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Yr 3 - Respiratory > Upper respiratory Tract Infections > Flashcards

Upper respiratory Tract Infections Flashcards

1
Q

What are the three features of rhinitis?

A

1) nasal discharge
2) a blockage occurring for more than an hour on most days
3) sneezing attacks

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2
Q

What is acute coryza?

A

common cold

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3
Q

What is the most common infectious agent behind the common cold?

A

rhinovirus

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4
Q

Other than rhinovirus, name two viruses that commonly cause the common cold?

A

1) coronavirus
2) adenovirus

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5
Q

What is the mode of transmission of the common cold?

A

direct contact and droplet

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6
Q

Give 5 clinical presentations associated with upper respiratory tract infections:

A

1) tiredness
2) slight pyrexia
3) sore nose and pharynx
4) sneezing
5) profuse watery nasal discharge followed by thick mucopurulent secretions

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7
Q

What is seasonal rhinitis?

A

hay fever - allergic, intermittent rhinitis

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8
Q

Give 5 clinical presentations associated with seasonal rhinitis:

A

1) nasal irritation
2) watery rhinorrhoea
3) itching of the eyes
4) itching of the soft palate
5) wheeze

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9
Q

Give 3 common seasonal allergens that cause seasonal rhinitis:

A

1) tree pollen
2) grass pollen
3) mould spores

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10
Q

What is perennial rhinitis?

A

persistent rhinitis experienced throughout the year

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11
Q

How does perennial rhinitis present?

A

1) long term nasal blockage
OR
2) long term sneezing and watery rhinorrhoea
+ patients may lose their sense of smell and taste

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12
Q

What is the most common cause of perennial allergic rhinitis?

A

faecal particles of the dust mite

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13
Q

What is vasomotor rhinitis?

A

non-allergic/ non-infectious rhinitis without eosinophilia caused by cold air, smoke, perfume or newsprints

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14
Q

Describe the appearance of nasal polyps:

A

round, smooth, soft, semi-translucent, pale or yellow glistening structures attached to the sinus mucosa by a narrow stalk or pedicle

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15
Q

In which two types of rhinitis would you find nasal polyps?

A

1) allergic rhinitis
2) vasomotor rhinitis

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16
Q

What three cells make up nasal polyps?

A

1) mast cells
2) eosinophils
3) mononuclear cells

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17
Q

Give 3 clinical presentations associated with nasal polyps:

A

1) nasal obstruction
2) loss of smell and taste
3) mouth breathing

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18
Q

What two methods can be used to check for allergies associated with rhinitis?

A

1) skin prick testing
2) allergen-specific IgE antibody tests

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19
Q

Give 6 ways in which rhinitis can be managed:

A

1) allergen avoidance
2) H1 antihistamines
3) decongestants
4) anti-inflammatory drugs
5) corticosteroids
6) leukotriene antagonists

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20
Q

Name two sedative antihistamines which are no longer used in practice:

A

1) chlorphenamine
2) hydroxyzine

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21
Q

Name two non-sedative antihistamines:

A

1) loratadine
2) cetirizine

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22
Q

Name two alpha adrenergic decongestants:

A

1) xylometazoline
2) oxymetazoline

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23
Q

Name two anti-inflammatory drugs used to treat rhinitis:

A

1) sodium cromoglicate
2) nedocromil sodium

24
Q

How do sodium cromoglicate and nedocromil sodium act as anti-inflammatory drugs for rhinitis?

A

they act by blocking intracellular Cl- channels influencing mast cell and eosinophil activation and nerve function

25
Q

What is the most effective treatment for rhinitis?

A

topical corticosteroid sprays

26
Q

Name 4 topical corticosteroid sprays used to treat rhinitis:

A

1) becolmetasone
2) fluticasone propionate
3) fluticasone furoate
4) mometasone furoate

27
Q

Give an example of a leukotriene antagonist used to treat rhinitis:

A

montelukast

28
Q

When would you consider prescribing a leukotriene antagonist for rhinitis?

A

when there is no response to antihistamines or topical steroids

29
Q

Is sinusitis typically caused by viruses or bacteria?

A

viruses

30
Q

What two bacteria are the leading causes of sinusitis?

A

1) Streptococcus pneumoniae
2) Haemophilus influenzae

31
Q

Give 4 symptoms associated with sinusitis:

A

1) frontal headache
2) purulent rhinorrhoea
3) facial pain and tenderness
4) fever

32
Q

Give 4 management techniques for bacterial sinusitis:

A

1) antibiotics (broad spectrum e.g. co-amoxiclav)
2) topical corticosteroid spray
3) steam inhalation
4) nasal decongestants

33
Q

How should chronic (>3 month) sinusitis be managed?

A

referral to ENT for CT of the sinuses

34
Q

What antibiotic is typically given for sinusitis?

A

Co-amoxiclav

35
Q

What infectious agent is the most common cause of pharyngitis?

A

adenoviruses

36
Q

Give three clinical presentations associated with pharyngitis:

A

1) sore throat
2) oropharynx and soft palate are reddened
3) inflamed and swollen tonsils

37
Q

Give the Centor Score point system:

A

1) absent cough - 1 point
2) exudate on tonsils - 1 point
3) tender cervical lymph nodes - 1 point
4) temp >38 degrees C - 1 point
5) age 3-14 - 1 point
(4-5 points indicates Strep throat infection - prescribe antibiotics)

38
Q

What antibiotic is typically prescribed for Strep throat/ bacterial pharyngitis?

A

phenoxymethylpenicillin

39
Q

What is acute laryngotracheobronchitis?

A

infection and inflammation of the larynx which may include the trachea and bronchi

40
Q

What two infectious agents typically cause acute laryngotracheobronchitis?

A

1) parainfluenza viruses
2) measles virus

41
Q

Give 4 presentations associated with acute laryngotracheobronchitis?

A

1) hoarse voice
2) barking cough
3) audible stridor
4) progressive airway obstruction

42
Q

Give 3 ways that acute laryngotracheobronchitis is managed?

A

1) nebulised adrenalin
2) oral or IM corticosteroids e.g. dexamethasone
3) oxygen and fluids

43
Q

What bacteria causes acute epiglottitis?

A

Haemophilus influenzae type B (Hib)

44
Q

In which patient demographic does acute epiglottitis occur?

A

children under 5 years of age (this is a life threatening emergency)

45
Q

Give two presentations associated with acute epiglottitis?

A

1) high fever
2) severe air flow obstruction

46
Q
A
47
Q

Give the two step management technique for severe acute epiglottitis:

A

1) urgent endotracheal intubation
2) IV ceftazidime antibiotics

48
Q

What vaccine is used to prevent acute epiglottitis?

A

Hib vaccine (given to infants)

49
Q

What type of virus is influenza?

A

Orthomyxovirus

50
Q

How long is the incubation period for influenza?

A

1-3 days

51
Q

Give 6 presentations associated with influenza:

A

1) fever
2) shivering
3) generalised aching of the limbs
4) severe headache
5) soreness of throat
6) cough that can persists for several weeks

52
Q

Why are antibiotics given to influenza patients with chronic bronchitis, cardiac or renal diseases?

A

to prevent secondary bacterial infection

53
Q

What two bacteria are the most common causes of secondary infection post-influenza?

A

1) Streptococcus pneumoniae
2) Haemophilus influenza

54
Q

Although lab testing is not required to diagnose influenza, what tests can be done for a definitive diagnosis? (2)

A

1) testing for a four fold increase in complement fixing antibody or haemagglutinin antibodies
OR
2) nasopharyngeal swabs

55
Q

How is influenza managed?

A

bed rest and paracetamol

56
Q

What antiviral drug may be given to influenza patients?

A

neuraminidase inhibitors such as oseltamivir (can help shorten the duration of symptoms in patients with influenza if given within 48 hours of the first symptom)

57
Q

Who is the flu jab offered to?

A

1) 65+ year olds
2) those with chronic disease
3) healthcare workers

Yr 3 - Respiratory (11 decks)

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