Upper respiratory tract infections Flashcards
What are the five most common causes of the common cold?
- Rhinovirus
- Coronavirus
- Influenza A + B
- Adenovirus
- Parainfluenza
–>REALLY important to distinguish these from GAS!
What’s the incubation period for the common cold?
2-3 days
How do you treat post-nasal drip?
intranasal ipratropium bromide or cromolyn sodium
What are the complications following a rhinovirus infection?
- Nasal symptoms
- Otitis media
- Post URI persistent cough
What are the Sx for Group A beta-hemolytic strep?
- abrupt onset
- prominent sore throat with pain on swallowing
- Systemic illness w/ fever/malaise
- Nasal congestion and cough
- Fever
- Bright red pharynx and tonsils
- tonsillar exudate
- enlarged cervical lymph nodes
The most important three PE findings with GAS:
- cervical lymphadenopathy
- tonsillar exudate
- T>100
What are the symptoms of mono?
- Fever/malaise
- Exudative pharyngitis/laryngitis
- Cervical adenopathy
- Splenomegaly
What are three causes of mono?
- EBV
- CMV
- HIV
What is special on microscopy of an EBV pharyngeal sample?
- atypical lymphocytes
What special serology would you see in mono?
Heterophile antibodies
Symptoms of acute bronchitits
- Cough for weeks
- May or may not have fevers/sputum
- Crackles and wheezes on exam
What bugs can cause acute bronchitis?
- mycoplasma pneumonia
- chlamydia pneumonia
- bordetella pertussis
How can you tell pneumonia versus bronchitis?
CXR is normal in bronchitis
Pneumonia has consolidation
–While bronchitis may or may not have sputum/fever, pneumonia will almost always have a strong, productive cough with high fever
How do you diagnose the different etiologies of bronchitis?
- IgM for mycoplasma pneumonia
2. PCR for pertusis and chlamydia pneumoniae
How do you treat bronchitis?
- Treat cough with dextromethaphan
- Use albuterol for wheezing
- Abx ONLY if pt tested positive for a bug (erythromycin)
What are the most common causes of bacterial sinusitis?
- Strep pneumo
2. H flu
What is a major predisposing factor for viral sinusitis?
acute bacterial sinusitis following viral sinusitis
What are the sx of bacterial sinusitis?
Headache and facial pain exacerbated by positional changes
What is the gold standard for diagnosing bacterial sinusitis?
aspiration and culture. In practice, this is not frequently used
How do you diagnose chronic sinusitis?
CT scan will show air fluid levels within the sinuses
What are the complications arising from untreated sinusitis?
Subdural empyema
- Pott’s tumor
- meningitis
If sphenoid sinus–>can have cavernus sinus thrombosis
How do you treat sinusitis?
Augmentin (amoxicillin+clavulanate)
Cefuroxine
PE findings in sinusitis
- purulent drainage
- Painful maxillary/frontal sinuses
- decreased transillumination
