Upper Respiratory Tract Infections

Question 1

What is rhinitis?

Answer 1

Inflammation of the mucous membrane in the nasal cavity

Rhinitis can be classified into Allergic Rhinitis (AR) and Non-Allergic Rhinitis (NAR)

Question 2

Which type of rhinitis is more common in females?

Answer 2

Non-allergic rhinitis

Question 3

What causes allergic rhinitis?

Answer 3

Type 1 hypersensitivity reaction to inhaled allergen, igE-mediated mast cell degranulation

This reaction causes histamines to sensitize receptors that stimulate pruritus, sneezing, and increased secretions.

Question 4

What is the main pathophysiological difference between allergic and non-allergic rhinitis?

Answer 4

AR is igE-mediated, while NAR involves upregulation of the parasympathetic nervous system causing nasal mucosa hyperactivity.

Question 5

List some common causes of non-allergic rhinitis.

Answer 5

• Infectious * Hormonal * Occupational * Drug-induced

Question 6

What is the most common viral infection that causes rhinitis?

Answer 6

Rhinovirus

Question 7

What are common presentations of rhinitis?

Answer 7

• Sneezing * Nasal congestion * Reduced sense of smell * Rhinorrhoea * Pruritic nose

Question 8

What is sinusitis?

Answer 8

Inflammation and swelling of the mucous membranes lining the paranasal sinuses.

Question 9

What is the typical age of onset for sinusitis?

Answer 9

Ranges from 45-75 years old

Question 10

What is rhinosinusitis?

Answer 10

Sinusitis that almost always occurs with rhinitis.

Question 11

What are the common causes of acute sinusitis?

Answer 11

• Bacterial infections (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) * Viral infections (rhinovirus, influenza, parainfluenza virus)

Question 12

What distinguishes chronic sinusitis from acute sinusitis?

Answer 12

Chronic sinusitis lasts over 12 weeks.

Question 13

What are common symptoms of sinusitis?

Answer 13

• Headaches * Facial tightness * Pressure * Pain * Nasal congestion * Decreased sense of smell

Question 14

What is acute epiglottitis?

Answer 14

Life-threatening inflammation and swelling of the epiglottis.

Question 15

What are common causes of acute epiglottitis?

Answer 15

• Viral infections * Bacterial infections (post-influenza staph infection, Haemophilus influenzae type b)

Question 16

What are respiratory distress symptoms associated with acute epiglottitis?

Answer 16

• Cyanotic lips * Tripod position * Inspiratory stridor * Intercostal retractions * Fever * Tachypnea

Question 17

What is a characteristic symptom of epiglottal swelling?

Answer 17

Drooling

Question 18

Fill in the blank: The most common symptoms of sinusitis are _______.

Answer 18

[headaches, facial tightness, pressure, pain]

Question 19

What is pharyngitis?

Answer 19

Inflammation and swelling of the pharynx (tube in neck that starts at back of nose and enters oesophagus).

Often coexists with tonsillitis.

Question 20

When does pharyngitis peak in incidence?

Answer 20

Peak incidence occurs in childhood and adolescence, particularly in winter and early spring.

Question 21

What are common causes of pharyngitis?

Answer 21

Commonly due to viral infections (e.g., adenovirus, enterovirus, influenza, rhinovirus, RSV, mono) and bacterial infections (e.g., Group A strep, haemophilus influenza b).

Question 22

What are the symptoms of pharyngitis?

Answer 22

Sudden onset of sore throat, marked pain when swallowing.

Viral cause: conjunctivitis, cough, diarrhoea; Bacterial cause: fever, headache, enlarged cervical nodes.

Question 23

What is laryngitis?

Answer 23

Inflammation and swelling of the larynx.

Question 24

What are the common causes of laryngitis?

Answer 24

Almost always due to viral infections (e.g., rhinovirus, adenovirus, influenza) but can be due to bacterial infections (e.g., haemophilus influenzae, streptococcus).

Question 25

What are the symptoms of laryngitis?

Answer 25

Most common symptoms are hoarse throat and voice deepening.

Question 26

What is otitis media?

Answer 26

Inflammation and swelling of the middle ear.

Question 27

When does otitis media peak in incidence?

Answer 27

Peak incidence occurs in autumn, winter, and early spring, most prevalent in young children.

Question 28

What are common causes of otitis media?

Answer 28

Almost always due to viral infections (e.g., rhinovirus, adenovirus, influenza) but can be due to bacterial infections (e.g., haemophilus influenzae, streptococcus).

Question 29

What are the symptoms of otitis media?

Answer 29

Slight to severe discomfort (otalgia), hearing loss due to fluid in middle ear, systemic symptoms, imbalance, fluid draining.

Question 30

What are the investigations for upper respiratory tract (URT) conditions?

Answer 30

History, clinical features, physical examinations, cultures from throat, pleural fluid, blood, sputum, PCR for antigen detection, serology, radiological imaging (e.g., HRCT), histopathology.

Question 31

What is the management strategy for URT conditions?

Answer 31

Usually self-limiting; treat with no antibiotic prescribing strategy or delayed antibiotic prescribing strategy if systemic unwellness develops.