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MS-PA: Respiratory Diseases > upper respiratory tract infections > Flashcards

upper respiratory tract infections Flashcards

1
Q

How many types of microorganisms lives in the human mouth ?

A

~ 700 kind
Gram positive ones are Streptococcus mutans & pneumoniae, Staphylococcus aureus. Gram negative ones are H. influenzae & Neisseria spp.
About 85 spp of fungi, particularly
Candida spp

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2
Q

What is responsible for the Humoral immunity of upper airway ?

A

Immunoglobulin A

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3
Q

What is responsible for the innate immunity of upper airway ?

A

Resident macrophages, monocytes,
neutrophils, eosinophils.

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4
Q

What is the annual incidence of common cold ?

A
  • Children 3-8 viral resp illnesses per year.
  • Adults 2-4 colds
  • > 60yoa fewer than 1
    cold/year.
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5
Q

when does Pharyngitis peaks in children ?

A

4 to 7 years

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6
Q

What is the trend of paediatric Epiglottitis?

A

Occurs in children aged 2-7 years and peaks at age 3.

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7
Q

What is the tend of Laryngitis & laryngotracheobronchitis?

A

Occurs from 6 months to 6 years and peaks at age 2.

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8
Q

What are the seasonal trend of various URTIs ?

A
  • Rhinovirus- b/w March and October.
  • Coronavirus- b/w Jan and april
  • Adenovirus- Throughout the year
  • parainfluenza virus type 3: March and July.
  • parainfluenza virus type 4: August and November.
  • RSV: between Jan to May and November and December.
  • Influenza: Jan to March and november to decemeber.
  • GAS: Jan to May and Nov to December.
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9
Q

What are the modes of spread of URTIs ?

A
  • droplet, fomite, aspiration and direct spread.
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10
Q

What is the main cause of common cold ?

A

Rhinovirus serotypes.

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11
Q

What are the symptoms of URTIs ?

A
  • Conjunctivitis can occurs rarely with adenovirus.
  • Nasal discharge and congestions are common.
  • Sneezing and Sore throats are very common.
  • Mild to moderate hacking cough is common.
  • Headache is rare and fever can occur in children but not in adults.
  • Malaise, fatigue, and weakness and slight myalgia can occur sometimes.
  • Symptoms typically resolves in 3 to 14 days.
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12
Q

What are the symptoms of Influenza ?

A
  • Sometimes soreness behind the eyes and conjunctivitis may occur.
  • Nasal discharge is common.
  • Nasal congestion, sore throat, and sneezing can sometimes occur.
  • Cough, headache, fever lasting for 3 to 4 days with chills are very common.
  • Malaise, fatigue, and myalgias are common.
  • 7 days of symptoms with cough and fatigue lasting for additional days.
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13
Q

What are the pharmacological approaches for common cold ?

A
  • Analgesics + combo products containing antihistamines and decongestants.
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14
Q

Honey should not be prescribed for children under the age of 1. why ?

A

Due to risk of botulism

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15
Q

What are the subtypes of influenza virus?

A

Influenza A, B and C

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16
Q

What is the influenza virus that most commonly cause influenza ?

A

influenza virus A

17
Q

How does influenza virus enter the respiratory tissue ?

A

It uses Haemagglutinin to bind to the sialic acid through the receptor sites and triggering viral entry.

18
Q

What is the action of viral neuroamnidase ?

A

NA cleaves sialic acid from cell surface and progeny virions facilitating virus release from infected cells and infection spread.

19
Q

What is the incubation period of influenza and its symptomatology ?

A

1 to 14 days. It can cause the spread of URTI to LRTI. It is associated fever and systemic symptoms not seen in common cold.

20
Q

What is the clinical presentation of Influenza ?

A

If it is sudden onset, the patients present with Chills,Fever, Generalized
aches & pains, Headache. If it is gradual onset Sore throat, dry cough and coryza progressing to persistent cough +/- productive cough. In both sudden and insidious forms rarely nausea, vomiting, and abdominal pain can occur.

21
Q

what is the dX workup in Influenza ?

A
  • It is a clinical diagnosis.
  • In hospital setting PCR may be done for clinical decision making and ruling out COVID-19.
    *If LRTI suspected chest X-Ray maybe needed.
22
Q

What is the Tx of Influenza ?

A
  • Symptomatic therapy (same as common cold)
  • NO ASPIRIN if < 18 years old (Reye’s Syndrome)
  • Antiviral therapy in SELECT patients
23
Q

What is the most common cause of sinusitis ?

A

It is mostly viral and only symptomatic treatment is done. Bacterial sinusitis are relatively rare.

24
Q

What are the investigations in Sinusitis ?

A
  • It is usually a clinical diagnosis.
  • When investigation is needed for patients presenting with co-occuring conditions like orbital cellulitis:
  • Sinus X-ray
  • CT sinuses
  • Sinus aspirate for culture
25
Q

What is the general management of viral sinusitis ?

A
  • Sinus X-ray
  • CT sinuses
  • Sinus aspirate for culture
26
Q

What is the general management of Bacterial sinusitis ?

A

– Fever & symptom > 10 days
– Maxillary toothache
– Initial symptom improvement and then deterioration
– Cacosmia
– Unilateral facial pain
treat with
* Empirical antibiotics (5-day course)
* Decongestants
* Analgesia

27
Q

What is the indication for Sinus puncture & lavage

A

If bacterial infection does not respond to antibiotics.

28
Q

What is the Tx of fungal sinusitis ?

A

*Surgical debridement
*Anti-fungal agent

29
Q

What are the causes of chesty cough ?

A
  • Acute viral bronchitis
  • Acute RSV bronchiolitis in children.
  • Pertussis in children
  • Acute laryngotracheobronchitis (Croup) in children.
  • Infective exacerbation of
    COPD and Pneumonia.
30
Q

What is the clinical presentation of ACUTE LARYNGOTRACHEOBRONCHITIS?

A

URTI progressing to Breathlessness, inspiratory stridor, seal-like cough due to inflammation of larynx and
trachea.

31
Q

What is the Tx of Croup ?

A

Corticosteroids and Humidified oxygen.

32
Q

What is the clinical presentation of acute bronchitis ?

A

Non-productive cough lasting for several weeks+/- substernal pain and fever due to bronchial inflammation.

33
Q

What is the Tx of acute bronchitis ?

A
  • Symptomatic – control of cough
  • Antibiotics
    – amoxicillin, clarithromycin, tetracycline
  • Severe disease may require ventilatory support

MS-PA: Respiratory Diseases (15 decks)

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