Upper Respiratory Tract Infections Overview
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Questions and Answers

Which of the following are examples of a common cold virus?

  • Rhinoviruses
  • Coronaviruses
  • Adenoviruses
  • All of the above (correct)
  • The role of the immune system in the respiratory tract is to destroy foreign material.

    True (A)

    What is the primary mode of transmission for influenza?

  • Droplet inhalation (correct)
  • Both C and A
  • Direct contact
  • Airborne particles (correct)
  • Which of the following viruses is responsible for Mumps?

    <p>Paramyxoviridae (B)</p> Signup and view all the answers

    What is the most common cause of Upper Respiratory Tract Infections (URTIs)?

    <p>Viral infection</p> Signup and view all the answers

    What are the most common bacteria that cause tonsillitis?

    <p>Streptococcus pyogenes (D)</p> Signup and view all the answers

    A throat swab is typically needed to diagnose a common cold.

    <p>False (B)</p> Signup and view all the answers

    Which of the following antibiotics is generally the first line of treatment for otitis media?

    <p>Amoxicillin (A)</p> Signup and view all the answers

    Which of the following medications is used to treat influenza?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the most important factor in preventing influenza?

    <p>Vaccination</p> Signup and view all the answers

    What is the most common symptom of scarlet fever?

    <p>Red tongue</p> Signup and view all the answers

    Mumps is a very common childhood illness and readily spreads.

    <p>True (A)</p> Signup and view all the answers

    There is no treatment for mumps.

    <p>True (A)</p> Signup and view all the answers

    Signup and view all the answers

    Flashcards

    Upper Respiratory Tract Infections (URTI)

    Infections affecting the nose, nasal passages, sinuses, ear, and throat (pharynx and larynx).

    Lower Respiratory Tract Infections (LRTI)

    Infections affecting the airways and lungs (trachea, bronchi, bronchioles, and alveoli).

    Mucociliary Escalator

    A natural defense mechanism of the respiratory system that traps and removes foreign particles from inhaled air, using mucus and tiny hair-like structures (cilia).

    Common Cold (Viral Rhinitis)

    A common viral infection of the upper respiratory tract, often caused by rhinoviruses, coronaviruses, or adenoviruses, resulting in mild symptoms such as nasal congestion, runny nose, sore throat, cough, and sneezing.

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    Pertussis (Whooping Cough)

    A serious respiratory infection caused by Bordetella pertussis bacteria, characterized by severe, uncontrollable coughing fits, often with a "whooping" sound upon inhalation.

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    Croup

    A viral infection of the upper respiratory tract, often caused by parainfluenza virus, characterized by a barking cough, hoarseness, inspiratory stridor, and respiratory distress.

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    Epiglottitis

    A bacterial infection of the epiglottis, often caused by Haemophilus influenzae type B (Hib) or Streptococcus pneumoniae. Symptoms include rapid onset of severe sore throat, high fever, difficulty swallowing, and drooling. Can rapidly progress to airway obstruction and respiratory failure.

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    Adenoiditis

    Inflammation of the adenoids, often due to viral or bacterial infections, resulting in nasal congestion, mouth breathing, snoring, and chronic or recurrent ear infections.

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    Bronchitis

    Inflammation of the bronchial tubes (airways), often viral in origin, characterized by persistent cough, sometimes with sputum production, chest discomfort, and low-grade fever.

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    Influenza (Flu)

    Caused by influenza viruses (A, B, and C), characterized by sudden onset of high fever, chills, headache, muscle aches, fatigue, dry cough, and sore throat. Can lead to severe complications like pneumonia.

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    Sinusitis (Sinus Infection)

    A bacterial infection that frequently occurs after a viral upper respiratory infection or allergies, resulting in facial pain or pressure, nasal congestion, headache, and post-nasal drip.

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    Strep Throat (Streptococcal Pharyngitis)

    A bacterial infection of the throat, caused by Group A Streptococcus (Streptococcus pyogenes), marked by severe sore throat, difficulty swallowing, fever, and swollen tonsils with white patches. Can lead to serious complications if untreated.

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    Streptococcus Pneumoniae

    A bacterial infection that can cause a variety of upper respiratory tract infections, including tonsillitis, sinusitis, and otitis media.

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    Moraxella Catarrhalis

    A bacterial infection often responsible for sinusitis and otitis media in children and adults with underlying respiratory conditions like cystic fibrosis.

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    Bordetella Pertussis

    A bacterial infection that causes whooping cough, characterized by severe coughing fits. Vaccination has significantly reduced incidence.

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    Mumps

    A viral infection extremely contagious spread through droplet transmission, known for causing swelling of the parotid salivary glands (causing earache, trismus). Can also affect other organs like the CNS or testes.

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    Subacute Sclerosing Panencephalitis (SSPE)

    A serious complication of measles infection, characterized by progressive neurological damage, leading to encephalitis and death.

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    Influenza Virus Subtype (e.g., H1N1)

    A specific type of influenza virus subtype, named according to its hemagglutinin (H) and neuraminidase (N) proteins. Examples include H1N1, H2N2, H3N2.

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    Antigenic Drift

    A mechanism of influenza virus evolution, where mutations occur in the viral genome, leading to small changes in the virus's proteins, resulting in an altered immune response, or less effectiveness of existing vaccines.

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    Antigenic Shift

    A mechanism of influenza virus evolution where major genetic reassortment occurs between two different influenza viruses, creating a completely new virus with different H and N proteins, potentially leading to pandemics.

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    Filtration in the Respiratory System

    A natural defense mechanism of the respiratory system that prevents and removes foreign particles from inhaled air, relying on the physical structure of the nose, such as nasal hairs and the tortuous channels.

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    Adhesion to Normal Mucosa

    The ability of microbes to attach to the normal mucosa of the respiratory tract, despite the mucociliary system, as a key step in the process of infection.

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    Professional Respiratory Tract Invaders

    A group of microbes referred to as "professional invaders" that have a specific set of characteristics allowing them to infect healthy respiratory tracts, such as the ability to adhere to the mucosa, interfere with cilia, resist destruction by macrophages, and cause tissue damage.

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    Secondary Respiratory Tract Invaders

    A group of microbes classified as "secondary invaders" that infect the respiratory tract primarily when the host's defense mechanisms are impaired, often following an initial infection.

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    Bacterial Virulence Factors

    Factors produced by bacteria that contribute to their ability to cause infection, such as pili for adhesion, capsules that help evade macrophages, and toxins that damage cells.

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    Viraemia

    The spread of infection through blood circulation, allowing microbes to reach various parts of the body.

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    Neuraminidase Inhibitors

    Antiviral medications that block the release of new viruses from infected cells, thereby limiting the severity of influenza infection. Examples include oseltamivir and zanamivir.

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    Amantadine

    A class of antiviral medications that block the function of the M2 ion channel, preventing uncoating of the influenza virus inside the host cell. Effective against influenza A only, with potential central nervous system side effects.

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    Viral Resistance

    The process by which an organism adapts to a new environment, usually involving changes in its genetic material, leading to increased resistance to drugs or antibiotics. In the context of influenza viruses, resistance to neuraminidase inhibitors can develop.

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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.

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