Exam 1 - Week 1 - Sinusitis

Question 1

What are some ways you can provide symptomatic treatment for sinusitis?

Answer 1

Analgesics
Saline spray/drops
Neti pot
Topical decongestants (only to allow steroid to work)
Topical nasal steroids

Question 2

Differentiation between viral and bacterial?

Answer 2

Viral < 10 days

Bacterial > 10 days

Question 3

Differentiation between acute and chonric rhinosinusitis?

Answer 3

Acute < 4 weeks

Chronic > 12 weeks (managed by specialist)

Question 4

Hallmark symptoms

Answer 4

• Nasal Congestion
• Nasal Discharge
• Facial pain or HA
• Anosmia (loss of smell)- Adults
• Cough-Peds

Question 5

How many hallmark signs needed to dx ARS and ARBS?

Answer 5

ARS 2 +

ARBS 3 +

Question 6

First line tx for ARBS in adults?

Answer 6

Amoxicillin
Augmentin
3rd gen cephalosporin - cefuroxime

Question 7

First line tx for ARBS in adults with PCN allergy?

Answer 7

Doxycycline

Resp fluroquinolone - moxi or levo

Question 8

Second line tx for ARBS in adults?

Answer 8

High dose amoxicillin (resistance concern)
Augmentin
Levofloxacin

Question 9

For how long do you treat adults with ARBS with ABX?

Answer 9

5-7 days

Question 10

First line tx for ARBS in peds?

Answer 10

Amoxicillin
Augmentin
3rd gen cephalosporin - cefuroxime

Question 11

First line tx in ARBS in peds with PCN allergy?

Answer 11

Levofloxacin
Macrolide (CADET - clarithro, azithro, dilithro, erythro, telithro)
3rd gen ceph - cefuoxime

Question 12

Second line tx in ARBS in peds?

Answer 12

High dose amoxicillin
Augmentin
Levofloxacin

Question 13

Fluoroquinolones BBW

Answer 13

Tendon inflammation/Tendon rupture

Avoid > 60 d/t prolonged QT

Question 14

First line treatment for allergic rhinitis

Answer 14

Intranasal corticosteroids (Flonase)

Question 15

Peds considerations for antihistamines

Answer 15

Allegra >= 6 years

Claritin, Clarinex, Xyzal >= 2 years

Question 16

Pregnancy considerations for antihistamines

Answer 16

Benadryl cat B

1st gen not approved in lactation

Question 17

How long will it take to see results from topical steroids

Answer 17

1-2 weeks

Question 18

Name a mast cell stabilizer

Answer 18

Cromolyn

Question 19

When should cromolyn be administered?

Answer 19

2-4 weeks before exposure and continue through exposure period