URTI

Question 1

ILI

Answer 1

Sore throat, Rhinorrhea, cough, Fever, myalgia, arthralgia

Question 2

Pharyngitis

Answer 2

usually caused by viruses
sore throat and pharyngeal inflammation (erythema, exudate, edema, vesicles and ulceration)
fever

Question 3

Diphtheria (caused by gram positive corynebacterium diphtheriae)

Answer 3

sore throat, laryngitis (hoarseness), pseudomembranne formation on the palate and tonsils, cervical lymphadenopathy
Complications: myocarditis, cranial and peripheral nerves palsy, paralysis of soft palate and posterior pharyngeal wall

Question 4

Pathogenesis of diphtheria

Answer 4

exotoxin of diphtheria, systemic effect and inactivation of elongation factor 2

Question 5

DTP (detection, treatment and prevention) of diphtheria

Answer 5

throat swab, hoyle’s medium containing tellurite (black colony)
penicillin or erythromycin, diphtheria antitoxin
toxoid vaccine (tetra)

Question 6

Larynngitis

Answer 6

hoarseness, dry cough, husky voice

vocal cord erythematous and hyperemia

Question 7

Possible aetiology of laryngitis

Answer 7

respiratory viruses
chlamydophila pneumoniae
mycoplasma pneumonia
Group A strep

Question 8

Acute epiglottitis

Answer 8

• may cause airway obstruction
• usually in children (H. influenzae), adult (H. influenzae, S. pneumoniae, S. pyogenes, non-innfectious causes)
• Symptoms: fever, irritability, dysphagia, dysphonia, respiratory distress, sore throat
• tripod like position, oral secretion drooling, toxic looking

Question 9

Treatment and diagnosis of acute epiglottitis

Answer 9

Diagnosis: thumb sign on XR, red and inflamed epiglottis, blood and pharyngeal culture
Treatment: 3rd generation cephalosporin (ceftriaxone and cefotaxime)

Question 10

Sinusitis (community acquired, acute)- Aetiology

Answer 10

S. pneumoniae
H. influenzae
moraxella catarrhalis (children)

Question 11

Sinusitis - clinical presentations)

Answer 11

• severe and persistent symptoms after URTI
• purulent nasal and post nasal secretions
• facial pain, headache and fever

Complications:

• intraorbital and intracranial extension of infections
• osteomyelitis of frontal bones

Question 12

Diagnosis of sinusitis

Answer 12

• Hx, physical examination
• sinus XR or CT
• sinus culture (sinus aspiration or puncture, not routine)

Question 13

Otitis media- aetiology

Answer 13

• usually in children, predisposing factors: immunodeficient, anatomical abnormalities and eustachian tube abnormality
• same as sinusitis: M. catarrhalis, S. pneumoiae, H. influenzae

Question 14

Otitis media- symptoms

Answer 14

ear pain, hearing loss, ear drainage

fever, irritability, lethargy

Question 15

Otitis media - diagnosis

Answer 15

erythema and bulging tympanic membrane, pus, fluid in the middle ear
tympanocentesis (not routine, only done when immunocompromised, not responding to antibiotics, critically ill)

Question 16

Treatment- otitis media and sinusitis

Answer 16

co-amoxiclav, sultamicillin, cefuroxime

Question 17

Symptoms of COVID-19

Answer 17

• ILI
• anosmia and dysgeusia
• LRTI (pneumonia)
• diarrhea

Complications: kawasaki-like disease, thrombosis and pulmonary embolism, organ specific