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Flashcards in URTI Deck (27):

what does the URT consist of?

nasal cavity


discuss features of nasal cavity?

-mucociliary lining: cells covered with cilia and goblet cells producing mucus
-defense mechanism
-air passage


discuss the features of the pharynx, larynx and trachea

pharynx- hallway for respiratory and digestive tract, epiglottis
larynx- passageway for air, vocal chords


what are the defence mechanisms of the URT?

1)smell and non-olfactory detection
2)mucociliary lining
3)lymphatic tissue of the tonsils and adenoids
4)cough reflex


what are the 2 roles of the normal microbial flora of the URT?

1)the organisms compete with pathogenic organisms for potential attachment sites
2)these organisms often produce substances (toxins or acids) which are bactericidal


What are the conditions for a respiratory disease to be established?

-sufficient number of infectious agent inhaled
-infectious particles must be airborne
-infectious organism must remain alive and viable while in the air
-organism must be deposited on susceptible tissue in the host


in terms of URTI discuss; incidence, infective agents and prognosis?

-incidence: child-7-10 annually, adult 2-5 annually
-Infective agents (usually viral esp. rhinoviruses or could be bacterium)
-prognosis: self limiting


List the common URTI?

1)common cold
2)sinusitis (rhinosinusitis)
5)sore throat
6)otitis media


provide a general discussion on the common cold?

-acute,mild, self limiting catarrhal syndrome
-usually viral
-incubation period: 24-72 hours (depends on virus)
-frequency (winter=most common): adults 2-4 and children up to 10


How is common cold transmitted?

Direct contact: skin or hand contact resulting in auto-inoculation nose/eyes
small-particle aerosols: linger in the air and can be highly infectious (influenza virus important route, rhinovirus use this route aswell)


What is the pathology of the common cold?

-virus acquired (rhinovirus)
-cells lining nasal passages and the pharynx are infected by the virus
-virus sheds coat, releases nucleic acid and replicates
-inflammatory changes occur
-ciliated coloumnar epithelial cells slough off
-destruction reaches peak 2-5 days
-regeneration of the cells begins quite quickly with new cells formed by about the 14th day.


what are the symptoms of the common cold?

-sore throat
-nasal discharge (gradual thickening of mucus)
-Nasal obstruction
-general malaise
-cough: 30% of colds, 4th-5th day when nasal symptoms decrease
-High temperature (infants and young children)


what is the prognosis for the common cold?

symptoms peak after 2-3 days, then decrease in intensity
median duration one week however smokers may suffer for an extended period


what are some complications associated with the common cold?

MAIN COMPLICATIONS is due to viral spread to other organs
adults and older children: sinusitis + LRTI
younger children: acute otitis media
very young children and babies: bronchiolitis, pneumonia and croup

Asthma may worsen and present as an acute exacerbation in people who are prone to the illness


what are the management steps for common cold treatment:

-non pharmalogical:
reassure, educate
adequate fluid
healthy food
adequate rest
self-care measures

symptom specific: saline nose drops, steam inhalation, vapour rubs, decongestants, cough remedies, antibiotics


discuss the use of decongestants in treating common cold symptoms?

oral: pseudoephedrine
-no immediate effect
-no rebound congestion on withdrawal
-sympathomimetic effects
-caution group

topical: ephedrine, oxymetazoline, xylometazoline
-immediate effect
-prolonged use can cause rebound congestion (rhinitis medicamentosa) on withdrawal (limit to 7 day use)


what is the law behind the supply of decongestants?

< 720mg of pseudoephedrine
< 180mg of ephedrine


what is sinusitis?

inflamation of the mucosal lining of the paranasal sinuses


what are sinuses?

-membrane-lined air spaces in the skull which are located near the nose
-frontal sinuses: above nose on either side
-maxillary sinuses: under cheekbones
-ethmoid and sphenoid sinuses: deeper parts of the skull near the eye sockets


what are the sinusitis classifications?

acute- sinusitis that completely resolves within 12 weeks
chronic sinusitis- sinusitis that causes symptoms that last for more than 12 weeks


what are the causes of sinusitis?

-streptococcus pneumoniae (1/3 cases)
-haemophilus influenzae
-Moraxella catarrhalis (common in children)
-main cause initially
-rare cause


how is an acute sinusitis diagnosis achieved?

-acute sinusitis usually follows common cold
-defined as an increase in symptoms after 5 days, or persistence of symptoms beyond 10 days, but less than 12 weeks
-adult symptoms: nasal blockage or congestion, nasal discharge, dental or facial pain or pressure, reduction or loss of the sense of smell
-children's symptoms:nasal blockage or congestion, discoloured nasal discharge, cough during the day or at night


How can you tell if the sinusitis is bacterial?

-symptoms persistant after 10 days
-discoloured or purulent nasal discharge
-severe localised unilateral pain
-deterioration after an initial milder phase


Discuss a sore throat?

usually viral infection
-Group A beta-haemolytic streptococcus, (strep. pyrogenes), most common bacterial cause
-acute throat infections commonly occur in children 5-10 and young adults 15-25


diagnosing the cause of a sore throat?

-sore throat
-non-specific symptoms: nausea, abdominal pain, headache and vomiting
score- feverPAIN or centor
-range of causes


what self care options are available for a sore throat?

-paracetamol for pain or fever
-medicated lozenges
-drink adequate fluids


patient 40yo exhibits a sore throat with a feverPAIN score of 4, no allergies?

prescribe penicillin V 500mg qds
(if they were allergic secon line would of been clarithromycin 500mg bd)