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NURS 518 > 526 URTI > Flashcards

526 URTI Flashcards

1
Q

hyposmia is ____

A

unable to less able to smell

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2
Q

Acute sinusitis is a duration of

A

< 4 weeks

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3
Q

what is 1st line treatment for bacterial sinusitis

A

amox/clav

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4
Q

what is the most common bacterial pathogen that causes sinusitis

A

s. pneumoniae

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5
Q

Decongestants can be used for symptom management in sinusitis but should not be used for longer than ____ to prevent ____

A

3 days
rebound congestion

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6
Q

true or false: oral corticosteroids may be helpful in treating sinusitis

A

false, only intranasal steroids like mometasone have been found to be helpful

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7
Q

true or false: antihistamines may help with symptom management in sinusitis

A

false, antihistamines have been shown to be of no use unless the cause if allergic

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8
Q

OTC cold medication should not be used in children younger than ____

A

4 years

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9
Q

what intranasal medication may help reduce coughing from the common cold

A

ipratropium (atrovent)

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10
Q

what medication may be of use in helping with symptom management of the common cold in older adults

A

Lactobacillus casei

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11
Q

should intranasal corticosteroids be used in the common cold

A

no, they have shown no benefit

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12
Q

what are the 4 cardinal symptoms of chronic rhinosinusitis

A

purulent nasal drainage
nasal obstruction
facial pain or pressure
decrease or loss of smell

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13
Q

what are the 3 cardinal symptoms of acute bacterial rhinosinusitis

A

mucopurulent discharge
nasal obstruction
facial pain or pressure

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14
Q

in patients presenting with sinusitis symptoms with fever and headache what is a “red flag” assessment that should not be missed

A

assess for any meningeal irritation (Kernig and Brudzinski sign)

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15
Q

what would transillumination of the sinuses tell you

A

if sinuses are able to be transilluminated, they are likely not filled with fluid

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16
Q

what medication may help with congestion and pain associated with sinusitis

A

NSAIDs
saline
topical decongnestants
topical nasal steroids

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17
Q

what are the most common pathogens in bacterial sinusitis

A

S. pneumonia
M. catarrhalis
H. influenzae

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18
Q

what is first line and second line abx treatment for bacterial sinusitis

A

first = amoxi/clav
second = doxycycline

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19
Q

hyper, hypo, or isotonic saline should be used for nasal rinse?

A

isotonic or hypertonic

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20
Q

what type of reaction if allergic rhinitis

A

type 1 hypersensitivity reaction

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21
Q

the nasal mucosa color is usually ____ in allergic rhinitis

A

pale

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22
Q

what is an allergic salute

A

a crease across the nose from manipulation of the tip of the nose

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23
Q

what is first line pharmacological treatment for allergic rhinitis

A

intranasal steroids

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24
Q

how long should nasal corticosteroids be used for allergic rhinitis

A

2-4 weeks of continued use is necessary to see reults

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25
Q

what is first line treatment of allergic rhinitis in a patient with narrow angle glaucoma or BPH.

A

oral second generation antihistamines

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26
Q

what is intranasal cromolyn used for and why might it not be chosen

A

inhibits mast cell degranulation in allergic rhinitis
good safety profile but has to be used 4 times a day

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27
Q

what comorbidities would cue you to use a leukotrine inhibitor in allergic rhinitis? what is an example of a leukotrine inhibitors

A

Montelukast is a leukotrine inhibitor
it is used for patients who need multimodal therapy
good for patients with asthma

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28
Q

what is rhinitis medicamentosa and how is it treated

A

rebound congestion from chronic use of sympatholytic meds, NSAIDs, or topical decongestants
treated by stopping the drug and can also give a 1-2 week course or nasal steroids during this time

29
Q

Can pregnant women use oral decongestants

A

not in the first trimester or when breastfeeding

30
Q

what might lead you to suspect street drug use in rhinitis symptoms

A

cocaine-induced midline destructive lesions or destruction of the nasal, palatal and pharyngeal tissue

31
Q

how long after use of intranasal steroids until effectiveness is seen

A

6-8 hours after doses

32
Q

what are the most common side effects of intranasal steroids

A

nasal burning
stinging
dryness
headaches
epistaxis
pharyngitis

33
Q

what is gustatory rhinitis and skiers rhinitis and what is an effective treatment

A

gustatory = with meals only
skiers = with exercise
intranasal ipratropium used before exposure can be helpful

34
Q

what medical history would increase the likelyhood of developing nasal polyps (6 items)

A

ASA and NSAID sensitivity
Primarily ciliary diskinesia
cystic fibrosis
frequent asthma exacerbation
chronic sinusitis
season allergies

35
Q

what diagnostics are used for nasal polyps

A

nasal endoscopy or CT

36
Q

what is the treatment for nasal polyps

A

nasal steroids or surgery if steroids are ineffective

37
Q

what is the atopic triag

A

allergic rhinitis
asthma
atopic dermatitis

38
Q

what might you suspect in a immunocompromised patient with high grade fever and dark necrotic ulcers on face

A

fungal rhinosinusitis

39
Q

what would you suspect with drooling, tender neck swelling, inspiratory stridor and difficulty swallowing

A

epiglottis or retropharyngeal abscess

40
Q

what URTI would also have a scarlatiniform rash and palatal petechiae

A

pharyngitis

41
Q

when might you suspect EBV mono

A

adolescent or young adult with sore throat, fever, malaise, lymphadenopathy and pharyngitis

42
Q

what will you do with a CENTOR score of
</=1
2-3
4

A

1 - viral pharyngitis
2-3 rapid strep, if negative send a culture
4 treat for bacterial, no diagnostics needed

43
Q

what is first line and second line treatment for bacterial pharyngitis

A

first line = amoxicillin
second = azithromycin

44
Q

what are complications of untreated bacterial pharyngitis

A

abscesses
rheumatic fever

45
Q

when would post-strep golmerulonephritis show

A

1-2 weeks after infection

46
Q

what symptoms would suggest a post strep glamerulonephritis

A

hematuria
oliguria
HTN
edema
proteinuria

47
Q

what are complications of untreated bacterial rhinosinusitis

A

AOM
meningitis
osteomyelitis
abscesses

48
Q

when would antivirals like oseltamivir be effective

A

confirmed influenza with symptoms that started less than 48 hours ago

49
Q

what is nirmatrelvir and ritonavir and when is it used

A

antivirals used for COVID 19 in high risk populations

50
Q

tripoding is a symptom of what specific URTI

A

epiglottitis

51
Q

what bacteria causes scarlet fever

A

group A strep

52
Q

an intercapillary hemolysis rash and sandpaper tongue is indicative of what

A

scarlet fever

53
Q

what does the acronym JONES stand for and what is it used for

A

for symptoms of acute rheumatic fever
Joint inflammation
Heart damage
nodules (elbows, knees, forearm)
Erythema marginatum (rash with thick red margin(
Sydenhams chorea (rapid involuntary movement of dace and hands

54
Q

What would you suspect with facial edema and dark red urine that occurs 2 weeks after a GAS infection

A

post strep glomerulonephritis

55
Q

what virus most commonly causes mononucleosis

A

epstein barr virus

56
Q

which lymph nodes are swollen in mono

A

posterior cervical chain

57
Q

severe fatigue with hepatomegaly and splenomegaly is characteristic of what disease

A

mono

58
Q

why is splenomegaly such a concerning finding

A

more susceptible to splenic rupture which could cause death

59
Q

what is the difference between an amoxil rash and a mono rash

A

both are pink patchy macules but mono is non itchy and amoxil rash is itchy

60
Q

how is mono diagnosed

A

peripheral blood smear with atypical lymphocytes
positive monospot test

61
Q

when would a monospot test be falsely negative

A

early in disease or children under 4

62
Q

why should contact sports be avoided for 3-4 weeks post mono infection

A

to avoid splenic rupture

63
Q

true or false: infection with EBV increased risk of developing cancer

A

true

64
Q

a pericardial friction rub might be from what complication after a GAS infection

A

rheumatic fever

65
Q

post strep glomerulonephritis usuall infects (adults or children) and is usually (mild or severe)

A

usually affects children and is usually mild and resolves spontaneously

66
Q

what pathogen can cause conjunctivitis, pharyngitis, urethritis, epidimytis, and prostatitis

A

gonorrhoeae and chlamydia

67
Q

pharyngitis ghonorrea requires retesting after treatment at what intervals

A

7-14 days and again at 12 weeks

68
Q

for pregnant women with GC&C, which abx is safe to use: azithromycin or doxycycline

A

azithromycin

NURS 518 (15 decks)

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