Podcast
Questions and Answers
What is the causative agent of epiglottitis?
What is the causative agent of epiglottitis?
- Strep pneumoniae
- Klepsiella spp
- Both A and B (correct)
- H.influenza
What type of agar is used to culture samples for diphtheria?
What type of agar is used to culture samples for diphtheria?
- Blood tellurite agar (correct)
- Chocolate agar
- Blood agar
- Mac Conkey agar
What is a common symptom of upper respiratory tract infections?
What is a common symptom of upper respiratory tract infections?
- Diarrhea
- Headache
- Vomiting
- Coughing (correct)
What is the purpose of a nasal swap sample in laboratory diagnosis?
What is the purpose of a nasal swap sample in laboratory diagnosis?
Which antibiotic is commonly used to treat pertussis?
Which antibiotic is commonly used to treat pertussis?
What is the primary purpose of a VITEK test?
What is the primary purpose of a VITEK test?
Which of the following is NOT a normal flora of the upper respiratory tract?
Which of the following is NOT a normal flora of the upper respiratory tract?
What is the main mechanism of host defense in the respiratory tract?
What is the main mechanism of host defense in the respiratory tract?
Which of the following pathogens is responsible for laryngeal TB of URT?
Which of the following pathogens is responsible for laryngeal TB of URT?
What is the main cause of tonsillitis and pharyngitis in children?
What is the main cause of tonsillitis and pharyngitis in children?
Which of the following is a common mode of transmission of upper respiratory tract infections?
Which of the following is a common mode of transmission of upper respiratory tract infections?
Which of the following diseases is NOT associated with the upper respiratory tract?
Which of the following diseases is NOT associated with the upper respiratory tract?
Which of the following pathogens is responsible for sinusitis?
Which of the following pathogens is responsible for sinusitis?
What is the primary function of the mucociliary escalator in the respiratory tract?
What is the primary function of the mucociliary escalator in the respiratory tract?
Study Notes
Upper Respiratory Tract Infection
- The upper respiratory tract consists of nasal cavity, sinuses, pharynx, and larynx.
- Normal flora of the upper respiratory tract includes:
- Streptococcus
- Staphylococcus
- Neisseria spp.
- Diphtheroids
- Haemophilus spp.
- Bacteroides
- Candida spp.
- Mycoplasma
- Fusobacterium
- Actinomyces
Host Defense Mechanisms of the Respiratory Tract
- Coughing and sneezing
- Presence of normal flora
- Nasal hair
- Cilia
- Mucociliary escalator
- Secretion of IgA antibody
- Macrophages eradicate microbes in the lungs
Pathogens of the Upper Respiratory Tract
- Streptococcus pyogenes (strep A)
- Staphylococcus aureus
- Corynebacterium diphtheria
- Haemophilus influenzae (immunocompromised patients)
- Streptococcus pneumoniae (sinusitis)
- Moraxella catarrhalis (sinusitis)
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Bordetella pertussis
- Legionella pneumophila
- Mycobacterium tuberculosis (laryngeal TB of URT)
- Some enterobacteria
Transmission of Infection
- Coughing
- Sneezing
- Contact with hands
- Utensils
Diseases of the Upper Respiratory Tract
- Tonsillitis and pharyngitis
- Laryngitis (Strep pneumoniae, H. influenzae, M. catarrhalis)
- Sinusitis (H. influenzae, S. pneumoniae, S. aureus, M. catarrhalis, S. pyogenes and some gram-negative)
- Diphtheria (C. diphtheria)
- Whooping cough (Bordetella pertussis)
- Epiglottitis (H. influenza, parainfluenza, Strep pneumoniae, Staph aureus, Klebsiella spp)
- Otitis media (S. pneumoniae, H. influenza, M. catarrhalis)
Symptoms of Upper Respiratory Tract Infections
- Coughing
- Sore throat (pain)
- Fever
- Myalgia
- Fatigue
- Pain when swallowing
Laboratory Diagnoses
- Samples: throat swab, nasal swab, nasopharyngeal swab (for otitis media, ear swab)
- Culture: blood agar and chocolate agar, incubated aerobically for 24h at 37°C
- If requested, culture on blood tellurite for diphtheria (black colonies)
- Confirmatory tests: catalase, coagulase, optichin disk (Strep. pneumoniae), bacitracin disk (strep A), Lancefield grouping (hemolytic strep)
- VITEK, serology, PCR (direct smears are not routinely done)
Treatment of URT Infections
- Self-limiting
- Penicillin
- Cephalosporin
- Amoxicillin
- Erythromycin, clarithromycin, azithromycin, and trimethoprim can be used for pertussis
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