Upper Respiratory Tract Infections: Pharyngitis, Epiglottitis, Deep Infections in Head and Neck
The document discusses various upper respiratory tract infections including pharyngitis, epiglottitis, and deep neck space infections. It provides guidelines for evaluating and diagnosing pharyngitis using the Centor criteria to determine if testing for Group A streptococcus is needed. It also discusses non-streptococcal causes of pharyngitis and outlines considerations and workup for dangerous deep neck space infections like epiglottitis and peritonsillar abscesses. The goal is to appropriately diagnose and treat conditions like streptococcal pharyngitis while excluding
Strep throat is the most common throat
infection caused by bacteria.
It is found most often in
children between the ages of 5 and 15, although it can occur in younger
children and adults. Children younger than 3 years old can get strep
infections, but these usually don’t affect the throat.
Strep throat infections usually occur in
the late fall, winter, and early spring.
Both acute and chronic pharyngitis are common diseases and they are important for the students to understand, Moreover acute tonsillitis is also very common and it becomes one of the most important causes of throat pain and fever.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
Strep throat is the most common throat
infection caused by bacteria.
It is found most often in
children between the ages of 5 and 15, although it can occur in younger
children and adults. Children younger than 3 years old can get strep
infections, but these usually don’t affect the throat.
Strep throat infections usually occur in
the late fall, winter, and early spring.
Both acute and chronic pharyngitis are common diseases and they are important for the students to understand, Moreover acute tonsillitis is also very common and it becomes one of the most important causes of throat pain and fever.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
Upper respiratory tract infections are characterized by self-limited irritation and swelling of the upper airways together with a cough that does not indicate pneumonia, does not have a coexisting medical condition that could be the cause of the patient's symptoms, and does not have a history of chronic bronchitis, emphysema, or COPD. Presentation gives an overview on "Upper Respiratory Tract Infections", including causes, symptoms, diagnosis, and Treatment to cure. For more information, please contact us: 9779030507.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
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5th edition of the Diagnostic and Statistical Manual of Mental Disorders
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disorder called alcohol use disorder (AUD), with mild, moderate,
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from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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2. Agenda
• Pharyngitis
• (briefly):
• Epiglottitis
• Deep neck space infections
• For PCPs:
• for pharyngitis: stop using so many antibiotics, but use them when you
need to!
3.
4. 30 year old intern presents with a sore throat
• Fever to 101.3 x 24 hours
• No cough
On exam:
-- tender LNs
-- no tonsillar exudates
5. Centor Criteria
• Is Group A beta-haemolytic streptococcus as a cause of presentation
with sore throat??:
• Tonsillar exudate
• Tender anterior cervical LAD
• Abscess of cough
• Fever
• Presence of 3 or 4 have a 40-60% likelihood of having GABHS as the cause.
• Absence of 3 or 4 suggests there is an 80% chance that GABHS is not the cause
6. What work up?
• 3 or 4 Centor criteria: RADT without backup throat culture (positive RADT
is specific and will allow for rapid initiation of antibiotic treatment). Good
neg predictive value
• RADT sensitivity 70-90% and specificity 90-100%
• How can we use the Centor criteria to aid in who should be tested?
• 1 Centor criteria: 7%
• 2: 21%
• 3: 38%
• 4: 57%
8. With 3 or more Centor criteria:
• Rapid antigen detection test (RADT)
• NO reflex culture
• Get a good sample, and do it before ANY abx
• If RADT +: PCN V x 10 days; consider azithromycin in the PCN allergic
pt
• Treat to reduce symptoms, transmission, and complications
• Severity of presentation does not portend likelihood of complications
9. GAS: 5-15%
• (+) Sudden onset sore throat, tonsillar exudate, TENDER cervical adenitis, fever
• (-) (Usually) cough, rhinorrhea
• Identification and treatment reduces risks of complications
• Suppurative complications:
• Tonsillopharyngeal cellulitis or abscess
• Otitis media
• Sinusitis
• Nec fasciitis
• Strep bacteremia
• Meningitis
• Jug vein septic thrombophebitis
• Nonsuppurative complications:
• ARF: 2-3 weeks after pharyngitis; arthritis, carditis, chorea, subQ nodules, EM
• Recent increase in US
• Scarlet Fever: delayed-type skin reaction to pyrogenic endotoxin (do rapid strep testing and throat culture)
• Strep TSS
• Acute glomerulonephritis
10. 30 year old intern presents with a sore throat
• No fever
• Purulent cough
• No LAD
• What is this NOT?
• What should you NOT do?
• What causes the majority of pharyngitis?
• 60% of patients with sore throats get abx, azithro>>PCN
11. Memorable Example
• 60 F w/ MMP presented to PCP with sore throat (1 Centor criteria)
• Empiric azithromycin no response
• Empiric ceftriaxone/azithromycin no response
• Empiric Ciprofloxacin no response
• Ultimate clinical improvement…BUT
• Develops diarrhea; C diff toxic positive
• Delay in initiation of treatment
• Develops toxic megacolin
• PEA arrests on feculent material, expires
12. 30 year old intern presents with sore throat
• No fever, LAD, tonsillar exudate
• Recent sexual activity
• What 4 diagnoses should you consider?
13. 30 year old intern presents with sore throat
• Persistent dry cough
• Otherwise, young, healthy person
• Feeling awful
• What diagnoses to consider?
14. 30 year old patient presents with sore throat
• Low grade fever
• Muffled voice
• Malaise
• On exam, lesion in the back of the mouth that bleeds when you poke
it
• What follow up history do you want from the patient?
16. Non-GAS Pharyngitis
• Causes (I):
• Viral (50%): influenza, parainfluenza, coronavirus, rhinovirus, adenovirus, enterovirus
RSV, metapneumovirus, coxsackie
• Strep/viral coinfection
• Influenza: cough, myalgias, hyperemia, NO (unlikely) tonsillar exudates
• EBV: malaise, HA, low grade fever, tonsillitis, pharyngitis, cervical LAD, high fevers
(diffuse adenitis, splenomegaly, skin rash less likely)
• Primary HIV: mononucleosis-like syndrome +/or aseptic meningitis
• HSV: pharyngitis and/or tonsillitis (up to 10% of cases in college students). Pharyngeal
edema, tonsillar exudate, oral exudate, ulcerative lesion.
• Non-group A strep (clinically indistinguishable from strep)(15%) (group C and G) (throat
culture)
17. Non-GAS Pharyngitis – Causes (II)
• Less common bacterial pathogens (<5%)
• Diptheria: pharyngitis, malaise, low-grade fever; gray membrane that bleeds; consider in pts
from other countries (lack of vaccine)
• N. gonorrhaeae: rare (but common in higher risk groups; consider for college students,
sexually active MSM, some HIV+ patients)
• C. pneumoniae: pharyngitis + bronchitis/pneumonitis;
• M. pneumoniae: young, healthy adult; pharyngitis, persistent cough, constitutional
symptoms
• No pathogen isolated (30%)
18. Pharyngitis Workup:
Emphasis on Dx Treatable Conditions
• If >2 Centor criteria:
• RADT with reflex throat cx for (+) RADT only
• Consider throat cx if RADT (-) ONLY in: poorly controlled DM,
immunocompromised
• Influenza PCR
• Consider: assessment for HIV, HSV, n. gonorrheae
• Rule out: dangerous conditions
19. Pharyngitis: Exclude dangerous conditions
• Epiglottitis: sore throat, odynophagia, muffled voice, fevers, stridor,
hoarseness. Severity of sore throat >>>>OP exam
• Peritonsillar abscess: unilateral sore throat, hot potato/muffled voice.
Pooling of saliva. Trismus (66%)
• Submandibular space infections: (Ludwigs): No trismus. Tender
woody induration, sometimes crepitus, no LAD
• Retropharyngeal space infections: often penetrating trauma
**Imaging, early intervention
