Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious Disease and Medical Microbiology > URTI's > Flashcards

URTI's Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
0
Q

What is the most significant method for transmission of the common cold?

A

Hands (droplet is less significant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What were the 6 URTI’s presented in lecture?

A
  1. Common Cold
  2. Pharyngitis
  3. Otitis media
  4. Sinusitis
  5. Croup
  6. Pertussis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the infectivity of the common cold

A

Viral shedding peaks on 3rd day, coinciding with peak symptoms. Low level shedding continues for 2 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the incubation period of the common cold?

A

24-72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name some viruses that cause the common cold

A

Rhinovirus, RSV, influenza, parainfluenza, adenovirus, enterovirus, coronavirus, human metapneumovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Briefly outline the pathogenesis of the common cold

A
  1. Virus deposited on nasal/conjunctival mucosa - attaches via host cell receptors
  2. Viral replication - host defence activated as cells are damaged
  3. Cytokine release (IL-8) attracts PMNs
  4. Increase in nasal secretions and slowed mucociliary clearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Severity of symptoms of the common cold correlate with what?

A

IL-8 level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rhinovirus infection results in the release of albumin and bradykinins, what is the outcome of this?

A
  1. Increased vascular permeability in nasal lamina propria

2. Bradykinins cause rhinitis, sore throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of the common cold in an infant?

A

Fever and and nasal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the duration of the common cold?

A

10 days. Prolonged in smokers. Can last 2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should be on your differential Dx (DDx) if you suspect the common cold?

A
  1. Allergic rhinitis
  2. Acute bacterial sinusitis
  3. Nasal foreign body
  4. Pertussis
  5. Structural abnormalities of the nose/sinuses
  6. Influenza
  7. Bacterial pharyngitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some OTC recommendations for the common cold?

A
  1. Antipyretic/pain control
  2. Saline irrigation
  3. Steam inhalation
  4. Decongestants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The majority of the cases of pharyngitis are due to what?

A

Viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

20-30% of sore throats in children and 5-15% in adults are attributed to this…

A

GAS (S. pyogenes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pharyngitis is unusual in children under the age of 3, T of F?

A

True, it is most common in school aged children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the incubation period for GAS pharyngitis?

A

2-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the infectivity of GAS pharyngitis?

A
  1. Highly communicable

2. Usually non-infectious within 24 hrs of antibiotic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is GAS pharyngitis spread?

A
  1. Person to person

2. Respiratory droplet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Viral pharyngitis is caused only by respiratory viruses, T or F?

A

False. Non-respiratory viruses may also be responsible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe some of the virulence factors that S. pyogenes has.

A
  1. Capsule - hyaluronic acid (camouflage)
  2. M proteins - resist phagocytosis
  3. Invasins and exotoxins (hemolysins) - cause tissue damage
  4. Streptolysin O - cytotoxin (including myocardium)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If GAS pharyngitis is left untreated or is treated inappropriately, what risk does this pose?

A

3% risk of Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What collection of clinical features may indicate a viral etiology for pharyngitis? (6)

A
  1. Conjunctivitis
  2. Cough
  3. Hoarseness
  4. Rhinorrhea
  5. Diarrhea
  6. Rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the typical S/S of GAS pharyngitis? (4)

A
  1. Pharyngeal or tonsillar exudate
  2. Fever
  3. Tender/enlarged anterior cervical lymph nodes
  4. Absence of cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When should you not test someone who presents with pharyngitis?

A

If the the S/S suggest a viral cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What testing is available if you suspect bacterial pharyngitis?

A
  1. Throat culture

2. Rapid antigen detection test (RADT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How should you manage viral pharyngitis?

A
  1. Symptomatic therapy: analgesic/antipyretic

2. NO ANTIBIOTICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the Tx for GAS pharyngitis?

A
  1. Penicillin x 10 days

2. OR Clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

List some benefits of antibiotic Tx for GAS pharyngitis

A
  1. Prevents complications (i.e. peritonsillar abscess, cervical lymphadenitis, rheumatic fever)
  2. Decreases transmission
  3. MINIMAL symptom improvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In what age group is acute otitis media most prevalent?

A

Infants

29
Q

List some risks factors for acute otitis media

A

Age (6-18 months), family Hx, daycare, lack of breastfeeding, tobacco smoke or air pollution, pacifier use, First Nations, poverty, lack of access to care

30
Q

What is the etiology of acute otitis media in 2/3 of patients?

A

Viral and bacterial combination

31
Q

What 2 factors are essential in the patho. of AOM?

A
  1. Antecedent viral URTI

2. Colonization with a respiratory bacterial infection

32
Q

Briefly describe the patho. of AOM

A
  1. Inflammation in response to virus obstructs isthmus of Eustachian tube
  2. Obstruction causes -ve pressure leading to the build up of secretions
  3. Bacteria colonizing the URT enter the middle ear and growth in the secretions
33
Q

S/S’s of AOM in children can include: (4)

A
  1. Otalgia
  2. Bulging of the tympanic membrane
  3. Otorrhea
  4. Hearing loss
34
Q

List 5 complications of AOM

A
  1. Vertigo
  2. Tinnitus
  3. Facial paralysis
  4. Mastoiditis
  5. Meningitis
35
Q

What is included in the Tx of AOM

A
  1. Watchful waiting
  2. Pain relief
  3. Amoxicillin (best coverage for S. pneumoniae)
36
Q

Why is a 3 month follow up recommended for AOM?

A

To assess for the presence of fluid in the ear, which can lead to hearing loss if not corrected.

37
Q

What is the spontaneous resolution rate of acute sinusitis?

A

About 70%

38
Q

What the most common cause of acute sinusitis?

A

Viral is 200X more common than bacterial

39
Q

3 viral agents that can cause acute sinusitis

A
  1. Rhinovirus
  2. Influenza
  3. Parainfluenza
40
Q

What is the natural progression of acute viral sinusitis?

A

Typically resolves in 7-10 days

41
Q

List some bacteria that may cause acute sinusitis

A
  1. S. pneumoniae
  2. H. influenzae
  3. M. catarrhalis
  4. Anaerobes (associated with dental disease)
42
Q

Briefly outline the patho. of acute sinusitis

A
  1. Common cold –> viral rhinitis –> spreads to paranasal sinuses
  2. Inflammation of sinuses = impairment of mucociliary defences, and 2ndary spread of bacteria into nasal cavities
43
Q

What conditions predispose someone to acute sinusitis (4)

A
  1. Dental infections
  2. Allergies
  3. Swimming
  4. Mechanical obstruction of nose
44
Q 
What imaging is recommended for acute sinusitis:
A - X-ray
B - CT
C - MRI
D - None of the above
A

D - imaging is not recommended

45
Q

How do you Dx acute sinusitis?

A
  1. Based on Hx and physical exam (purulent rhinorrhea, nasal congestion)
46
Q

To Dx bacterial sinusitis…

A
  1. URTI symptoms for > 10 days or worse after 5-7

AND, nasal congestion/purulent nasal discharge + facial pain - with or w/o fever/maxillary tooth ache/facial swelling

47
Q

How do you manage acute sinusitis?

A
  1. Analgesics
  2. Steam inhalation
  3. Decongestants
  4. NO ANTIHISTAMINES
  5. Selective antibiotic therapy = amoxicillin
48
Q

Croup is AKA…

A

Laryngotracheitis

49
Q

What is Croup?

A

Self-limited illness characterized by inflammation of larynx and trachea

50
Q

Croup is most common for what age group?

A
  1. 6-36 months

2. Rare beyond 6 yrs of age

51
Q

What time of day is Croup most common?

A
  1. Late evening or early morning

2. Recurrences are common

52
Q

What is the most common cause of Croup?

A

Parainfluenza virus type 1

53
Q

Briefly describe the patho. of Croup?

A
  1. Virus infects nasal pharyngeal mucosa
  2. It invades respiratory epithelium and causes inflammation of cartilage in subglottic region
  3. This narrows the trachea
  4. Fibrinous exudates may worsen narrowing
54
Q

What may predispose someone to Croup? (3)

A
  1. Genetics (differing immune response to Parainfluenza virus)
  2. Anatomic narrowing
  3. Hyperactive airways
55
Q

What is the typical presentation of Croup?

A
  1. Sudden onset (inspiratory stridor, cough, hoarseness)
  2. Rapidly progressive
  3. Previous Hx of Croup
56
Q

What is the hallmark of Croup in infants?

A

Barking cough

57
Q

What is the DDx for Croup?

A
  1. Epiglottitis (throat pn more prominent, difficulty swallowing, LOTS OF SALIVA, high fever)
  2. Pharyngitis
  3. Foreign body aspiration
  4. Allergic reaction (swelling of lips/tongue, rash)
  5. Peritonsillar abscess (enlarged lymph nodes, tonsillar asymmetry
58
Q

Outline the management of Croup

A
  1. NO ANTIBIOTICS (viral)
  2. Systemic/nebulized steroids

If severe:

  • Nebulized epi
  • Blow-by O2 if hypoxic
  • NO SEDATION
59
Q 
Whooping cough is:
A - a boy band
B - not a big deal
C - highly contagious RT infection
D - none of the above
A

C

60
Q 
Pertussis occurs in cyclic epidemics every:
A - 3 years
B - year
C - decade
D - 2-5 years
A

D

61
Q

How is Pertussis transmitted?

A
  1. Direct contact

2. Inhalation of respiratory droplets

62
Q

What is the incubation period of Pertussis?

A

7-10 days (4-21 days)

63
Q

What causes Whooping Cough?

A

Bordetella pertussis

64
Q

Features of B. pertussis (3)

A
  1. Obligate human pathogen
  2. Fastidious Gram -ve coccobacilli
  3. Needs special growth medium
65
Q

List some virulence factors of B. pertussis

A
  1. Adhesins
  2. Tracheal cytotoxin/dermonecrotic toxin
  3. Interferes with host immune system
  4. Endotoxins
66
Q

Classic clinical manifestations of Pertussis (3)

A
  1. Paroxysmal cough
  2. Inspiratory whoop
  3. Post-tussive emesis
67
Q

In which age group is Pertussis most deadly?

A

Infants

68
Q

What labs can be performed if you suspect Pertussis?

A
  1. cough < 3 weeks = nasopharyngeal swab for culture and PCR

2. cough > 3 weeks = PCR

69
Q

What is the antibiotic therapy for Pertussis?

A
  1. Macrolide or TMP-SMX
70
Q

What are the potential benefits of antibiotic therapy for Pertussis?

A
  1. May reduce duration and severity of cough

2. Limits transmission

71
Q

When would you give prolonged antibiotic therapy for Pertussis?

A
  1. If there is potential for exposure to high risk pt’s (i.e. infants, pregnant women, healthcare worker, childcare worker)

Infectious Disease and Medical Microbiology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions