Week 2: Minor illness 1/3 Flashcards
influenza
Contagious respiratory illness caused by influenza virus that infect the nose, throat and sometimes the lungs. Can cause mild to severe illness and can lead to death
causes of influenza
- Spread mainly by tiny droplets made when people with flu cough, sneeze or talk
presentation of influenza
- fever* or feeling feverish/chills
- cough
- sore throat
- runny or stuffy nose
- muscle or body aches
- headaches
- fatigue (tiredness)
- some people may have vomiting and diarrhoea, though this is more common in children than adults.
complications of flu
- bacterial pneumonia
- ear infections
- sinus infections
- worsening of chronic medical conditions e.g. CHF, asthma or diabetes
prophylaxis of influenza
flu vaccine
diagnosis of influenza
- presentation
- rapid influenzas diagnostic test
management of influenza
- antipyretic
- anti-viral – oseltamivir (Tamiflu)
common cold
A mild self-limiting upper respiratory tract infection characterised by nasal stuffiness and discharge, sneezing, sore throat and cough.
causes of cold
- Wide range of virus’ inc rhinovirus, coronavirus, influenza
- Can be transmitted in a variety of ways including
- Direct contact
- Small-particle aerosols
- Large-particle aerosols
presentation of common cold
The onset of symptoms is usually rapid, over 1–2 days.
- Sore or irritated throat — often the first symptom, typically has a sudden onset and resolves rapidly.
- Nasal irritation, congestion, nasal discharge (rhinorrhoea), and sneezing — nasal discharge is often profuse and clear, but may become thicker and darker as the infection progresses (although this does not usually indicate that bacterial infection is present).
- Cough develops in about 30% of people, typically after nasal symptoms have cleared.
- Hoarse voice caused by associated laryngitis.
- General malaise.
- Other symptoms are less common and may include:
- Fever — this is unusual in adults and is typically low grade.
- Headache and myalgia — more often associated with influenza rather than the common cold.
- Loss of taste and smell, eye irritability, and a feeling of pressure in the ears or sinuses (due to obstruction or mucosal swelling).
diagnosis of common cold
history
management of common cold
- No know treatment improves the time course of infection
- Symptom relief and rest
- Adequate fluid
- Healthy food
- Adequate rest
- Paracetamol or ibuprofen
- Steam inhalation
management of common cold
- No know treatment improves the time course of infection
- Symptom relief and rest
- Adequate fluid
- Healthy food
- Adequate rest
- Paracetamol or ibuprofen
- Steam inhalation
sore throat can be caused by
- Acute pharyngitis- inflammation of the pharynx
- Tonsilitis- inflammation of the tonsils
- Common cold
- Glandular fever
- Flu
non-infectious causes of sore throat
- GORD
- Drug induced e.g. Carbimazole
- Smoking
- Hayfever
infectious causes of sore throat
- Rhinovirus
- Coronavirus
- Influenza type A and B
- Streptococcal infection e.g. strep pyogenes
- Adenovirus
- Haemophilus influenza
How to different between pharyngitis and tonsilitis?
- Pharyngitis exudate and erythema on pharyx
- Tonsilitis- exudate and erythema on tonsils
- Higher temp
in a person with a sore throat when should 999 be called
- epiglottitis
- high pitched stridor
- haemophilus type B
- high fever
- sore throat
- sitting up and leaning forward
- drooling due to difficulty swallowing
- dont examine childs throat- dont want to distress
in which patients should specialist advice be soert if they present with a sore throat
If person is on chemo, or has known suspected leukaemia (can be caused by carbimazole), asplenia, aplastic anaemia or HIV/AIDs or taking immunosuppressive therapy seek immediate specialist advice.
which tool is used to decide whether sore throat is viral or bacterial in origin
- Viral if more systemic symptoms e.g. fever and cough
- Bacterial if localised to tonsils
antibiotic of choice for tonsillitis
penicillin (5-10 days, QDS)or erythromycin
common ear infections
- Otitis externa
- Otitis media
- Otitis media with effusion
Signs and symptoms of ear disease (can be varied!)
- Otalgia (ear pain)
- Discharge
- Hearing loss (conductive vs sensorineural)
- Tuning forks
- Tinnitus
- Vertigo
- Facial nerve palsy
- Through the petrous bone (middle ear)
- Disease involving the ear may manifest as facial palsy
otitis externa
- Inflammation of the external ear esp EAM
- Known as swimmer ear
- Rare complication of otitis externa= malignant otitis externa
- Rare and very serious potential life threatening esp in immunocompromised e.g. diabetics
presentation of otitis externa
- Presents with ear pain and itchiness
- Discharge
management of otitis externa
- Advice on self-care measures e.g. avoid swimming for 7 days, use hairdryer to dry ear out after swim, over counter ear drops
- Topic antibiotics e.g. amoxicillin with or without steroids e.g. hydrocortisone
- Oral if immunosuppressive
otitis media
- Middle ear infection
- More common in infants/ children than in adults
causes of otitis media
- Mostly viral aetiology
- Occasionally bacterial
- S. pneumonia
- H. influenza
presentation of otitis media
- Otalgia infants may pull or tug at ear
- Other non-specific symptoms e.g. temp
- Red +/- bulging TM and loss of normal landmarks middle ear cavity full of puss
why are children more susceptible to otitis media
Why are children more susceptible?
- Pharyngotympanic tube is shorter and more horizontal in infants
management of otitis media
amoxicillin
paracetamol and ibuprofen
presentation of Otitis media with effusion “glue ear”
- Looks retracted and TM looks straw coloured
- May see evidence of fluid
MOA of otitis media
- Not an actual infection- can predispose to infection
- Due to eustachian tube dysfunction
- Fluid and negative pressure in middle ear
- Decreases mobility of TM and ossicles affecting hearing
- Also draws fluid from across the mucous membrane in the middle ear
- Most resolve spontaneously without Abx in 2/3 months
- If persists or impede speech and language development/ school performance
- Require grommets (tympanostomy tube)
- Act to maintain equilibration of pressure
sinusitis is
Symptomatic inflammation of the paranasal sinuses.
sinusitis causes
- Viral upper resp tract infection, followed by bacterial infection
- Sinus mucosa oedema, obstruction of the sinus ostia, and reduction in mucociliary action allow secretions to stagnate and give bacteria a suitable environment in which to grow
- Allergic rhinitis
- Smoking
- Impaired ciliary motility
presentation of sinusitis
- Usually follows a common cold
- Nasal blockage/ discharge
- Facial pain/ pressure
- Reduction in smell
- Tenderness, swelling or redness over cheekbone
- Cough
- Bacterial sinusitis when symptoms
- >10 days
- Discoloured or purulent nsala discharge
Management of sinusitis
- If less than <10 days – do not offer antibiotics
- >10 day
- High-dose nasal corticosteroid
- Antibiotics- penicillin
