Arfoosh: Upper Respiratory Disease Flashcards
**4 symptoms of pharyngitis?
(1 point each):
- fever >100.5 or 38.1
- ABSENCE of cough
- tender anterior cervical lymphadenopathy
- tonsilar exudates
**Based on score, recommended treatment of pharyngitis/sore throat.
0: no test/no tx
1: no test/no tx
2: RADT, Penicillin V if test is pos
3: no test, Empiric Penicillin V. Or RADT, then Penicillin V if test is pos
4: no test, empiric Penicillin V
**What is the first line of treatment of acute bacterial sinusitis?
Amoxicillin-Clavulanate
Diagnosis for rhinosinitis?
Gold standard: Sinus aspiration with culture
CT Scan
What are three things that may change your dx from viral to bacterial rhinosinitis?
- Sx >10d without improvement
- Severe sx or HIGH fever with purulent nasal discharge OR facial pain for 3-4 d at illness at onset
- sx worsen after onset, sating 5-6d, has started to improve
3 Complications of rhinosinitis?
- Cavernous sinus thrombosis (TOM CAT) (fever, N/V, HA, Orbital Edema, Cranial Nerve Palsy)
- osteomylitis
- brain abscess
Treatment for allergen rhinitis?
Topical nasal steroids antihistamines topical anticongestants SALINE IRRIGATION leukotriene receptor blockers topical cromolyn SC allergen immunotherapy
**Most common cause of non-allergic rhinitis?
- Vasomotor Rhinitis (**Drug-induced)
- Rhinitis Medicamentosa (nasal spray - will cause rebound rhinitis if used consecutively for >3d. then stopped. nasal sprays are strongly discouraged.
- IgA deficiency (commonly missed)
Key deference between allergic and vasomotor rhinitis?
There is no trigger for symptoms in vasomotor, unlike in allergic.
What are the 4 main risk factors for testing someone for lung cancer per USPSTF? What is the diagnostic test?
4 main risk factors:
- current/former smoker
-
What drug can you use in a patient for acute bacterial sinusitis if they are allergic to penicillin (amoxicilin-clavulanate)?
Doxycycline.
First line treatment for bacterial pharyngitis?
Penicillin
