ID E3 Flashcards
Sinusitis S/sx that might indicate bacterial and need Abx
Purulent anterior nasal discharge
Purulent/discolored posterior nasal discharge
Nasal congestion/obstruction
Facial congestion/fullness
Decreased smell
Fever
Chronic sinusitis classification and treatment plan
S/sx greater than 12 weeks often not infectious caused by s. Pneumonia and H. Influenza
Only C&S no Abx
Bacterial caused sinusitis non pharm TX options
No decongestant/antihistamines
Viral caused sinusitis nonpharm TX options
Decongestants, irrigation, mucolytics
When to use Abx in sinusitis (4)
- Persistent s/sx for greater than or equal to 10 days without evidence of clinical improvement
- Severe s/sx (T > 102F, facial pain, Purulent nasal discharge) for greater than or equal 3 - 4 days at the beginning
- Worsening s/sx such as new onset fever, HA, increased nasal discharge after a typical viral URTI (which is for 5 days). Aka double worsenining
- Presenting to the ER with sinusitus
Pharyngitis s/sx
Suddenly onset of sore throat
Tonsillopharyngeal Inflammation
History of exposure to strep pharyngitis
Anterior cervical adenitis (tender nodes)
Scarlatiniform rash (rosy cheeks)
Palatial petechiae
OM criteria per Pediatric Academy
Middle Ear Effusion + Moderate to severe bulging of tympanic membrane or new onset otorrhea
OR
Middle Ear Effusion + Mild bulging of tympanic member + onset of ear pain within last 48 hrs or intense erythema of tympanic membrane
Criteria for use of Abx in OM
6 months - 1 year old + moderate/severe pain OR T > 102
6 months - 23 months + non severe bilateral acute OM
Criteria for considering Abx use in OM
6 months - 23 months + non severe unilateral acute OM
2 yo - 12 yo + acute non severe OM
Common cause of AOM
Most URTI are virtual
Bacterial, Streptococcus pneumoniae
Common cause of Acute Sinusitus
Most URTI causes are viral
Bacterial, Streptococcus pneumoniae
Common cause of acute pharyngitis
Most URTI causes are viral
Bacterial, group A B-hemolytic streptococcus
S/Sx of pneumonia
Purulent Sputum, Hemoptysis (blood in sputum), Dyspnea (chest pain because of inflammation)
Leukocytosis (>12K, <4K WBC), decreased O2, RR > 30, HR > 100, T > 100 (Fever)
Typical pneumonia s/sx
Abrupt Onset
Unilateral well-defined infiltrate
Significant fever, chills, sweats, dyspnea
Purulent sputum product
Primarily pulmonary symptoms might have pleuritic chest pain
Atypical Pneumonia s/sx
Gradual Onset
Diffuse infiltrates, ground glass appearance
Mild fever, mild dyspnea
Dry cough
Extra pulmonary symptoms common such as myalgias, Diarrhea, Abdominal pain
Viral pneumonia s/sx
Caused by Respiratory syncytial virus (RSV), Influenza A & B, Adenovirus, parainfluenza
Presenting with wheeling, dyspnea and less incisive of febrile episodes
