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3C - Respiratory > URTI > Flashcards

URTI Flashcards

1
Q

Define URTI

A

Infections of the upper respiratory tract (URTIs) include; sinusitis, pharyngitis, epiglottitis, laryngitis and acute bronchitis.

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2
Q

URTI Complicaitons

A
  • Pneumonia
    • Exacerbation of COPD
    • Higher CV death rate
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3
Q

Common Cold Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Aka rhinitis/ rhinosinusitis

Cause

  • Viral
  • Rhinovirus
  • Parainfluenza
  • RSV
  • Coronavirus
    (0. 5-2% of viral infections are complicated by bacterial infections)

Clinical Presentation

  • Sneezing
  • Nasal blockage
  • Nasal discharge

Investigations
- None

Management

  • Rest, fluids and prevention of spread
  • Consider
  • – NSAIDs or paracetamol (pain or fever)
  • – Antihistamines (nasal congestion)

Prognosis
- Remits in days

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4
Q

Pharyngitis Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause
-Viral
-Strep pyogenes
(rare, but more common in indigenous)

Clinical Presentation

  • Fever
  • Sore throat
  • S.pyogenes has
  • > 38 fever
  • tender cervical lymphadenopathy
  • tonsilar exudate
  • no cough

Investigations
-Throat swab

Management
-NSAIDs or paracetamol

  • If Strep pyogenes (Group A)
  • Phenoxymethylpenicillin

-ABs shorten the illness by less than one day and reduce otitis media risk

Prognosis
-Remits in 1 week if viral

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5
Q

Severe pharyngitis Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause

  • Infective Mononucleosis
  • Epstein-Barr Virus

Clinical Presentation

  • Prodrome of malaise, anorexia
  • Fever
  • Tonsillar exudate
  • Lymphadenopathy
  • Pharyngitis
  • +/- hepatosplenomegaly, rash (amoxycillin)
  • Infant: mild symptoms

Investigations

  • Serological testing
  • Heterophile test

Management

  • NSAIDs or paracetamol
  • Corticosteroids (parenteral)
  • Avoid contact sports

Prognosis
-Resolves 2-3 weeks

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6
Q

Laryngitis (adults) Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause

  • Viral
  • Pneumococci or
  • H. influenzae (uncommon)Fever
  • Hoarse voice

Investigations
-Throat swab

Management

  • Viral
  • – as per common cold
  • Pneumococci
  • – Benpen then amoxycillin
  • H. influenza
  • – BenPen or amoxycillin

Prognosis
-Remits in 1 week

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7
Q

Epiglotitis (children) Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause

  • H. influenzae
  • Pneumococci (rare)

Clinical Presentation

  • Fever
  • Hoarse voice
  • Stridor
  • Barking cough (due to upper airway obstruction)

Investigations

  • Throat swab
  • Blood cultures
  • Lateral neck XR

Management

  • Ceftriaxone
  • PLUS
  • Dexamethasone
  • Intubation (if severe)
  • Prevention of HiB with vaccine

Prognosis

  • Slow improvement
  • Risk of death from airway obstruction
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8
Q

Bronchitis Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause

  • Viral
  • Pneumococci
  • H. influenzae
  • (rare)

Clinical Presentation

  • Dry cough
  • Retrosternal soreness
  • Wheeze

Investigations

  • Sputum (if bacterial)
  • Sputum culture

Management

  • Rest, fluids and prevention of spread
  • NSAIDs or paracetamol (pain or fever)

Prognosis
-Improves over a week

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9
Q

Sinusitis Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

Cause

  • Various bacterial
  • Viral (15%)

Clinical Presentation

  • Headache
  • Facial pain
  • Nasal congestion

Investigations

  • None
  • Sinus XR if severe

Management

  • As rhinitis (above)
  • Surgery if chronic

Prognosis

  • Remits if acute
  • Chronic problems are common
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10
Q

Bronchiolitis Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

(infants < 1)
Leading cause of hospitalisation in infants in due to smaller airways and immature immune system. Can be life threatening

Cause

  • RSV (45-75%)
  • Parainfluenza virus
  • Adenovirus
  • Mycoplasma pneumoniae

Clinical Presentation

  • Nasal discharge
  • Fever
  • Wheezy congestion

Investigations

  • Pulse 02
  • CXR (if pneumonia)

Management

  • Oxygen
  • Fluids
  • Minimal handling
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11
Q

Croup Overview

  • Cause
  • Clinical Presentation
  • Investigations
  • Management
  • Prognosis
A

(children 6m-3y) AKA Laryngotracheobronchitis

Cause

  • Parainfluenza viruses (1, 2 & 3)
  • Respiratory Syncytial Virus (RSV)

Clinical Presentation

  • Coryzal prodrome
  • Hoarseness
  • Barking cough (obstruction)
  • Airway obstruction

Investigations
-None

Management

  • Dexamethasone
  • PLUS
  • Adrenaline (if severe)
  • Intubation (if severe)

Prognosis

  • Slow improvement
  • Risk of death from airway obstruction
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3C - Respiratory (6 decks)

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