Upper Respiratory Tract Pathology

Question 1

Fall pathogens

Answer 1

rhinovirus
parainfluenza virus
GAS
(same ones as spring)

Question 2

Winter pathogens

Answer 2

RSV
adenovirus
influenza virus

Question 3

spring pathogens

Answer 3

rhinovirus
parainfluenza virus
GAS
(same ones as fall)

Question 4

summer pathogens

Answer 4

adenovirus
bordetella pertussus
enterovirus

Question 5

what are the most common bacterial causes of paranasal sinusitis?

Answer 5

Streptococcus pneumoniae
nontypeable Haemophilus influenzae
Moraxella catarrhalis
(same as cause for otitis media)

Question 6

what are the most common viral causes of paranasal sinusitis?

Answer 6

adenovirus
influenza
parainfluenza
rhinovirus

Question 7

what happens on day 1-2 of the common cold?

Answer 7

throat irritation
sneezing
nasal stuffiness

Question 8

what happens on day 2-4 of the common cold?

Answer 8

rhinitis
watering eyes
sometimes hoarseness
cough

Question 9

what happens on day 5-7 of the common cold?

Answer 9

low grade fever (100.5-102)
chilliness
headache
myalgia

Question 10

for paranasal sinusitis, what will you find on the physical exam?

Answer 10

mucopurulent discharge
mucosa is erythematous
cervical LNs NOT tender/big
tenderness over sinuses

Question 11

what causes compression of the alveolar nerve?

Answer 11

paranasal sinusitis —> plugged up maxillary sinus –> cold 10+ days –> distended maxillary sinus presses on alveolar nerves —> teeth ache

Question 12

what are the complications of paranasal sinusitis?

Answer 12

orbital “swollen eye”
osteomyelitis
intracranial

Question 13

how long does pharyngitis last?

Answer 13

4-10 days

Question 14

what causes pharyngitis?

Answer 14

adenovirus
influenza
parainfluenza

Question 15

what does NOT cause pharyngitis?

Answer 15

rhinovirus

RSV

Question 16

what are the less likely causes of pharyngitis?

Answer 16

GAS
EBV
Enterovirus

Question 17

what causes otitis externa? Does it present with fever?

Answer 17

NO FEVER 
Pseudomonas aeruginosa (in tap water = swimming)
staphylococcus aureus (drug users, it's on the skin) 
GAS = group A streptococcus 

drug users clean syringes with tap water

Question 18

how do you treat otitis externa?

Answer 18

ear drops = acetic acid washes with a mixture against gram + rods

Question 19

what pathogens cause otitis media? Does it present with fever?

Answer 19

yes to fever 
Streptococcus pneumoniae 
Nontypeable Haemophilus influenzae 
Moraxella catarrahalis 
(same as cause for paranasal sinusitis)

Question 20

how do you define recurrent acute otitis media?

Answer 20

3 episodes in 6 months
OR
4 episodes in 12 months

Question 21

whats the most likely cause of epiglottitus/supraglottitis?

Answer 21

Haemophilus influenzae type b causes 90% of cases.

May also be caused by nontypeable H. influenzae or other bacteria

Question 22

what pathogens cause Croup? What does it look like on X-ray?

Answer 22

STEEPLE SIGN!! = SUBepiglottic edema 
viruses:
PARAINFLUENZA (think Puppy sound)
influenza
RSV
adenovirus

rapid onset in epidemic patterns like DAYCARE –> outbreaks

transmitted by respiratory droplets of hand –> mouth

Question 23

what are Sinonasal Papillomas (nasal polyp) associated with?

Answer 23

HPV 6 and 11

CF

Question 24

what markers do you use for olfactory neuroblastoma?

Answer 24

S100
neuron specific enolase
chromogranin
synaptophysin

Question 25

what are “rossets” associated with?

Answer 25

“smell the roses”

Olfactory Neuroblastoma

Question 26

who gets vocal cord polyps?

Answer 26

singers

smokers