Exam 3 - Lecture 2 (upper respiratory tract infections)

Question 1

most common pathogens for URTI

Answer 1

many respiratory viruses

Question 2

acute bronchitis tx

Answer 2

no abx needed
no corticosteroids needed
-self limiting

Question 3

acute exacerbation of chronic bronchitis s/sx

Answer 3

1. increased sputum purulence
2. increased sputum volume
3. increased cough or SOB

Question 4

most common organisms for acute exacerbation of chronic bronchitis

Answer 4

strep pneumo
H. flu
M. cat

Question 5

acute exacerbation of chronic bronchitis preferred tx and duration

Answer 5

aug
cefuroxime
cefpodoxime

*duration 5-7 days

Question 6

acute exacerbation of chronic bronchitis alternative tx and duration

Answer 6

doxy
bactrim
azithro

*duration 5-7 days

Question 7

acute exacerbation of chronic bronchitis pseudomonas risk tx and duration

Answer 7

levofloxacin

duration of 5-7 days

Question 8

acute pharyngitis common pathogens

Answer 8

viruses (rhino, corona, adeno)
bacteria - strep pyogenes (group A)

Question 9

acute pharyngitis preferred tx
and tx duration

Answer 9

target group A strep (pyogenes)
-pen VK
-amox

*typically 10 days

Question 10

acute pharyngitis alternative tx
and tx duration

Answer 10

if penicillin allergy:
non-anaphylactic rxn:
-cephalexin
-cefadroxil
-cefuroxime
-cefpodoxime
anaphylactic rxn:
-azithromycin
-clindamycin

*typically 10 days (besides azithromycin 5 day course)

Question 11

acute bacterial rhinosinusitis (ABRS) symptoms description

Answer 11

-persistent sx 10 days or more with no improvement
-severe sx: fever, puru;ent discharge, facial pain for 3-4 consecutive days at beginning of illness
-worsening sx: new onset of sx after initial improvement in sx

Question 12

acute bacterial rhinosinusitis 1st line tx

Answer 12

1. watchful waiting until bacterial infection established, then:
   -aug 500/125 x 5-7 days
   -aug 2000/125 x 5-7 days if concerned for penicillin resistance

Question 13

acute bacterial rhinosinusitis 2nd line tx

Answer 13

doxy
levo
moxi

*5-7 days duration

Question 14

acute bacterial rhinosinusitis MRSA concern tx

Answer 14

add MRSA coverage like:
-doxy
-bactrim
-linezolid
-clindamycin

Question 15

acute bacterial rhinosinusitis pseudomonas tx

Answer 15

levo

Question 16

acute bacterial rhinosinusitis supportive care

Answer 16

NSAIDs/APAP
intranasal saline irrigation
warm facial packs
hydrate
avoid antihistamines
caution with decongestants due to rebound congestion