Upper Respiratory Tract Infections COPY Flashcards
How do you differentiate between a cold and something more serious in a child?
Reassure the parents and tell them to seek medical advice if the child becomes ‘unwell’
Where does the URT boundary lie?
Level of the larynx
What are some infections of the URT?
- Rhinitis
- Otitis media
- Pharyngitis
- Laryngitis
- Epiglottitis
- Croup
What are examples of viral infective agents?
- Adenovirus
- Influenza A, B
- Para’flu I, II
- RSV
- Rhinovirus
What are examples of bacterial infective agents?
- H influenza
- M catarrhalis
- Mycoplasma
- Staph. aureus
- Streptococci (S. Pyogenes, S. pneumoniae)
How do URTI’s usually start?
With a sore throat and runny nose
How do you know if the child is going to get worse, is at their worst or past their worst?
You can’t know all you can do is ask their parents to review them
What is rhinitis a prodrome to?
- Pneumonia
- Bronchiolitis
- Meningitis
- Septicaemia
What is the treatment for the common cold?
Time, clear fluids and not wasting money on ‘remedies’
Describe the appearance of otitis media?
Erythema
Bulging drum
How can otitis media occur?
- As a primary viral infection
- As a secondary infection with pneumococcus/ H’flu
Why is it advisable to not treat otitis media with antibiotics?
- Often the main symptom is pain and that can be treated with analgesics
- Antibiotics would take effect from day 2/3 after the worst of the symptoms
- Studies show that a large proportion of those who took antibiotics suffered from side effects
- The benefits do not outweigh the negatives
- First do no harm
What are common side effects of the antibiotics sometimes used in otitis media?
- Diarrhoea
- Nappy rash
How long does the earache associated with otitis media usually last?
Usually up to 8 days
What are the benefits of delaying treatment for otitis media?
- Fewer patients are treated unnecessarily saving money and decreasing risk of antibiotic resistance
- Fewer people experience side effects
What is definite about treatment for otitis media?
- Analgesia works
- Antibiotics may work after 24 hours but they are not advised
- The illness resolves within a short period of time
What is the main symptom of tonsillitis/pharyngitis?
Sore throat
What should not be given to treat tonsillitis?
Amoxycillin
How can bacterial and viral tonsillitis be differentiated?
The only way is for a throat swab to be sent to the lab and cultured to see if bacterial colonies grow. Culturing takes 48 hours
What is the dilemma surrounding whether to treat tonsillitis with antibiotics or not?
Culturing takes 48 hours to show if it is bacterial and will respond to antibiotics. However within this time the infection will start to improve by itself
What is another name for croup?
Laryntracheobronchitis
What causes croup?
Para’flu I
How does the child appear with croup?
Well
What are the characteristic symptoms of croup?
- Coryza
- Stridor
- Hoarse voice
- Barking cough
How to you treat croup?
Oral dexamethasone
What cause epiglottitis ?
H innfluenzae Type B
How does the child appear with epiglottitis?
Toxic and very unwell
What are the characteristic symptoms of epiglottitis?
- Stridor
- Drooling
What is the most concerning symptom of croup?
Stridor
What is the treatment for epiglottitis?
Intubation and antibiotics
What is the dilemma between diagnosis of croup/ epiglottitis?
- You need to get it right
- Epiglottitis is the differential diagnosis for croup
- However, epiglottitis is extremely serious as it can block the airways
What are the majority of URTIs caused by?
Pathogens
What is normally not useful in the treatment of URTIs?
Antibiotics
What are most URTIs?
Self-limiting
