Exam 3 - URIs

Question 1

Rhinitis (Cold)
common causes (5)

Answer 1

• parainfluenza
• RSV
• rhinoviruses
• coronaviruses
• enteroviruses

Question 2

Rhinitis (Cold)

worse causes

Answer 2

• influenza

- adenoviruses

Question 3

Rhinitis (Cold)

epi/tranmiss

Answer 3

• cold months
• young children (res)
• secretions, aersolized

Question 4

Rhinitis (Cold)

clin/sx

Answer 4

-nasal drain/obstruction
-RSV, parainfl->pneumonia, croup,
bronchiolitis

Question 5

Rhinitis (Cold)

dx

Answer 5

• clinical sx

- r/o GAS if exudate

Question 6

Rhinitis (Cold)

tx

Answer 6

-sx (vasoconstrictors, antihist, antipyr)

Question 7

Pharyngitis

viral causes

Answer 7

• rhino
• adeno
• influenza
• parainfluenza
• HSV, EBV, CMV

Question 8

Pharyngitis

bacterial causes

Answer 8

• Strep A/C
• N. gonorrhea
• C. diphteria
• Mycoplasma
• anaerobes

Question 9

Pharyngitis

bacterial clin/sx

Answer 9

• odynophagia, fever
• erythematous pharynx
• exudate
• cervical adenopathy

Question 10

Pharyngitis

viral clin/sx

Answer 10

• milder than bacterial when influenza

- EBV and adenovirus can cause exudate

Question 11

Pharyngitis

dx

Answer 11

• rapid antigen for strep

- throat culture if negative

Question 12

Pharyngitis

tx

Answer 12

• viral: supportive

- strep: penicillin or macrolide

Question 13

Epiglottitis

definition

Answer 13

-rapid cellulitis of epiglottis;

can occlude airway

Question 14

Epiglottitis

cause

Answer 14

• H. influenz (pediatric)

- S. pneum, Staph

Question 15

Epiglottitis

clin/sx

Answer 15

• 2-4 y/o
• dysphonia, sore throat, odynophagia
• drooling, resp distress, stridor
• epiglottal erythema

Question 16

Epiglottitis

dx

Answer 16

• clin exam under anesthesia

- blood, epiglottal culture

Question 17

Epiglottitis

tx

Answer 17

• protect airway (intubation in kids)
• abx for H. inflienz
• chemoprophylaxis for <4yo

Question 18

Croup

aka

Answer 18

acute laryngotracheobronchitis

Question 19

Croup

cause

Answer 19

• parainfluenza 1/3/2
• RSV, Rhino, Influenza
• Mycoplasma pneumoniae

Question 20

Croup

sx

Answer 20

• 3-36 mo/old
• subglottic inflammation
• hoarseness, cough, stridors, tachypnea
• spasmodic croup

Question 21

Croup

dx

Answer 21

-clin

Question 22

Croup

tx

Answer 22

• supportive
• oxygen
• nebulized epi, corticosteroids

Question 23

Otitis Externa

cause

Answer 23

• Staph
• Strep
• Pseudomonas
• fluid trapped in outr ear canal

Question 24

Otitis Externa

Acute localized

Answer 24

• Staph furuncle
• Strep erysipelas
• Abx, drainage

Question 25

Otitis Externa | Acute diffuse OE

Answer 25

- "swimmer's ear" - edematous, red - pseudomonas perhaps (gram neg rods) - topical abx, steroids

Question 26

Otitis Externa | malignant OE

Answer 26

- elderly, DM, AIDS - cartilage/bone/vessel involvement - Pseudomonas - long course abx

Question 27

Otitis Media | cause

Answer 27

1) Strep pneum 2) H. influenz 3) M. catarrhalis 4) Mycoplasma 5) Viral

Question 28

Otitis Media | path

Answer 28

- eustachian tube - disequilibrium - secondary to URI

Question 29

Otitis Media | clin/sx

Answer 29

- pain, drainage, fever, hearing loss | - erythema, fluid in middle ear

Question 30

Otitis Media | tx

Answer 30

- cephalopsorins - augmentin - macrolides - myringotomy - adenoidectomy - tympanostomy tube

Question 31

Sinusitis | cause

Answer 31

1) S. pneum 2) H. influenz 3) viral 4) nosocomial staph, GNRs

Question 32

Sinusitis | clin/sx

Answer 32

- nasal drainage, sinus pressure, headache, fever | - severe: bone involvement, brain abscess, meningitis

Question 33

Sinusitis | dx

Answer 33

- clin | - sinus puncture + culture

Question 34

Sinusitis | tx

Answer 34

-abx (augmentin, cephs, macs, quins)

Question 35

Acute bronchitis | cause

Answer 35

-common cold -adenoviruses -influenza some bacterial

Question 36

Acute bronchitis | clin/sx

Answer 36

- nasal dc, cough, fever | - 50% have purulent sputum

Question 37

Acute bronchitis | dx

Answer 37

clinical

Question 38

Acute bronchitis | tx

Answer 38

sx (cough suppressant)

Question 39

Chronic Bronchitis | definition

Answer 39

-productive cough for >3 mos for | more than 2 yrs

Question 40

Chronic bronchitis | risk factors

Answer 40

- smoking - infection - irritants - immunosuppression

Question 41

Chronic bronchitis | path

Answer 41

- increased # goblet cells - hypertrophy of mucous glands - increased secretions, cough, bronchospasm

Question 42

Chronic bronchitis | dx

Answer 42

clin hx

Question 43

Chronic bronchitis | tx

Answer 43

- smoking cessation | - abx (for H influenz, S. pneum) for acute exacerbation