binds

A

Release pro inflammatory mediators causing recruitment + activation of inflam and immune cells and immune respinse

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11
Q

How do URTIs cause Rhinorrhea and nasal obstruction

A

Neutrophilic inflammation increases vascular permeability and mucus hypersecretion

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12
Q

How do viruses impede immune recognition

A

High glycosylation
Structural variability of surface G protein
Release of soluble G protein ‘decoy’

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13
Q

How does release of soluble G proteins from viruses impede immune recognition

A

Virus specific antibodies bind to released G proteins instead of virus

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14
Q

Why are asthma patients more susceptible to HRV infection

A

Incr cytokines release
Incr intracellular adhesion molecule

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15
Q

What do viral infections commonly cause in asthma and COPD patients

A

Exacerbations

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16
Q

What do frequent acute exacerbations of COPD lead to

A

Worsening symptoms
Increased disease progression
Increased hospitalisation
Increased airway inflammation
Worsening hyperinflation
Lung function decline
Death

17
Q

How is virus infection risk decreased

A

Wash hands
A valid touching face
Disposable tissues
Hand sanitiser
PPE

18
Q

How long does nasopharyngitis last, and how long is it symptomatic

A

Lasts up to 2wks
Symptomatic 7-11 days

19
Q

How can nasopharyngitis be treated

A

Nasal/systemic steroids
Nasal irrigation
Antibiotics
Decongestants
Mucolytics

20
Q

How do decongestants work

A

Cause vasoconstriction in blood vessels around nasal sinuses

21
Q

What is the mechanism of decongestants

A

Alpha 1 adrenoreceptor agonists

22
Q

Which features are involved in FeverPAIN score

A

Fever
Purulence
Attend within 3 days or less
Severely inflamed tonsils
No cough or coryza

23
Q

What characteristics are involved in Centor score

A

Tinsilkar exudate
Tender anterior cervical lymphadenopathy or lymphadenitis
History of fever
No cough

24
Q

What are the 2 scored sore throat assessments

A

FeverPAIN score
Centor score

25
Q

What is a backup antibiotic prescription

A

Patient given slip to get antibiotics only if needed / symptoms not improved in certain timeframe

26
Q

What FeverPAIN score should a backup antibiotic be considered, but not an immediate antibiotic

A

2 or 3

27
Q

What FeverPAIN or Centor scores should an immediate or backup antibiotic prescription be considered

A

FeverPAIN 4/5
Centor 3/4

28
Q

When should a URTI patient be given an immediate antibiotic prescription

A

Systemically very unwell
Symptoms and signs of more serious condition
High risk of complications

29
Q

First choice antibiotic for sore throat

A

Phenoxymethylpenicillin

30
Q

Which antibiotics could be given to a sore throat patient with a penicillin allergy

A

Clarithromycin
Erythromycin

31
Q

What condition is known as the common cold

A

Nasopharyngitis

32
Q

What do HRV and RSV cause

A

Nasopharyngitis

CR2 (33 decks)

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