HEENT

Question 1

Otitis Externa Treatment: Mild

Answer 1

Voscol drops; 5 drops in ear(s) 3-4 times/day until resolved

Question 2

Otitis Externa Treatment: Moderate-Severe with significant swelling

Answer 2

Choose an option with steroid:
ciprofloxacin-hydrocortisone (Cipro-HC Otic); 3 drops BID x 7d
ciprofloxacin-dexamethasone (Ciprodex); 4 drops BID x 7d

Question 3

Otitis Externa Treatment: Moderate to Severe

Cheaper option

Answer 3

ofloxacin 5 drops once daily x 7 days

Question 4

First Line AOM Treatment (peds)

Answer 4

amoxicillin 80-90 mg/kg/d in 2 divided doses
or
amoxicillin-clavulanate 80-90 mg/kg/d in 2 divided doses

Question 5

AOM treatment if PCN allergic (non-anaphylactic)- peds

Answer 5

cefdinir 14 mg/kg/day

in 1-2 divided doses (but if you can just give it once a day, why not?!)

Question 6

AOM treatment if anaphylactic PCN reaction- peds

Answer 6

clindamycin 30 mg/kg/d in 2 divided doses

Question 7

Know how to calculate and write peds Rx!

Example: prescribe 1st line AOM treatment to a 30 lb 18-month old with no allergies

Answer 7

amoxicillin 400/5
Sig: 8 mL q 12 hours x 10 days
Disp: 160 mL

Question 8

Duration of AOM Treatment

Answer 8

10 days if <2y

5-7 days if >2y

10 days if adult

Question 9

First Line Treatment of AOM- adult

Answer 9

amoxicillin 1000 mg TID x 10 d

amoxicillin-clavulanate 875/125 mg BID x 10 d

cefdinir 600 mg QD x 10 d

Question 10

First Line Treatment of ABRS- adults

Answer 10

amoxicillin-clavulanate 875/125 BID x 7 d

Question 11

First Line Treatment of ABRS- peds

Answer 11

amoxicillin-clavulanate 90 mg/kg/d in 2 divided doses

for 5-7 days

Question 12

First Line Strep Treatment- adults

Answer 12

penicillin V K 500 mg BID x 10 d

or

amoxicillin 500 mg BID x 10 d

Question 13

IM treatment of strep- adults or peds > 60 lb

Answer 13

Benzathine PCN G
1.2 million units IM x 1 dose

(observe 30 min)

Question 14

Strep treatment options if PCN-allergic (adults)

Answer 14

cephalexin 500 mg BID x 10 d (avoid if reaction was anaphylactic)
clindamycin 300 mg TID x 10 d
azithromycin 500 mg QD x 5
clarithromycin 250 mg BID x 10

Hint: pick one (other than cephalexin) to really memorize

Question 15

Treatment of Hordeolum

Answer 15

External: hot packs only

Internal: Dicloxacillin 250-500 mg po q6h x 10 d; plus hot packs

Question 16

Treatment of Bacterial Conjunctivitis

Answer 16

Cipro 0.3% ophth. soln.1-2 gtts q2h 1st 2 days, then q4-8hup to 7 days

Question 17

Treatment of Adult ABRS with Type 1 PCN Allergy

Answer 17

Doxycycline 100 mg BID
Levofloxacin 750 mg once daily
Moxifloxacin 400 mg once daily

(all 5-7 d)

Question 18

Treatment of Adult ABRS with skin rash to PCN

Answer 18

Cefdinir 600 mg once daily
Cefpodoxime 200 mg BID

Duration: 5-7d

Question 19

Treatment of Peds ABRS with Type 1 PCN Allergy

Answer 19

Clindamycin 30 mg/kg/d divided TID

Levofloxacin
If >6 m and <50 kg, levofloxacin 16 mg/kg/d divided q 12h up to max 250 mg daily
If >50 kg, levofloxacin 500 mg daily

Duration 10-14 d

Question 20

Treatment of Peds ABRS with Skin Rash to PCN

Answer 20

Cefdinir 14 mg/kg/d up to 600 mg/d
Cefpodoxime 10 mg/kg/d divided q 12 h

Duration 10-14 d

Question 21

Best treatment option for peds with strep

Answer 21

Amoxicillin 50 mg/kg/day PO in 2 or 3 divided doses for 10d

Pen VK tastes awful