ENT Al-Mehdi Flashcards
organism responsible for otitis externa
Pseudomonas aeruginosa
why do children develop otitis media more commonly than adults do?
b/c their Eustachian Tube is more flat and narrow than adults and can’t drain well
2 most common pathogens that can cause otitis media
S. pneumoniae
Haemophilus influenza B
one infection invites other types of organisms
super infection
s’x include itching, pain, erythema, edema of EAC, pinna tenderness
otitis externa
topical treatment for otitis externa
polymyxin + neomycin + hydrocortisone
OR
Cipro + hydrocortisone
presence of fluid behind tympanic membrane and inflammation means
otitis media
first line of treatment for otitis media
Amoxicillin
if there is no response of infection to amoxicillin for otitis media, what do you do
Amoxicillin + clavulanate
(Augmentin)
complication of otitis media
mastoiditis
what 2 things can arise from mastoiditis
- brain abscess
- sinus thrombosis
2 pathogens that cause common cold
rhinovirus
coronavirus
starts as viral infection
common cold
patient experiences itchy throat and sneezing first
common cold
by day 2, patient experiences rhinorrhea, then later can experience cough
common cold
allergic rhinitis and acute bacterial rhinosinusitis are DDx for
common cold
first line treatment for acute bacterial rhinosinusitis
amoxicillin + clavulanate
if patient w/ acute bacterial rhinosinusitis has allergy to penicillin, what to treat them with
doxycycline
treatment for common cold
NONE
this drug is an M3 blocker (allows for bronchodilation)
Ipratropium
this drug is used to help patient breathe while they are having sx of rhinorrhea
Ipratropium
antihistamine used to help treat sx of rhinorrhea
chlorpheniramine
______ are ineffective to treat nasal congestion
antihistamines
alpha-1 adrenergic agonist such as ______ are used to treat nasal congestion
pseudoephedrine
cough reflex in a nut shell:
signal travels along phrenic to brain, then back down to diaphragm and abdomen to contract and produce cough
common component of cough drugs that is centrally active (acts at cough center in brain)
DEXTROMETHROPHAN
best prophylaxis you can do for common cold
hand-washing
treatment for pertussis
macrolides
treatment for diphtheria
penicillin and antitoxin
infection of which air sinus is the most difficult to evaluate by physical exam
sphenoid sinus
unilateral HA, swelling of eyes, purulent secretions from L middle turbinate, eye paralysis, neck stiffness; fever
labs: increase WBC in CSF and blood
(all signs of infection)
sphenoid sinusitis
deals w/ unilateral retro-orbital pain and purulent drainage from nose
sphenoid sinus
signs of this include proptosis (eye bulging), and chemosis (fluid coming from conjunctiva)
cavernous sinus septic thrombosis
signs mainly include neck stiffness and facial/orbital cellulitis, abnormal eye movements
meningitis
2 main causes of bacterial sinusitis
S. pneumoniae
H. influenza
complaints of nasal obstruction, facial/dental pain, and purulent discharge in the nose or posterior nasopharynx
bacterial sinusitis
2 main causes of viral sinusitis (most common)
rhinovirus
influenza
drug of choice for bacterial sinusitis
Amoxicillin
drug to use if patient w/ sinusitis is allergic to penicillin
Fluoroquinolones
patient w/ frontal, ethmoid, or sphenoid sinus infection require hospitalization and IV Ab’s including…
oxacillin + ceftriaxone + metronidazole
most common cause of pharyngitis; 50% of all cases in children
S. pyogenes (Group A strep)
if there is a cough, what infection will it NOT be
pharyngitis
2 complications of pharyngitis include
peritonsillar abscess
pericarditis
in cases of proven S. pyogenes for pharyngitis, treat with what
penicillin
in cases of S. pyogenes for pharyngitis in patient who is allergic to penicillin, treat with what
cephalosporin or macrolides
sequelae to strep infection
acute rheumatic fever
primary agent that causes epiglottitis
H. influenza B
sore throat, drooling, dysphagia, dyspnea, swollen epiglottis
epiglottitis
to prevent epiglottitis
vaccinate against H. influenzae B
to treat epiglottitis
ceftriaxone
penicillin-allergic patients can tolerate this 3rd generation cephalosporin
Ceftriaxone
super Ab for gram +
vancomycin
treats TB
cycloserine
SE of this drug causes “red-man” syndrome (massive release of histamine)
vancomycin
2 drugs that disrupt cell membrane integrity
polymyxin nad daptomycin
drug that forms channels in the cell membrane; operates in seconds (bactericidal)
daptomycin
drug used if patient has vancomycin resistance
daptomycin
most toxic class of Ab’s; inhibits DNA synthesis (replication)
fluoroquinolones
inhibits DNA synthesis (transcription)
Rifampicin
bactericidal for TB/leprosy (mycobacterium infections); SE- gives red-orange color to urine
Rifampicin
binds to 30S reversibly; treats weird obligate intracellular pathogens
tetracycline (doxycycline)
irreversibly binds 30S; bactericidal; primarily for gram -‘s
aminoglycosides
SE of aminoglycosides
vestibulotoxicity
nephrotoxicity
neurotoxicity
reversibly binds 50S; bacteriostatic
Macrolides
this drug targets dihydropteroate synthase (DHPS) and disrupts folic acid metabolism
sulfonamides
this drug targets dihydrofolate reductase (DHFR) and disrupts folic acid metabolism
Trimethoprim
these 2 drugs combine and form bactrim and it now bactericidal; used to treat UTI’s caused by E. coli
trimethoprim + sulfamethoxazone
this pathogen lives on skin and has capsule
S. aureus
this pathogen lives in large intestine and has capule
E. coli
these 4 pathogens live in URT and have a capsule
S. pneumoniae and S. pyogenes
N. meningitis
H. influenzae
