URTI Flashcards
the common cold
40-60% rhinovirus/coronavirus
15-20% influenza/parainfluenza
influenza
paramyxovirus
usually influenza A or B
neuraminidase inhibitors
oseltamivir
given to patients with severe flu in intensive care
amantidine
only covers influenza A
pharyngitis
at risk groups of streptococcil infections should have antibiotics
causes of pharyngitis
adenovirus, coronavirus, parainfluenza, influenza, RSV
common bacterial causes of pharyngitis
strep progenies
arcanobacterium haemolytic
uncommon bacterial causes of pharyngitis
mycoplasma pneumonia
rare bacterial causes of pharyngitis
corynebacterium diphtheriae
EBV
causes exudative pharyngitis/tonsilitis fever, sore throat cervical lymphadenopathy hepatosplenomegaly chronic
streptococcal pharyngitis
group A haemolytic strep
abrupt onset sore throat and fever
tender cervical/tonsillar lymph nodes
scarlet fever - turn red due to toxin and strawberry tongue
types of investigations
throat swab
serology
bloods
serology
detect antibodies
complications of GAS pharyngitis
otitis media sinusitis peritonsillar obsess bronchopneumonia meningitis rheumatic fever glomerulonephritis
quinsy
peritonsillar abscess
unusually unilateral
often with mixed anaerobes
surgical drainage often required
pharyngitis in indigenous people
penicillin for 10 days
notamoxycillin/ampicillin - cross reacts with EBV causing an allergic response
acute epiglottis
inflammation of the epiglottis
haemophilus influenza capsular type B Hib
rare disease with the advent of immunisation
acute epiglottis clinical presentation
children especially 2-4 years old common cold sudden onset high fever, sore throat bacteraemia at presentation, look toxic dysphagia prominent, often drool
visualising the larynx in acute epiglottis
will precipitate in sudden deterioration if a tongue depressor is used
support maintenance of airway and antibiotics
diphtheria
corynebacterium diphtheriae
bacterium adheres to mucosa, releases exotoxin
causes cell death - necrotic tissue forms a membrane - may cause obstruction
systemic - myocardial toxicity and neurotoxicity - fever, pallor, exhaustion, myocarditis, polyneuritis
diphtheria clinical presentation
bull neck
diphtheria treatment
antitoxin (raised in horses)
penicillin or erythromycin
family members given antibiotics and immunisation
despite therapy 2-3% death
croup
a clinical syndrome
fever, laryngitis, barking cough, inflammatory obstruction of subglottic area in contract to epiglottis
croup management
maintenance of airway fluid balance and rest steroids severe cases progress to respiratory failure intubation and mechanical ventilation
