Upper Respiratory Tract Infections

Question 1

Most common viral URI

Answer 1

rhinovirus

Question 2

In chronic sinusitis (>30 days), you sometimes find ______ or _____.

Answer 2

S. aureus
alpha-hemolytic Strep
Anaerobes

Question 3

You typically treat sinusitis clinically. If you need a diagnosis (immunocompromised, life-threatening, or failure of therapy), what do you do?

Answer 3

Bacterial cultures

*CT is unreliable

Question 4

Child had sinusitis, how has frontal bone swelling, tenderness, headache, photophobia, fever. Can be very ill.

Answer 4

Potts Puffy Tumor

Question 5

Child with sinusitis develops headache then altered mental status. Bilateral ptosis, proptosis, opthalmoplegia, periorbital edema.

Answer 5

Septic cavernous sinus thrombosis

Question 6

Sinusitis organism: neutropenic

Answer 6

Fungal
Candidia
Aspergillus

Question 7

Sinusitis organism: diabetic (poorly controlled). Exam: black escar on nasal turbinate.

Answer 7

Mucormycosis: very dangerous. Grows backward to the brain

Question 8

Sexually abused teen with acute pharyngitis.

Answer 8

N. gonorrhea

Question 9

2 year old (or younger) with rhinitis, postnasal drainage, phyaryngitis, poor appetite, tender cervical LN, fever.

Answer 9

Streptococcocis

Fever can last up to 8 weeks

Question 10

Child wakes up with barky cough that is fine the next morning. The following night, barky cough with stridor.

Answer 10

Spasmodic croup

Question 11

How to treat spasmodic croup

Answer 11

You can try:
Albuterol (can be asthma variant)
Reflux (GERD can be big component)

Question 12

How can you tell a kid has a retropharyngeal abscess vs. epiglottitis?
i.e. They both have sore throat, fever, drooling, trismus

Answer 12

RPA: neck extended
Epiglottitis: tripod forward

Question 13

“Croup” that does not respond to rac epi. High fevers, brassy cough.
*Rapid deterioration

Answer 13

Bacterial tracheitis

Question 14

Bacterial tracheitis: pathogen

Answer 14

S. aureus