Upper Respiratory Tract Infections (URTI)

Question 1

Respiratory differences in children - AIRWAY

Answer 1

• Smaller diameter
• Shorter length
• Tongue relatively larger in the oropharynx
• Smaller mandible
• Floppy soft palate
• Epiglottis is relatively long, floppy, and narrow
• Infraglottic at cricoid cartilage = narrowest portion of the airway.
• Obligate nasal breathers until 5 months old (mucus blockage)
• Short neck, large head (occiput)
• Trachea is soft and short

Question 2

Respiratory differences in children - BREATHING

Answer 2

• Low O2 reserve
• High O2 consumption (higher metabolic requirement)
• Compliant chest wall
• Horizontal ribs
• Weak respiratory muscles
  i. Immature musculature
  ii. Easy fatigability of the diaphragm

Question 3

Viruses that cause the COMMON COLD

Answer 3

Parainfluenza, influenza, adenovirus, RSV & enterovirus.

Question 4

Bacteria that causes the COMMON COLD

Answer 4

• Streptococcus pneumonia
• Haemophilus influenzae
• Staphylococcus aureus
• Moraxella catarrhhalis
• Streptococcus spp
• Anaerobes

Question 5

COMMON COLD - Symptoms

Answer 5

• Usually no fever (especially in adults)
• Nasal congestion, sneezing, headache.
• Rhinorrhea (clear nasal discharge) gradually progressive
• General body aches, teary eyes, sore throat, anosmia (loss of smell), ageusia (loss sense of taste), anorexia.

Question 6

COMMON COLD - Epidemiology

Answer 6

< 5 yrs old = 5-7 colds/year

Adults < 2 colds/year

Spread by person to person = hand to hand contact.

Question 7

Viruses that cause PHARYNGITIS

Answer 7

Epstein-Barr virus (EBV)
Adenovirus
Influenza A & B
Coxsackie A
Parainfluenza

Question 8

Bacteria that causes PHARYNGITIS

Answer 8

• Streptococcus pyogenes
• Corynebacterium diphtheriae
• Neisseria gonorrhea
• Streptococcus spp

Question 9

Complications of Common cold

Answer 9

Rhinosinusitis
Pharyngitis
Acute Otitis Media
Pneumonia
Urinary tract infections

Question 10

At risk populations

Answer 10

• Neonates/infants
• Elderly
• Chronic illness
• Immunocompromised

Question 11

Pharyngitis can occur as part of ________.

Answer 11

common cold

Question 12

Symptoms of Pharyngitis

Answer 12

• Sore throat
• Fever >38
• Dysphagia
• Headache
• Fatigue
• Muscle pain
• Nausea
• Vomiting

Question 13

Signs of Pharyngitis

Answer 13

• Tender (anterior) cervical lymphadenopathy
• Tonsillar hyperemia/exudates
• Soft palate petechia
• Absence of:
  coughing, nose drip & hoarseness.

Question 14

What is petechia?

Answer 14

Pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechia to appear red, brown or purple.

Question 15

Streptococcus pyogenes spreads by?

Answer 15

Close contact & through air.

Question 16

Streptococcus is most: common among?

frequent among?

Answer 16

5-15 age group

lower socio-economic classes

Question 17

What is the incubation period for S.pyogenes?

Answer 17

2-4 days

Question 18

What happens when S.pyogenes is left untreated?

Answer 18

Can develop to Suppurative & Non-suppurative complications.

Question 19

Define Suppurative complications

Answer 19

Complications with pus formation.

Question 20

Define Non-suppurative complications

Answer 20

Complications that lack or doesn’t involve pus formation.

Question 21

Name 3 Suppurative complications

Answer 21

1. Peritonsillar abscess
2. Cervical lymphadenitis
3. Mastoiditis

Question 22

Name 2 Non-suppurative complications

Answer 22

1. Acute glomerulonephritis

2. Rheumatic fever