Flashcards in URT Disorders Deck (32)
etiologies of the common cold
group A strep
Seasonality of rhino virus
Seasonality of corona virus
Why does the common cold lead to rhinorrhea?
virus infect cells
--> inflammation --> inc vascular permeability --> serum transudation --> rhinorrhea
--> irritation of airway receptors --> cholinergic stim --> inc mucus production
Why does the common cold lead to cough?
virus infect cells --> irritation of airway receptors --> cholinergic stim -->bronchoconstriction --> cough
Why does the common cold lead to nasal obstruction?
virus infect cells --> inflammation
--> inc vascular permeability --> tissue edema --> obstruction
--> vascular dilation --> obstruction
how is the common cold transmitted
direct contact > inhalation
how is the common cold managed?
supportive care, NO abx
What usually causes sinusitis?
2ndary infection bc the outflow from one of the sinuses is decreased
**most often maxillary sinus
What are the predisposing factor to developing sinusitis ?
1. impaired mucocillialry function
2. obstruction of sinus ostia
3. immune defects
4. increased risk from cocaine use. swimming, intubation, etc
Nasal discharge, nasal congestion, facial pressure, cough, fever, muscle aches, joint pains, sore throat with hoarseness
acute viral rhibosinusitis
What is the seasonality of acute viral Rhinosinusitis
fall, winter, spring
Causative agents of acute bacterial sinusitis
Nontypeable Haemophilus Influenzae
Feeling of fullness and pressure over the involved sinuses, nasal congestion and purulent nasal discharge.Sore throat, malaise, low grade fever, headache, toothache, cough > 1 week duration.
acute bacterial sinusitis
How long does cough usually last in acute bacterial sinusitis?
> 1 week
How long may symptoms last in acute viral and bacterial sinusitis?
How is the diagnosis of sinusitis made?
clinical signs and symptoms:
palpate sinuses and look for deviated nasal septum
How is bacterial sinusitis treated?
most improve w/o intervention
abx for those that have symp > 10 days or worsening symp
What tx for acute bac sinusitis should be discouraged
OTC nasal decongestant sprays for > 5 days
What supportive therapies can be used for sinusitis?
1. steam to liquify secretions
2. sailine qid to liquify secretions
3. decongestants to inc ostial diameter
4. topical steroids (limit to chronic sinusitis/allergies)
What is the definition of chronic sinusitis?
What is the "cure"?
1. sinusitis symptoms for > 12 weeks
2. > 4 episodes/year (each lasting >10 days)
3. CT showing persistent infection despite abx
pathogenesis of chronic sinusitis
Who gets acute phayngitis?
5-18 yo and adult women
1. tonsilar exudates
2. tender ant cervical adenopathy
3. Hx of fever
4. absence of cough
**Patients with 0-2 Centor criteria = unlikely to have GAS (should not receive either antibiotic treatment or diagnostic testing)
*CENTor (cervical LAD, exudates, no cough, temp)
Dx of strep pharyngitis \
Gold std = throat culture
rapid Ag detection
** if rapid Ag screen in negative, get CULTURE
Complications of strep pharyngitis
1. acute rheumatoid fever
2. post strep glomerulonephritis
3. scarlet fever
4. peritonsilar abscess
5. strep TSS
GREATS (glomeruloneph, rheumatoid fever, epiglottitis, abscess, toxic shock, scarlet fever)
coalescing pseudomembrane that adheres tightly to the underlying tissue and bleeds with scraping
WHat is the most common infectious cause of epiglottitis?
Haemophilus influenzae type b (Hib)
***there is a vaccine so it is rate now
T or F: suspected epiglottitis is a medical emergency
How does epiglottitis presnet
the three Ds
dysphagia, drooling, and distress
**will be in tripod position too