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Questions and Answers
Which of the following are examples of a common cold virus?
Which of the following are examples of a common cold virus?
The role of the immune system in the respiratory tract is to destroy foreign material.
The role of the immune system in the respiratory tract is to destroy foreign material.
True
What is the primary mode of transmission for influenza?
What is the primary mode of transmission for influenza?
Which of the following viruses is responsible for Mumps?
Which of the following viruses is responsible for Mumps?
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What is the most common cause of Upper Respiratory Tract Infections (URTIs)?
What is the most common cause of Upper Respiratory Tract Infections (URTIs)?
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What are the most common bacteria that cause tonsillitis?
What are the most common bacteria that cause tonsillitis?
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A throat swab is typically needed to diagnose a common cold.
A throat swab is typically needed to diagnose a common cold.
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Which of the following antibiotics is generally the first line of treatment for otitis media?
Which of the following antibiotics is generally the first line of treatment for otitis media?
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Which of the following medications is used to treat influenza?
Which of the following medications is used to treat influenza?
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What is the most important factor in preventing influenza?
What is the most important factor in preventing influenza?
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What is the most common symptom of scarlet fever?
What is the most common symptom of scarlet fever?
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Mumps is a very common childhood illness and readily spreads.
Mumps is a very common childhood illness and readily spreads.
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There is no treatment for mumps.
There is no treatment for mumps.
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Study Notes
Upper Respiratory Tract Infections (URTIs)
- URTIs affect the nose, nasal passages, sinuses, ear, and throat (pharynx and larynx)
- LRTIs affect the airways and lungs (trachea, bronchi, bronchioles, and alveoli)
Objectives
- Students should differentiate between URTIs and LRTIs
- Students should describe the pathophysiology and epidemiology of various respiratory infections
- Students should understand the role of the immune system in respiratory tract infections (RTIs)
- Students should know appropriate treatment regimens for named RTIs
Respiratory System Anatomy
- The respiratory system includes the nasal cavity, mouth, pharynx, larynx, trachea, bronchi, bronchioles, and alveoli.
- A diagram shows the upper and lower respiratory tracts.
Definitions
- URTIs affect the nose, nasal passages, sinuses, and the throat (pharynx and larynx)
- LRTIs affect the trachea, bronchi, bronchioles, and alveoli.
Natural Host Defenses
- Saliva contains antibodies and has a specific pH level
- Sinuses have immune-defense mechanisms
- Tonsils are part of the lymphatic system
- Nose hairs, sneezing filter and remove particles
- The mucociliary escalator and cough reflex remove microscopic particles from the lungs
- Respiratory tract epithelium secretes antimicrobial peptides
Normal Respiratory Tract Flora
- Common flora includes oral streptococci, Neisseria spp., and Branhamella spp in high numbers
- Occasional residents include Streptococcus mutans, Haemophilus influenzae, and Streptococcus pyogenes
- Uncommon residents include Neisseria meningitidis, Corynebacterium diphtheriae, and potentially others
Typical Causative Organisms
- Bacterial: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Mycoplasma pneumoniae, Streptococcus pyogenes
- Viral: Respiratory syncytial virus (RSV), Adenovirus, Influenza viruses (most common causes of URTIs).
RT Defence Mechanisms (1)
- Filtration: Air passes through mucous-coated channels, filtering out particles smaller than 3 mm in size
- Mucosal adherence: Stress on the immune system can lead to imbalance resulting in Gram-negative infections
- Macrophages: Destroy foreign material
- Bacterial interference, altered flora can lead to superinfections
- Secretions like lysozyme
RT Defence Mechanisms (2)
- Secretory IgA plays a role in homeostasis in the GI, respiratory, and genitourinary tracts
- Mucociliary clearance: removes debris from the airways using ciliary action
- Cough reflex: A normal tracheobronchial reflex mechanisms for removing foreign material
- Cells & cell products: compromised immune systems lead to opportunistic infections, e.g., AIDS
Common URTIs (1/3)
- Croup: common viral disease in children characterized by a barking cough
- Epiglottitis: bacterial infection of the epiglottis, causing severe sore throat
- Pertussis (whooping cough): caused by Bordetella pertussis, initially presenting as a common cold.
Common URTIs (2/3)
- Adenoiditis: Inflammation of the adenoids (often bacterial)
- Pharyngitis (sore throat): Viral or bacterial.
- Common Cold (viral rhinitis): caused by rhinoviruses, coronaviruses, and adenoviruses.
Common URTIs (3/3)
- Influenza (Flu): viral infection of the respiratory tract
- Sinusitis (sinus infection): often follows a viral respiratory infection and characterized by facial pain or pressure, nasal congestion, and headache.
- Strep Throat (Streptococcal Pharyngitis): Bacterial infection, presents with severe sore throat, swollen tonsils, often with white patches
- Bronchitis: inflammation of the bronchial tubes; generally viral.
Pathogenesis
- Most common causes of URTI are viral infections
- There are two types of infection
- Local (mucosal) defenses and adaptive (immune) response play a critical role
- Short incubation periods are common
Pathogenesis: Microbes
- Professional invaders have abilities to adhere to the mucosa and interfere with cilia. They resist elimination by alveolar macrophages and cause damage to local tissues.
- Secondary invaders infect where host defenses are impaired, e.g., cystic fibrosis. Their abilities include initial infection, immune defense impairment, and damage to local mucosal tissues. Factors associated with diminished immune response include chronic bronchitis, local foreign bodies, tumors, etc.
Virulence Factors
- Pili (adhesins): enable bacteria to attach to host cells (e.g., Bordetella pertussis)
- Capsules: prevent phagocytosis (e.g., Streptococcus pneumoniae, H. influenzae).
- M proteins: resist phagocytosis (e.g., Streptococcus pyogenes).
- Toxin production: damaging chemicals (e.g., Staphylococcus aureus, Streptococcus pyogenes).
Anatomy and Microbiology
- Diagram showing anatomical structures, clinical presentations, and areas affected by different microorganisms in the respiratory tract
Investigations for URTI
- Typically not necessary unless suspected strep throat
- Throat swab is the primary investigation tool. Image showing normal and abnormal characteristics of the throat.
Antibiotic Treatment
- Guidelines for antibiotic choice, based on suspected bacterial infection (tonsillitis, sinusitis, and otitis media). Choices include penicillins and derivatives (e.g., penicillins, amoxicillin, clarithromycin, doxycycline)
Infections: Summary Table
- Table summarizing key points, treatment, doses, lengths for common infections, influenza, acute otitis media, acute otitis externa, scarlet fever, and sinusitis. Infections include viruses like influenza and bacteria such as Streptococcus pyogenes.
Mumps
- Viral infection (paramyxoviridae family)
- Highly contagious, spread through droplets
- Characteristic features include swelling of the parotid salivary glands.
- Potential for complications in males (e.g., orchitis, epididymitis)
- Incubation period, spread, symptoms, and potential complications.
Measles
- Viral infection
- Highly contagious
- Characteristic features include rash, fever, cough, and runny nose.
- Potential for complications.
Summary:
- Discuss pathophysiology and epidemiology for RTIs, including those spread by droplet transmission
- Understand the role of the immune system in RTIs
- Value of non-RTI spread (e.g., mumps, measles)
- Identify appropriate treatment regimens for various respiratory infections (RTIs)
- The five Rights of Medication Administration
Important note:
- Consult with a physician for accurate medical advice and treatment options for any health issues.
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Description
This quiz focuses on Upper Respiratory Tract Infections (URTIs) and their differentiation from Lower Respiratory Tract Infections (LRTIs). Students will explore the pathophysiology, epidemiology, and immune responses related to respiratory infections, as well as treatment options. A solid understanding of respiratory system anatomy is essential for mastering this content.
