13 - 40 yo M with persistent cough Flashcards
to diagnose a pt with acute bacterial sinusitis, they should have symptoms for a minimum of _____ days following a ___________
- 7-10 days
- viral URI
nasal congestion or obstruction persisting for over ____ weeks would be associated with chronic sinusitis
12
in order to diagnose sinusitis patients must have two of which set of symptoms?
- nasal obstruction or congestion
- mucopurulent drainage (anterior, posterior, or both)
- facial pain, pressure, or fullness
- decreased sense of smell
also must have signs of inflammation on exam
in patients with asthma it is particularly important to ask about what type of drug use?
aspirin (NSAIDs)
what criteria are used to classify asthma?
- frequency of symptoms
- frequency of nighttime awakenings
- frequency of short acting b2 agonist use for symptom control
- interference with normal activity
- FEV1 value
- FEV1/FVC ratio
what is the most concerning long term effect of asthma?
less reversibility of the airway obstruction with medication
what are the PFT parameters for diagnosing asthma?
- improvement in FEV1 by at least 12% OR
- increase in % predicted FEV1 by 10% after a bronchodilator
what is the medical management for allergic rhinitis?
- oral antihistamine
- inhaled nasal corticosteroid
what are the 4 key tasks in an initial evaluation of asthma?
- classify asthma severity
- assess patient’s knowledge and skills for self-management
- identify and control environmental factors and comorbid conditions that may aggravate asthma
- offer appropriate medications
what is the treatment for moderate persistent asthma?
- low dose inhaled corticosteroid
- LABA
OR
- medium dose inhaled corticosteroid alone
what is the most effective medication for allergic rhinitis?
nasal corticosteroids
what is the recommendation for antibiotic use for chronic sinusitis?
no compelling evidence to support use of abx in patients with chronic sinusitis
