Upper Respiratory Diseases

Question 1

What is the common cold?

Answer 1

acute contagious disease of the upper respiratory tract that is marked by inflammation of the mucous membranes of the nose, throat, eyes, and eustachian tubes with a watery, then purulent, discharge.
difficulty eating and breathing
run course in 4-5 days
rest, fluid intake, diet as tolerated
antibiotic treatment for complications like secondary bacterial infection, extension of infection into lower respiratory tract or into middle ear

Question 2

what is the average incidnece of common cold in preschool children and adults

Answer 2

preschool children - 5 to 7

adults - 2 to 3

Question 3

s/s of common cold?

Answer 3

runny nose
nasal congestion
discharge
sneezing
watery eyes
sore throat
hoarseness of voice
coughing
discharge starts clear and thin, can turn greenish yellow and thick
headache
slight fever
chills

Question 4

what is the cause of colds?

Answer 4

caused by 200 diff viruses but most common r rhinoviruses followed by coronavirus

transmitted by respiratory droplets or by touching an contaminated inanimate object then ur eyes or nose

Question 5

What is allergic rhinitis?

Answer 5

inflammation of the mucous membrane of the nose caused by an allergic reaction to airborne substances

s/s r caused by hypersensitivity to an allergen caused by Ig E (causes mast cells to release histamine)

Question 6

Approximately ___________, or __%, of American adults are
diagnosed with allergic rhinitis in any 12-month
period

Answer 6

17 million or 7%

Question 7

what are the s/s of allergic rhinitis?

Answer 7

runny nose, congestion, watery eyes, and sneezing

Question 8

How to diagnose and treat Allergic Rhinitis?

Answer 8

Diagnose - physical examination, medical history, and allergy testing

Treat - avoiding allergens and nasal steroids (can take allergy shots to desensitize)

Question 9

What is sinusitis + etiology ?

Answer 9

inflammation of the mucous membrane lining of the sinuses (sinuses r air-filled cavities behind the facial bones)\

usually caused by viral infection (often common cold), fungal or more, commonly, bacteria infections that travel to sinuses from nose, often pt had common cold

can also be caused swimming or diving, tooth extractions, tooth abscess, allergies that affect nasal passages

Question 10

Approximately _________ Americans are diagnosed with sinusitis each year

Answer 10

30 million

Question 11

Wat are risk factors for sinusitis?

Answer 11

having an upper respiratory infection, allergies, obstruction of the nose (deviated septum, polyps), and a weakened immune system

Question 11

What are sinusitis s/s?

Answer 11

frontal sinuses and maxillary sinuses r most commonly involved sinuses

facial pain and pressure (intensifies when bending over), nasal stuffiness, nasal discharge, loss of smell, and cough or congestion, headache 9esp on waking in morn), and drainage will be thick,greenish yellow mucopurulent liquid

Question 12

Diagnosis of sinusitis?

Answer 12

medical history
physical examination
nasal endoscopy to visually inspect the sinuses (endoscopic sinoscopy)
imaging tests (appears as white areas)
nasal and sinus cultures
allergy testing
CT
bedside transilluminatoin

Question 13

What is the treatment for sinusitis?

Answer 13

treatment is symptomatic

may use saline nasal spray to rinse the nasal passages, nasal corticosteroids to reduce inflammation, decongestants and pain relievers, antibiotics, oral and topical corticosteroids, antihistamines, sinustomy if inflammation persists

Question 14

What is tonsilitis?

Answer 14

infectious inflammation of the tonsil caused by bacteria or viruses

Question 15

s/s of tonsilitis?

Answer 15

severe sore throat
red, swollen tonsils
difficulty or painful swallowing
white or yellow patches on the tonsils
fever

Question 16

How to diagnose and treat tonsilitis?

Answer 16

diagnose - visual exam of the tonsil, rapid strep test, or throat culture

treat - depends on cause, if bacterial then antibiotics, usually symptomatic based so pain relievers, rest and fluids, may need to be surgically removed

Question 17

What is pharyngitis + etiology?

Answer 17

inflammation of the pharynx, characterized by pain in the throat

Most common cause is viral infection (tonsillitis) but can also be bacterial infection (in children it can be extension of streptococcal infection from tonsil, adenoids, nose or sinuses) (can be secondary to systemic viral infections such as chickenpox and measles), gonococcal pharyngitis, irritaiton and inflammation (tobacco smoke and alc), excessivly heated air, chemical irritants, swallowing sharp objects, seasonal alelrgies

Question 18

risk factors of pharyngitis?

Answer 18

living or working in close quarters
being immunocompromised
having diabetes mellitus
smoking or exposure to cigarette smokE

Question 19

S/S OF PHARYNGITIS

Answer 19

joint pain or muscle aches
cervical lymphadenoathy
dysphonia
dysphagia
sensation of lump in throat
fever
headache
swollen lymph nodes in the neck
inflammation of tonsils, uvula, and palate
sore throat with dryness, burning sensation,
chills
fever

Question 20

How to diagnose and threat pharyngitis?

Answer 20

diagnose - based on physical examination and may include a rapid strep test or throat culture, CBC and sinus radiography

treat - if viral than treatment may include gargling with salt water, anti-inflammatory medications, and pain relievers, if bacterial than antibiotics, surgical excision for chronic tonsillitis, adenoiditis, adenoid hypertrophy

Question 21

What is laryngitis + etiology?

Answer 21

inflammation of the larynx or voice box, usually caused by viral infection (URI auch as common cold, tonsilitis, pharyngitis, sinusitis, bronchitis, pertussis, influenza, pneuomina, measles, mononucleosis, diphteria, syphilis, TB) or overuse of voice or bacterial infection, acid reflux, inclement weather, tobacco smoking, alc consumption, inhalation of irritating materials

Question 22

risk factors for laryngitis?

Answer 22

respiratory infection, exposure to irritating substances (cigarette smoke, alcohol, stomach acid, workplace chemicals), and overuse of the voice)

Question 23

s/s of laryngitis

Answer 23

dysphonia, difficulty swallowing, throat pain and fever, aphonia, hoarseness, maliase, dysphagia

Question 24

how to diagnose and treat laryngitis?

Answer 24

diagnose - signs and symptoms and physical examination and may include laryngoscopy to visually examine the vocal cords treatment - treating underlying cause, resting voice, controlling heartburn, reduced exposure to alc or cig smoke, bed rest, lozenges and couhg syrup, antibiotis, may use corticosteroids to reduce inflammation of vocal cords (severe)

Question 25

chief symtpoms of resporiatory tract disorders:

Answer 25

- chest pain - dyspnea - SOB - productive or nonproductive cough that is acute or chronic - hemoptysis - dysphonia - chills - low-or high-grade fever - wheezing - fatigue

Question 26

how to diagnose and treat common cold/

Answer 26

diagnose - symptoms, cultures of nasal discharge and sputum along with CBC treat - ordinarily clear up in 4 to 5 days, bacterial infection should resolve in no longer 7 to 10 days, resting, drinking plenty of fluids, vaporizer, OTC antihistamines, decongestatns, cough suppressants, mild analgesics

Question 27

What is nasopharyngeal carcinoma + s/s?

Answer 27

- in areas of parynx that opens into nasal cavity anteriorly and oropharynx inferiorly - not as strongly linked to tobacco use (often linked to dietary intake or Epstein-Barr virus (EBV) infection) - s/s r neck mass, nasal obstruction with epistaxis, serous otitis media, headache, hearing loss, tinnitus, pain, impaired function of cranial nerves

Question 28

risk factors of nasopharyngeal carcinoma?

Answer 28

-rare in US and W Europe, is high in S China, around Mediterranean Sea, SE Asia, Arctic (2-3x more in males, most in ppl 10-25 and 50-60) - consumption of slated fish as diet standard - food with high levels of nitrate and Chinese herbs - infeciotn by EBV -first-degree relative with nasoopharyngeal carcinoma - use of alc and tobacco in low-risk areas

Question 29

DIAGNOSE AND treat nasopharyngeal carcinoma?

Answer 29

diagnose - full clinical exam of head and neck, endoscopic exam of nasopharynx, biopsy, testing for EBV, MRI, bone scanning, CT, PET treat - no surgery, radiation, chemo

Question 30

What is deviated septum?

Answer 30

- crooked nasal septum (cartilage partition btwn nostrils) - cause narrowing and obstruction of air passage and mild breathing problems - congenital anomaly = minor, trauma = substantial - diagnose with aid of nasal speculum, pt history - no treatment unless compromise of air passage (rhinoplasty or septoplasty)

Question 31

What is nasal polyps + etiology, diagnose and treat?

Answer 31

- benign growth that form as consequence of distented mucous membrane protrudign into nasal cavity - not harmful bu can become large neough to obstruct nasal airay (making breaking difficult and impair sense of smell) - caused by overproduction of fluid in cells of mucous membrane, often result of allergic rhinitis (some aspirin-sensitive ppl have them) - diagnose with nasal speculum - treat with surgical removal, inject steroid into polyps, rhinoplasty

Question 32

What is anosmia + etiology, diagnose & treat?

Answer 32

- impairment or loss of sense of smell - continues w/o obvious cause (abiltity to taste liquids and food is also impaired or lost) - most common cause is chronic conditions such as nasal polyps and allergic rhintits, intranasal swelling, phobia concernign a partitulcar odor, rdamage to olfactory nerves, symptoms of brain tumor - diagnose: if not physical abn, recent head trauma or allergic then neruologist - treat: aimed at cause of condition, remove polyps, correct nerve damage, sensitive allergic pt

Question 33

What is epistaxis, s/s, etiology, diagnose and treat?

Answer 33

- hemorrhage of nose - usually from 1 nose, usually have vertifo, increase in pulse, pallor, SOB, drop in bp - common causes r cold, infections (= damge to mucous membrane of nose), direct trauma to nose, systemic disorders (measles, scarlet fever, pertussis, rheumatic fever, hypertension, CHF, chronic renal disease, hemophilia, thrombocytopenia, agranulocytosis, leukemia - risk facttors r vitamin K deficiency, hypertension, aspirin ingestion, high altitude, anticoagulant therapy - diagnose based on pt history - treat based on severity of blood loss (mild hemorrhage - costant direct pressure, internal compression device such as Rhino rocket, severe - epinephrine, cauterization with silver nitrate or laser cauterization, mild sclerosing agent)

Question 34

What are tumors of larynx, types, diagnose and treat?

Answer 34

- dysphonia is usually only symptom - in children stridor bc small airways (high-pitches crowing sounds) - 2 types: papilloma (multiple), polyps (single), r caused by misuse or overuse of vocal cords (malignant r more often in those who indulge in heavy tobacco use) - diagnose with examination and biopsy - treatm with corecction of vocal strain, management oof acid reflux, smoking cessation,excise growths, if malignant radioaton, laryngectomy

Question 35

What is laryngeal cancer? +s/s and risk factors

Answer 35

- neaoplasm of larynx (most common site for head and neck tumors) - mostly squamous cell carcinomas - referred pain to ear, persistent hoarsness, dys[hagia, hemoptysis, chronic cough, stridor, airway obstruction - major risk factor r smoking, alchol abuse, HPV-16 or 18, occupational exposure to carcinogenic agents or asbestos, and hving first-degree reative with laryngeal cancer

Question 36

diagnose and treat laryngeal cancer?

Answer 36

diagnose- flexible fiberoptic endoscopy, biopsy, CT or MI, panendocscopy, PET treat - radiation, partial, total laryngectomy, ndoscopic laser resection, chemoradiotherapy, speech therapy and swallowing therapy

Question 37

What is hemoptysis + etiology, diagnose and treat?

Answer 37

- coughing or spitting up of blood from respiratory tract - ss r sputum streaked or spotted with blood, bright or dark blood-streaked sputum or dark red clots, profuse bleeding - causes r trauma, erosion of vessel, calcification, tumor can cause bronchial bleeding, inflammatory conditions such as bronchitis or bronchiectasis, pulmonary arterial hypertension (often associated with right-side heart failure) and pulmonary venous hypertension (associated with left-sided heart failure) may precipitate bleeding from fungal infection, pulmonary infarcts, tumor or ulceration of larynx or pharyx - diagnose with visual exam, inspection of lung with radiographic studies, pulmonary angiography, coagulation studes, PPD test, lung scanning, CT, pulmoanry angio - treat w/ ligation, surgical removal or repair, prevent asphyxiation and exsanguination, antibiotics and cough suppressants

Question 38

What is legionellosis?

Answer 38

- AKA LEGIONNARIES DISEASE AND PONTIAC FEVER - type of pneumonia caused by legionella pneumophila (not contagious, thrive in warm aquatic environments, r inhaled from contamined aerosolized water droplets, hot water btwn 95F and 115F) - has 2 forms: more severe legionnaires disease and the milder form, Pontiac fever

Question 39

s/s of legionellosis?

Answer 39

- typical symptoms include general maliase, headache, cough, chills, fevere, chest pain, dyspnea, myalgia, vomting, diarrhea, anorexia - incubation period is 2 to 10 days, usually abt 1 week - symptoms of Pontiac fever are less severe and icnlude a higher fevere and muscle aches, with duration of 2 to 5 days (incubation period for Pontiac fevere is shorter than Legionnaires disease)

Question 40

diagnose and treat legionellosis?

Answer 40

diagnose - complete physical exam, pt history, chest radiographic studies, testing of blood smaples (elevated WBC, liver enym level, ESR), culture from sputum to isolate Legionella bacterium, urine sample , convalescent serum samples treat - antibiotics, oxygen for dypnea, antipyretics, antiemetics, analgesics

Question 41

What are foriegn bodies in the nose?

Answer 41

- obstruction in the nares - mostly cereals, dried peas or beans, grapes, styrofoam particles, pebbles, cotton - will notice mucus running from one of the nares, swelling near bridge of nose, congested breathing - diagnose w/ history and visualization - treat by encoruraging blow the nose or use forcep ro suction device to remove