#5 Habal - Cold, Otitis Media, Sinusitis

Question 1

Identify

Answer 1

Strepococcus pneumoniae

Otitis Media

(Also CAP, meningitis, sinusitis)

Question 2

Identify

Answer 2

Haemophilus influenzae

Otitis media

Question 3

Identify

Answer 3

Streptococcus pneumoniae

Fever, cough, dyspnea

Rusty colored sputum

Question 4

Identify

Answer 4

Coxsackivirus A

Hand, Foot & Mouth

Question 5

Identify

Answer 5

Coxsackivirus A

Herpangia

Question 6

Identify

Answer 6

Coxsackievirus A

Conjunctivitis

Question 7

9 month old comes in with accumulation of fluid behind the membrane. What is the diagnosis and what is it a complication of?

Answer 7

Acute Otitis Media

Common Cold

If there is no fluid it is NOT acute otitis media!

Question 8

A 23 month old comes in with acute otitis media due to fluid accumulation. What are the three common bacteria that cause the AOM and how would you treat it?

Answer 8

H. influenza

Streptococcus pneumoniae

Moroxella catarrhalis

Question 9

If you diagnosed your patient with acute otitis media and he is not responding to Amoxicillin, what would you treat him with next?

Answer 9

Augmentin (Amocillin + Clavunate)

Ceftriaxone

Question 10

Your patient has returned again with the same sinus congestion after 45 days. How is the sinus infection now classified? How would this change your prescription?

Answer 10

Subacute sinus infection

Augmentin (Amoxicillin-Clavunate)

[oil - peppermint and lemon]

Question 11

Your patient comes in with a sinus infection and you culture the nasal cavity. The results are gram positive, catalase negative and alpha hemolytic. What bacteria is probably causing the infection? How would you treat it?

Answer 11

Streptococcus pneumoniae

Tx: penicillin, ampicillin, tetracyclin, doxycyclin

Question 12

Your patient comes in with the following presentation. The culture comes back with a gram negative non motile coccobacilli, serotype b. What is the organism? What drugs would you not use to treat this organism due to resistance?

Answer 12

Haemophilus influenzae

NO penicillin or choramphinicol

Question 13

What is your recommendation for treatment against H. influenza?

Answer 13

Vaccine

Question 14

Patient comes in complaining of cough, fever, and rusty colored sputum. What is your ddx?

Answer 14

Strep Pneumo

Question 15

Child comes in with vesicular rash on feet and tongue and has a mild fever. Diagnosis?

Answer 15

Coxsackievirus

Hand Foot & outh (HFM)

Question 16

Which labs would you use to diagnose H. influenzae?

Answer 16

Latex agglutination

Counterimmunoelectrophoresis

Fluorescent antibody staining