Upper Respiratory Tract Infections Flashcards
What is coryza?
The common cold.
An acute self-limiting, viral inflammation of the mucosa in the upper respiratory tract.
What viruses are respnsible for the cold?
Rhinovirus (most common)
Coronavirus
Respiratory syncytial virus (RSV)
How is coryza diagnosed?
It is a clinical diagnosis.
What is croup?
A childhood illness caused by inflammation in the upper respiratory tract.
What is the most common cause of croup?
parainfluenza virus I.
It can also be caused by other strains of parainfluenza virus, RSV, and adenovirus.
When is croup most common?
The second year of life.
What is responsible fo the characteristic cough in croup?
Impaired movement of the vocal cords.
How does croup present?
Starts with nonspecific symptoms - rhinorrhoea, sore throat, fever and cough.
Escalates to barking cough, hoarseness and stridor - tends to be worse at night.
How is croup treated?
Mild cases can be managed at home.
If more severe, hospitalisation is needed - give dexamethasone and oxygen as required.
What is diphtheria?
A life-threatening condition caused by bacterial toxins.
Presents with a characteristic pseudo-membrane at the back of the throat.
It is not seen in the UK due to vaccinations.
What is epiglottitis?
Inflammation of the epiglottis and superior larynx.
What organisms are most commonly responsible for epiglottitis?
Streptococcus (most common)
Staphylococcus aureus
Pseudomonas
What is the gold standard investigation for epiglottitis?
Laryngoscopy - only carried out in operating theatres.
How is epiglottitis treated?
Ceftriaxone
What are symptoms of epiglottitis?
Sore throat
Odynophagia
Inability to swallow secretions (often presents with drooling).
Muffled voice
Fever
Is tonsillitis most commonly viral or bacterial?
Viral
Causes include EBV, rhinovirus, influenza, parainfluenza, enterovirus or adenovirus.
What is the most common bacterial cause of tonsillitis?
Streptococcus pyogenes (group A)
What scoring systems are used in tonsillitis?
Centor
FeverPAIN
What is the criteria for FeverPAIN?
Fever
Purulence
Attend rapidly (within 3 days)
Inflamed tonsils
No cough
What is a late complication of streptococcus pyogenes tonsillitis?
Rheumatic fever - symptoms include fever, arthritis and pancarditis.
Often weeks after sore throat will be observed.
What is rhinitis?
Inflammation of the nasal mucosa.
What are the three main groupings of rhinitis?
Allergic
Non-allergic
Mixed
What is the pathology related to allergic rhinitis?
Allergen inhalation increases levels of specific IgE levels within the blood.
These bind to receptors on the surface of mast cells and basophils. Upon re-exposure to the allergen, there will be degranulation from the mast cells and basophils, producing an inflammatory response.
Results in acute rhinorrhoea, itching and sneezing. The recruitment of lymphocytes and eosinophils causes a delayed response.
What is an example of a non-allergic cause of rhinitis?
Viral infection
What causes sinusitis?
Blockage of the sinuses, may be the common cold, resulting in bacterial overgrowth.
What is stridor?
An inspiratory wheeze caused by a large airway obstruction.
What causes stridor in children?
Most are due to croup, or epiglottitis - infectious aetiology.
Can also be the result of a foreign body.
What causes stridor in adults?
Most commonly due to tumours.
Why is laryngoscopy dangerous to perform in epiglottitis?
Can cause further inflammation of the airway - may lead to cardiac arrest.
Only perform if anesthetic delivered.
How is stridor treated in an emergency?
Cricothyroidotomy/Tracheostomy
