URTI in adults

Question 1

what are the main cause/es of URTI

Answer 1

mainly due to self limiting viral iinfections

Question 2

is an URTI contagious

Answer 2

yes from person to person, by droplets from coughing or sneezing

Question 3

what are some common examples of URTI

Answer 3

sinus infection
common cold
oral candidas
tonsillitis
tracheitis

Question 4

what causes URTI

Answer 4

direct invasion of upper airway by virus or bacteria

Question 5

what are some of our defense barriers that can defend us against URTI

Answer 5

hair lining the nose
wet mucus inside nose
cilia

immune system-tonsils and B cells

Question 6

viruses and bacteria can still cause URTI desoite our defense mechanisms, how

Answer 6

produce toxins to impair the body’s defense

change shape or size of outer structural proteins

Question 7

what is pertussis

Answer 7

whooping cough

Question 8

why shouldnt you use a tongue depressor if suspect epiglottis

Answer 8

throat spasm could occur and close the airway completely

Question 9

Is it worth doing laboratory testing in URTI

Answer 9

no as there is typically no specific treatment for different types of viral URTI

Question 10

how would you treat epiglottitis

Answer 10

avoid instrumentation
monitor for respiratory fatigue 
oxygen according to saturation
start iv antibiotics according to culture specimens 
may need steroids

Question 11

what are some complications that can happen because of an URTI

Answer 11

respiratory compromise especially from epiglottitis
secondary infection
peritonsillar abcess
Rheumatic fever from strep pyogenes throat

Question 12

what are some common symptoms of epiglottitis

Answer 12

sore throat 
stridor
muffled voice
dry cough
painful swallowing 
fever 
drooling

Question 13

Bacterial pharyngitis signs?

Answer 13

Erythema, swelling, or exudates of the tonsils or pharynx
Temperature of 38.3°C (100.9°F) or higher
Tender anterior cervical nodes (≥1 cm)

Question 14

what is infectious mononucleosis also known as

Answer 14

acute glandular fever

Question 15

what are common clinical features of infectious mononucleosis ( aka glandular fever)

Answer 15

sore throat
fever
palatal petechiae
fine red rash
Lymphadenopathy
puffy eyes 
inflammation of the liver

Question 16

if you suspect that a patient had glandular fever what tests could you do

Answer 16

blood film
monospot test
look for Epstein Barr virus itself-IgM raised in acute infection

Question 17

what is the normal flora of the URTI in most people

Answer 17

Streptococcus viridans
neisseria
diptheriods
anaerobic cocci

Question 18

why do URTI cause symptoms

Answer 18

symptoms result from
1.toxins released by pathogens

2.inflammatory response mounted by the immune system to fight the infection

Question 19

when should a patient with an URTI see a doctor

Answer 19

> 2wks of symptoms that are sever or worsening

difficulty breathing

impaired swallowing

recurring URTI

Question 20

when would you consider giving treatment for rhinosinusitis (the cold)

Answer 20

if symptoms dont improve after 10 days

if symptoms are severe or worsening

Question 21

what are likely pathogens to cause rhinosinusitis

Answer 21

stretococcus pneumonia
heamophilus influenzae
moraxella catarrhalis

Question 22

what Ab is firstline treatment for rhinosinusitis ( the cold)

Answer 22

amoxicillin or clavulanate

Question 23

what is the treatment for strep pyogenes ( group A strep) sore throat

Answer 23

Oral penicillin or amoxicillin for 10 days

Question 24

if a patient with strep pyogenes ( group A strep) sore throat was allergic to penicillin what are the other ab options

Answer 24

clindamycin or clarithromycin

Question 25

what organism usually causes the common cold

Answer 25

rhinovirus

Question 26

what are complications of strep pyogenes throat

Answer 26

1. ottis media-esp children
2. pain in ears
3. eardrum- dilated vessels, perforation,bulging
4. scarlet fever - rare

Question 27

what is Erythema Nodosum

Answer 27

condition where red bumps form on the shin.

it is a inflammatory condition of the fat cells under the skin resulting in tender red nodules

Question 28

what antibiotics could you give for epiglottitis

Answer 28

augmentin

cephalosporin

Question 29

what organism is oral candidiasis caused by

Answer 29

candida albicans

Question 30

what organism is glandular fever caused by

Answer 30

epstein barr virus

Question 31

what is the treatment for glandular fever ( aka infectious mononucleosis)

Answer 31

mainly supportive
avoid penicillin esters like ampicillin as they can cause rash
steroids if pharyngeal oedema is severe
patient can do aspirin gargles