URTI

Question 1

Viral rhinitis progression

Answer 1

1. Sore throat (mild)
2. Congestion
3. Rhinorrhea clear then opaque
   4.cough
   5.chills

Question 2

Viral rhinitis red flags

Answer 2

high breathing rate, dysphonia, confusion, SOB, dehydration, high fever >40.5, neck stiffness, severe throat pain

Question 3

Otitis media signs

Answer 3

fever 37.7
Pulling ear
previous URTI
Ear discharge

Question 4

Rhinosinusitis

Answer 4

-yellow/green purulent mucus
-no sore throat

Question 5

COVID

Answer 5

-SOB
-taste or smell disturbance

Question 6

Influenza

Answer 6

-Sudden fever
-dry cough
-muscle pain

Question 7

Croup

Answer 7

-Hoarseness
-dyspnea
-barking cough
-Sx worse at night
-Wheezing on breath in

Question 8

Pharyngitis

Answer 8

-sudden sore throat and headache
-pain on swallowing
-rare cough
-Check with centor score

Question 9

Centor score

Answer 9

-Fever +1
-Tonsillar exudate +1
-no cough +1
-neck lymph node swelling +1
-3-14yo +1
->44yo -1
above 2 strep likely and test

Question 10

Congestion treatments

Answer 10

<6: saline spray
>6 <12: oral antihistamines and oral decongestants
>12 topical decongestants F3D

Question 11

Cough red flags

Answer 11

SOB or wheezing, chest pain, hypoxic, confusion, high fever (40.5), vomiting

Question 12

cough duration

Answer 12

acute <3w
subacte 3-8w (post viral)
Chronic 8w

Question 13

URTI children

Answer 13

For cold only use saline and non pharm (humidifier, fluids)

Question 14

URTI elderly

Answer 14

Watch for medication interaction
Check for renal and hepatic function
more prone to side effects (anticholinergics)

Question 15

URTI pregnant

Answer 15

Brompheniramine, chlorpheniarmine and diphenhydramine are safe
Oral decongestants are teratogenic in 1st trimester (use topical only if very bad and not for long)
dextromethorphan for cough
Avoid all NPH except honey

Question 16

URTI breastfeeding

Answer 16

bropheniramine, chlorpheniramine, diphenhydramine are safe but watch for sedation in child
-Decongestants can decrease milk production
-Dextromethorphan is safe

Question 17

Fever red flags

Answer 17

<3m, stiff neck, chemotherapy, very ill and concerning parents (Straight to emerg)
<6m, high fever, confused, serious co morbidity, recent medical procedure, recent travel, new medication, uncooked meat/fish (these all go to urgent care or their doctor), >72h