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IDMM > Upper RTI > Flashcards

Upper RTI Flashcards

1
Q

Acute Otitis Media

  • who gets it
  • risk factors
A
  • common in infancy (6-18 mo). More boys than girls

- age, family Hx, day care, lack of breastfeeding, tobacco smoke/air pollution, pacifier use

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2
Q

Acute Otitis media

-etiology

A
  • 2/3 combined viral/bacterial
  • Bacterial: S. pnuemoniae, H. influenzae, M. cattarhalis
  • Viral: RSV, rhinovirus, picoronaviruses, coronaviruses, influenza virus, adenovirus, human metapneumovirus
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3
Q

Acute otitis media

-pathophysiology

A
  • antecedent viral URTI closes the eustachian tube with inflammation
  • middle ear secretions build up
  • bacteria gain access to middle ear and grow in secretions
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4
Q

Acute otitis media

-S/S in infants and children

A
  • Infants: nonspecific, maybe fever

- children: otalgia, bulging tympanic membrane, otorrhea

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5
Q

Acute otitis media

-management

A
  • many resolve spontaneously (organism-dependant)
  • Usually watchful waiting
  • Treat if <6 months, perforated ear drum, day care, previous Ab in last 3 months, unlikely to return
  • Amoxicillin (want to cover S. pneumoniae)
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6
Q

Acute otitis media

-how long do children have effusions

A

50% of children have them at 1 month (do not treat) only 10% have them at 3 months

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7
Q

Acute sinusitis

  • epidemiology
  • Risk factors
A
  • adults and children, but women more frequent than men

- dental infection, allergies, swimming, obstruction of nose

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8
Q

Acute sinusitis

-etiology

A
  • Viral 200x more common (rhinovirus, influenza virus, parainfluenza virus
  • Bacterial: S. pneumoniae, H. influenzae, M. cattarhalis, anaerobes associated with dental disease
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9
Q

Acute sinusitis

-pathophysiology

A
  • common cold spreads to paranasal sinuses (systemic or direct)
  • secondary spread of bacteria into nasal cavities
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10
Q

Acute sinusitis

-S/S

A
  • purulent rhinorhea
  • nasal congestion
  • Cannot differentiate viral vs. bacterial, but bacterial more likely if:

-URTI persist for >10 days, or worsen after 5-7 days AND (above symptoms +pain OR fever and pain)

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11
Q

Acute sinusitis

-Management

A
  • No Ab (even for bacterial sinusitis), no topical steroid
  • Analgesics
  • Saline irrigation
  • Steam inhalation
  • Decongestants

-If must use Ab, use Amoxil

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12
Q

Croup

-epidemiology (demographics, season, time of day)

A
  • 6-36 months, rare beyond 6 y.o
  • more common in boys
  • more common in the fall/winter
  • more common in late evening/early morning
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13
Q

Croup

-Etiology

A
  • Parainfluenza virus type 1 (50%)
  • RSV
  • Adenovirus
  • Coronavirus
  • Influenza
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14
Q

Croup

-Pathophysiology

A
  • Virus invades respiratory epithelium
  • Inflammation of trachea and larynx
  • Narrowing trachea –> barking cough
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15
Q

Croup

-S/S

A

-inspiratory stridor, barking cough, sudden onset and rapid progression

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16
Q

Croup

-management

A
  • no Ab
  • systemic or nebulized steroids
  • no sedation– have to be awake to breath
17
Q

Pertussis

-epidemiology (transmission, frequency of outbreaks)

A
  • cyclic epidemics q2-5 yrs
  • highly contagious
  • respiratory droplet or direct contact
  • adults are a reservoir for transmission
18
Q

Pertussis

-etiology

A

Bordetella pertussis

19
Q

Pertussis

-pathophysiology

A

-various toxins and interference of host-defence (e.g. lives in macrophages)

20
Q

Pertussis

  • S/S
  • typical course
A

-paroxysmal cough, inspiratpry whoop, post-tussive emesis

1) cattarhal phase (runny nose, fever) (1-2 wks, v. contagious)
2) paroxysmal phase (3-6 wks)
3) convalescent phase ( >6 wks)

21
Q

Pertussis

-diagnosis

A
  • nasopharyngeal swab–> culture and PCR

- clinical signs

22
Q

Pertussis

-management

A
  • macrolides or TMP-SMX

- give longer if infant, pregnant woman, health care worker, childcare worker

23
Q

Common cold

-epidemiology (who gets it, what season, transmission, infectivity)

A
  • mostly children
  • year round (mostly winter)
  • hands +++, droplets +
  • incubation: 24/72h
  • Infectivity: peaks with symptoms, shedding continues ~3wks
24
Q

Common cold

-etiology

A 
ALL VIRAL
rhinovirus
influenzavirus
adenovirus
enterovirus
coronavirus
RSV
Parainfluenza virus
human metapnuemovirus
25
Q

Common cold

-pathophysiology

A

virus attaches to conjunctival and nasal mucosa and replicates causing inflammation

26
Q

Common cold

-diagnosis

A

-rhinorhea, sneezing/congestion, low-grade fever, cough

27
Q

Common cold management

A
  • HANDWASHING
  • Saline irrigation
  • Steam inhalation
  • Decongestants
  • No antibiotics
28
Q

Pharyngitis

-epidemiology (who gets it, when)

A
  • school aged kids

- winter/spring

29
Q

Pharyngitis

-etiology

A

-80-90% viral

adenovirus
RSV
parainfluenzae virus
rhinovirus
influenza virus
coxsackie virus
echovirus
HSV
EBV

-10-20% virus

GAS, GCS, GGS
N. gonorrhea
C. diptheriae
Fusobacterium necrophorium
arcanobacterium hemolyticum
30
Q

Pharygitis

-pathophysiology

A

GAS resists phagocytosis

31
Q

Pharyngitis

-S/S of viral vs. bacterial

A

Viral:

Rhinorhea
cough
conjunctivitis
rash
diarrhea

Bacterial

F: fever
A: adenopathy
C: absence of cough
E: exudate on tonsils

32
Q

Pharyngitis

-Daignosis

A
  • Only swab or do RADT on those that don’t appear to be viral
33
Q

Pharyngitis

-Management

A

-Viral: analgesic, antipyretic. NO antispetic or antibiotic

Bacterial: Penicillin (want to prevent rheumatic fever)

34
Q

Signs of infectious mononucleosis

A

Fever, LAD, pharyngitis

35
Q

Two most common causes of mono

A

CMV and EBV

IDMM (33 decks)

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