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Flashcards in PATHOPHYS: URTIs Deck (52):
1

What is otitis media?

Infection of the middle ear caused by viruses or bacteria.

2

What are the important causative pathogens of otitismedia?

Strep pneumoniae
H. Flu
Moraxella catarrhalis
RSV
Coronavirus
Rhinovirus

3

What is the most common predisposing factor to otitis media?

seasonal allergic rhinitis

4

Who gets otitis media?

children under 3

5

Why are young children most likely to develop otitis media?

they have small opening of the eustachian tube that is easily blocked by inflammation caused by viral infection/allergic response (which will cause fluid retention and infection in the middle ear)

6

What are the physical findings of otitis media?

erythematous tympanic membrane with loss of light reflex and decreased mobility (sometimes tympanic membrane may bulge and rupture)

7

HOw do you treat otitis media?

amoxicillin

8

What is sinusitis?

inflammation of the paranasal sinuses

9

What causes sinusitis?

impaired mucociliary clearance caused by viral infection or allergic rhinitis can obstruct the orifice of the sinus leading to mucus accumulation and bacterial overgrowth

10

Which sinuses does sinusitis typically involve?

maxillary sinus (ostium of sinus is superior so mucus drainage has to go against gravity)

11

What are symptoms of sinusitis?

Purulent nasal discharge
Nasal congestion
Facial/sinus pain
Fever

12

What are the important pathogens of sinusitis?

S. pneumoniae
H. flu
M. Catarrhalis

13

What is the treatment for sinusitis?

if symptoms last over ten-fourteen days, give amoxicillin (or augmentin if resistant)

14

What is pharyngitis?

inflammation of the throat caused primarily by viruses (ex. adenovirus)

15

What bacteria are involved in pharyngitis?

Strep pyogenes (GAS)
Neisseria gonorrhoeae (sexually)
Corynebacterium diptheriae (where no diptheria vaccine is given)
Mycoplasma, chlamydia, etc.

16

What are the symptoms/signs of pharyngitis?

sore throat that is worse when swallowing
Fever
Inflamed pharynx, tonsils, and palate
Greyish exudate on tonsils
Lymphadenopathy (tender)
Petetchiae on palate

17

How do you diagnose a GAS pharyngitis?

rapid antigen detection tests

18

How do you treat GAS pharyngitis?

penicillin G, penicillin V, or amoxicillin

Erythromycin or cephalexin if penicillin allergy

19

True or false: most sore throats are bacterial.

FALSE: most are viral, so prescribing antibiotics is a major problem!

20

What is the common cold?

viral infection of the URI

21

What types of viruses cause the common cold?

nonenveloped viruses like rhinovirus and coronavirus

22

What may help to reduce symptoms of the common cold?

Zinc acetate in doses greater than 75 mg/day

23

What is croup?

inflammation of the larynx, trachea, and large bronchi

24

What is the key finding of croup?

inspiratory stridor
Barking cough

25

What is the most common cause of croup?

parainfluenza virus
RSV
Flu

26

What radiologic manifestation may indicate croup?

"steeple sign" which is subglottic tracheal narrowing

27

What is the treatment of the croup?

corticosteroids (ex. dexmethasone)
with or without epinephrine

28

What is laryngitis?

inflammation of the vocal cords of the larynx

29

What are the common clinical manifestations of laryngitis?

hoarseness
aphonia

30

What is the most common cause of laryngitis (top 2)?

parainfluenza virus
rhinovirus

31

How do you treat laryngitis?

hydration
voice rest

32

What is epiglottitis?

inflammation of the epiglottis

33

What are the clinical manifestations of epiglottitis?

rapidly worsening sore throat
odynophagia (pain swallowing)
dysphagia (difficulty swallowing)
muffled voice
MEDICAL EMERGENCY for young children because may cause airway obstruction

34

What is the most common cause of epiglottitis?

H. influenzae type B

35

What is seen on indirect laryngoscopy of a patient with epiglottitis?

swollen, cherry red epiglottis

36

What radiologic finding may be indicative of epiglottitis?

"thumb" sign (enlarged epiglottis)

37

What is the treatment for epiglottitis?

IV ceftriaxone
(maybe corticosteroids to reduce inflammation)

38

Is someone with a cold caused by rhinovirus at risk for pneumonia?

no Rhinovirus does NOT cause LRTI

39

Is someone with a cold caused by coronavirus at risk for pneumonia?

NO coronavirus does not cause LRTI (unless it is SARS or MERS)

40

Can rhinovirus survive in the GI tract?

NO--they are acid labile (killed by gastric acid when swallowed)

41

Can coronavirus survive int he GI tract?

yes!

42

Why do we not have a vaccine for rhinovirus?

because there are too many serotypes (over 100)

43

How many serotypes are there for strep pneumo?

93

44

What is the major pathogenesis of rhinovirus?

Chemical mediators of inflammation cause congestion and mucous secretion (LOOK BACK)

45

What is a common complication of URTI?

acute bacterial sinusitis

46

What is second line treatment for otitis media?

Augmentin

47

How long do children get observed?

48-72 hours

48

What is the pathogenesis of diptheria?

A-B toxin blocks protein synthesis by inactivating EF-2 by ADP ribosylation,resulting in decreased protein synthesis

49

What is the pathogenesis for H. flu?

Produces IgA protease facilitating attachment to the mucosa, also is encapsulated and evades phagocytosis.

50

What is the receptor for rhinovirus?

ICAM-1

51

What is the most typical epidemiology for epiglottitis patient?

Urbanmale in his 40s with rapid onset of sore throat, muffled voice, and odynophagia/dysphagia

52

Why are ear infections more common in children?

Ear infections are more common in children because their Eustachian tubes are shorter, narrower, and more horizontal than in adults.