Upper Respiratory Tract Infections Overview
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Questions and Answers

What is the most appropriate treatment for a patient with a fever, chills, and significant halitosis after dental surgery?

  • 10 day high dose oral amoxicillin-clavulanate treatment (correct)
  • 1-3 day intramuscular ceftriaxone treatment
  • 10 day high dose oral amoxicillin treatment
  • Over the counter antipyretic and nasal decongestants with mucolytic

    • Which condition is most likely causing the symptoms of fever and chills in the 52-year-old patient?

  • Acute bacterial rhinosinusitis (correct)
  • Acute viral rhinosinusitis
  • Acute otitis media
  • Acute laryngitis

    • Which demographic is at the highest risk for developing acute otitis media?

  • 51 year old male daycare worker
  • 36 year old pregnant mother of two
  • 5 year old female child
  • 1.5 year old male infant (correct)

    • Which pathogen is most commonly treated successfully with first-line amoxicillin-clavulanate therapy in cases of acute bacterial rhinosinusitis?

    <p>Non-typeable Haemophilus influenzae</p> Signup and view all the answers

    What distinct sign is primarily associated with acute laryngitis that differentiates it from other upper respiratory infections?

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

    What is the recommended initial treatment for GABHS infections in patients without penicillin allergies?

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

    Which of the following is a common symptom of acute laryngitis?

    <p>Raspy voice</p> Signup and view all the answers

    What treatment is recommended for chronic laryngitis if it is suspected to be caused by uncontrolled GERD symptoms?

    <p>Voice rest</p> Signup and view all the answers

    What indicates a need for corticosteroid treatment in cases of croup?

    <p>Respiratory distress</p> Signup and view all the answers

    Which of the following viruses is most commonly associated with acute infectious laryngitis?

    <p>Parainfluenza virus</p> Signup and view all the answers

    What is the duration during which acute laryngitis typically resolves?

    <p>3 to 7 days</p> Signup and view all the answers

    What type of examination is used for diagnosing laryngitis?

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

    Which of the following antibiotics is commonly prescribed for patients with penicillin allergies who have GABHS?

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

    What is a significant co-morbidity often associated with acute laryngitis?

    <p>Gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    What differentiates acute from chronic laryngitis?

    <p>Duration of symptoms</p> Signup and view all the answers

    What is the most common type of upper respiratory tract infection (URI)?

    <p>Acute otitis media</p> Signup and view all the answers

    Which of the following statements about the epidemiology of URIs is correct?

    <p>There were 25 million visits for URIs in the US before COVID-19.</p> Signup and view all the answers

    Which URI is often referred to as 'glue ear'?

    <p>Otitis media with effusion</p> Signup and view all the answers

    What clinical test is commonly used to diagnose acute otitis media?

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

    Which of the following is NOT a type of URI?

    <p>Chronic sinusitis</p> Signup and view all the answers

    What is a significant concern regarding URIs and antibiotic use?

    <p>Improper antibiotic prescriptions contribute to resistance.</p> Signup and view all the answers

    What symptom is commonly associated with acute rhinosinusitis?

    <p>Facial pain or pressure</p> Signup and view all the answers

    What is the primary rationale for prioritizing first-line treatment strategies in managing URIs?

    <p>They help reduce the risk of complications.</p> Signup and view all the answers

    What defines chronic otitis media (COM)?

    <p>Long-term middle ear inflammation causing damage</p> Signup and view all the answers

    Which age group accounts for 50% of the cases of otitis media worldwide?

    <p>Children under 5 years</p> Signup and view all the answers

    What is the most common bacterial cause of acute pharyngitis (AP)?

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

    Which of the following is a sign suggestive of viral acute pharyngitis?

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

    Which test is considered the gold standard for determining the cause of acute pharyngitis?

    <p>Throat swab culture</p> Signup and view all the answers

    What feature is common in both bacterial and viral causes of acute pharyngitis?

    <p>Red swollen tonsils</p> Signup and view all the answers

    What does coryza refer to in the context of viral infections?

    <p>Inflammation of nasal cavities</p> Signup and view all the answers

    Which factor is primarily responsible for spreading viruses and bacteria causing pharyngitis?

    <p>Coughing and sneezing</p> Signup and view all the answers

    Which of these signs would not typically suggest acute viral pharyngitis?

    <p>Pus-filled lesions</p> Signup and view all the answers

    What is the primary method of diagnosing GABHS in patients with acute pharyngitis?

    <p>Throat swab and culture</p> Signup and view all the answers

    What is the next recommended course of action for a 2-year-old with ear pain and signs of a non-severe penicillin allergy?

    <p>Referral for tympanocentesis</p> Signup and view all the answers

    Based on the symptoms, what is the likely diagnosis for a 10-year-old with severe throat pain and conjunctivitis?

    <p>Acute viral pharyngitis (AVP)</p> Signup and view all the answers

    What nasal cavity symptom is primarily responsible for congestion during acute viral rhinosinusitis?

    <p>Obstruction of the sinus ostia</p> Signup and view all the answers

    Which infectious agent is most commonly associated with acute viral pharyngitis?

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

    What would be the most appropriate test for a 10-year-old suspected of having acute bacterial pharyngitis?

    <p>Rapid antigen-detection test (RADT)</p> Signup and view all the answers

    What is a common complication of untreated acute otitis media in children?

    <p>Tympanic membrane perforation</p> Signup and view all the answers

    Which symptom is NOT typically associated with acute viral pharyngitis?

    <p>Severe headache</p> Signup and view all the answers

    What would be the appropriate management for a persistent sinus congestion and cough lasting beyond 10 days?

    <p>Topical nasal decongestants</p> Signup and view all the answers

    In the case of a 2-year-old with tympanic membrane infections, which condition can lead to hearing loss if repeated?

    <p>Chronic otitis media</p> Signup and view all the answers

    Which finding would likely indicate a bacterial infection rather than a viral one in a patient with throat pain?

    <p>Fever greater than 101°F (38.3°C)</p> Signup and view all the answers

    Study Notes

    Upper Respiratory Tract Infections (URIs)

    • Most frequent infection leading to physician visits, totaling 25 million annually pre-COVID in the US; rates increased by 30% since 2022.
    • Major contributor to bacterial antibiotic resistance due to misuse and over-prescription of antibiotics.
    • Four primary types of URIs:
      • Acute otitis media
      • Acute rhinosinusitis
      • Acute pharyngitis
      • Acute laryngitis

    Otitis Media (OM)

    • Represents inflammation of the middle ear, with three forms:
      • Acute otitis media (AOM)
      • Otitis media with effusion (OME) also known as "glue ear."
      • Chronic otitis media (COM) leads to long-term inflammation and multi-drug resistant infections.
    • Over 700 million global cases annually, with 50% affecting children.

    Acute Pharyngitis (AP)

    • Most commonly caused by Group A beta-hemolytic streptococcus (GABHS); other viral and non-streptococcal bacterial causes also possible.
    • Symptoms include sudden sore throat, fever, and constitutional signs, typically resolving in 3-5 days.
    • Clinical signs for GABHS and viral causes are often similar.

    Diagnosis of GABHS Pharyngitis

    • Throat swabs utilized for:
      • Rapid antigen-detection test (RADT)
      • Gold standard microbiological culture.

    Treatment Considerations

    • Viral AP management involves symptomatic relief with anti-pyretics and analgesics.
    • GABHS treatment includes:
      • First-line: Penicillin V, Penicillin G benzathine, Amoxicillin (10-day course).
      • Alternatives for penicillin allergy: Cephalexin, Clindamycin, Azithromycin, Clarithromycin.

    Acute Laryngitis (AL)

    • Inflammation of the larynx, typically self-limiting and lasts 3-7 days; chronic if >3 weeks.
    • Commonly viral in origin; pediatric cases may include "croup."
    • Symptoms: voice changes, dry cough, throat pain, fever; often associated with gastroesophageal reflux disease (GERD).

    General Diagnosis and Treatment for AL

    • Diagnosis through laryngoscope examination.
    • Treatment includes voice rest, supportive care, and corticosteroids for croup.

    Risk Factors and Clinical Management

    • Common risk factors shared between different URIs, with a focus on ensuring proper antibiotic use to prevent complications and resistance.

    Study Question Highlights

    • Importance of differentiating viral vs bacterial infections in treatment decisions.
    • Understanding of conditions leading to acute otitis media and appropriate treatment choices based on patient history and symptoms.
    • Recognizing signs that distinguish laryngitis from other URIs, with particular focus on aphonia as a unique symptom.

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    Related Documents

    Upper Respiratory Tract Infections (URIs) PDF

    Description

    Explore the various types of upper respiratory tract infections (URIs) including acute otitis media, acute rhinosinusitis, acute pharyngitis, and acute laryngitis. Learn about their prevalence, causes, and impacts on health, particularly in children. This quiz addresses the major contributors to antibiotic resistance as well.

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