Upper Respiratory Tract Infections Overview
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Questions and Answers

What is the typical duration of acute infectious laryngitis?

  • 1 to 2 days
  • 2 to 4 weeks
  • More than 4 weeks
  • 3 to 7 days (correct)
  • Which antibiotic is not a first-line treatment for GABHS pharyngitis?

  • Amoxicillin
  • Cefadroxil
  • Penicillin G benzathine
  • Tetracycline (correct)
  • What is often a common co-morbidity associated with acute laryngitis?

  • Asthma
  • Chronic bronchitis
  • Gastroesophageal reflux disease (GERD) (correct)
  • Hypertension
  • Which of the following is a recommended treatment for patients with penicillin allergies when treating GABHS?

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

    Which of the following indicates a potential bacterial etiology for laryngitis?

    <p>Duration exceeding 7 days</p> Signup and view all the answers

    What is a common symptom of acute laryngitis?

    <p>Dryness of throat</p> Signup and view all the answers

    Which treatment is essential if symptoms of uncontrolled GERD are present in patients with laryngitis?

    <p>Corticosteroid treatment</p> Signup and view all the answers

    Which viral organism is commonly associated with cases of pediatric acute laryngitis known as croup?

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

    Which of the following treatments is used for acute infectious laryngitis if bacterial etiology is suspected?

    <p>First-line antibiotics</p> Signup and view all the answers

    What characterizes chronic laryngitis when acute laryngitis lasts longer than?

    <p>3 weeks</p> Signup and view all the answers

    What is one major consequence of improper antibiotic prescriptions for URIs?

    <p>Bacterial antibiotic resistance</p> Signup and view all the answers

    Which of the following is NOT one of the four most common types of URIs?

    <p>Common cold</p> Signup and view all the answers

    Which clinical term is associated with inflammation of the middle ear?

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

    What term is also known as 'glue ear'?

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

    What is the primary aim of the first- and second-line treatment strategies for managing URIs?

    <p>Reduction of inflammation and pain</p> Signup and view all the answers

    How has the rate of URI-related visits to physicians changed since 2022?

    <p>Increased by 30%</p> Signup and view all the answers

    What is the primary focus of URIs in relation to epidemiology and risk factors?

    <p>They remain the most common patient infection</p> Signup and view all the answers

    Which symptom is typically associated with otitis media with effusion (OME)?

    <p>Hearing impairment</p> Signup and view all the answers

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

    <p>10 day high dose oral amoxicillin-clavulanate treatment</p> Signup and view all the answers

    What is the most likely cause of symptoms in a 52-year-old patient with fever and chills after dental surgery?

    <p>Acute bacterial rhinosinusitis</p> Signup and view all the answers

    Which patient is most at risk for developing acute otitis media?

    <p>1.5 year old male infant</p> Signup and view all the answers

    Which bacterial infection is most likely to be successfully treated with first-line amoxicillin-clavulanate therapy?

    <p>Moraxella catarrhalis</p> Signup and view all the answers

    What sign or symptom specifically distinguishes acute laryngitis from other upper respiratory infections?

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

    What is the primary cause of chronic otitis media (COM)?

    <p>Multidrug resistant infections</p> Signup and view all the answers

    Which of the following is the only commonly occurring form of acute pharyngitis (AP) that requires antibiotic therapy?

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

    What is the most appropriate course of action for a 2-year-old with ear pain and a history of non-severe penicillin allergy?

    <p>Treatment with first-line ceftriaxone</p> Signup and view all the answers

    Which symptom is least likely to be associated with GABHS acute pharyngitis?

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

    What URI is likely indicated for a 10-year-old with severe throat pain, red, swollen tonsils, and conjunctivitis?

    <p>Acute bacterial pharyngitis (ABP) and rapid antigen-detection test (RADT)</p> Signup and view all the answers

    What percentage of persons of all ages with pharyngitis are likely caused by GABHS?

    <p>10%-30%</p> Signup and view all the answers

    Which of the following is NOT a sign suggestive of viral acute pharyngitis?

    <p>Fever lasting over 5 days</p> Signup and view all the answers

    Which symptom during acute viral rhinosinusitis explains nasal and facial congestion?

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

    Which infectious agent is most commonly identified in patients with acute viral pharyngitis (AVP)?

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

    What is the gold standard for determining the cause of bacterial or viral acute pharyngitis?

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

    Which one of the following is a common mode of transmission for viruses or bacteria causing acute pharyngitis?

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

    For a patient presenting with persistent headache, facial and sinus congestion after 14 days of worsening cold symptoms, what is the likely diagnosis?

    <p>Acute bacterial rhinosinusitis (ABR)</p> Signup and view all the answers

    After 12 days of throat pain and dysphagia in a child, what is the most appropriate follow-up action?

    <p>Perform a rapid antigen-detection test</p> Signup and view all the answers

    Which symptom is primarily associated with acute viral pharyngitis?

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

    How long do symptoms of viral acute pharyngitis typically last?

    <p>3-5 days</p> Signup and view all the answers

    What clinical finding is most indicative of acute otitis media?

    <p>Inflamed, bulging tympanic membrane with otorrhea</p> Signup and view all the answers

    In the assessment of a child with throat pain and conjunctivitis, which additional symptom supports a viral infection over a bacterial one?

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

    What is a key feature that distinguishes bacterial acute pharyngitis from viral acute pharyngitis?

    <p>Presence of white spots or exudates</p> Signup and view all the answers

    Which condition would typically present with nasal congestion accompanied by purulent sinus drainage?

    <p>Acute bacterial rhinosinusitis</p> Signup and view all the answers

    What is the expected temperature during a viral upper respiratory infection?

    <p>Usually low-grade, around 99°F (37.2°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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    Description

    This quiz covers the major aspects of Upper Respiratory Tract Infections (URIs), including types, causes, and implications for health. Learn about specific infections like otitis media and acute pharyngitis, alongside their complications and prevalence. Test your knowledge on the significant role URIs play in healthcare and antibiotic usage.

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