Unit 9 Discussion Questions

Question 1

Is allergy testing of great value in diagnosing the actual cause of allergic rhinitis?

Answer 1

For allergic rhinitis: NO

Focus on symptomatic therapy.

Question 2

How is dacryocystitis usually managed?

Answer 2

massage

warm compresses every 3-4 hrs

Question 3

What is Dacryocystitis

Answer 3

inflammation of the lacrimal sac (wear tears drain)

can be present at birth

Question 4

What is Hordeolum

Answer 4

Inflammation of the hair follicles on the eyelid.

a stye

Question 5

Which conditions cause serious visual problems on a chronic basis, especially in elderly ?

Answer 5

Cataracts

Glaucoma

Question 6

What are the two most common eye conditions seen in primary care?

Answer 6

Conjunctivitis (bacterial or viral)

Seasonal allergic conjunctivitis

Question 7

A child presents rubbing eyes with purulent green drainage from eyes and mother states it has been constant. What is diagnosis?

Answer 7

Bacterial conjunctivitis

Question 8

URIs are most commonly caused by which two viral classes?

Answer 8

rhinoviruses
adenoviruses
NO ABX- WILL NOT WORK FOR VIRUS

Question 9

What bacteria most likely the cause bacterial/infectious conjunctivitis?

Answer 9

Viruses most common cause! spread by contact.

Streptococcus pneumonia, Staphylococcus aureus, Haemphilus influenza, Moraxella catarrhalis

Question 10

Allergic conjunctivitis is most often seasonal. Year-round allergies are most due to allergies to what entities in the environment?

Answer 10

most often indoor allergens
fungi (mold)
dust
mites and their saliva

Question 11

When is the use of fluorescein indicated?

Answer 11

diagnostic for eye abrasions and foreign bodies.

it drains into tear ducts and will show yellow nasal drainage

Question 12

What condition may call for the use of ocular lubricants?

Answer 12

irritated and dry eyes

r/t viral conjunctivitis, meds that cause dry eyes, symptomatic relief

Question 13

First line topical antibiotic treatment for bacterial conjunctivitis?

Answer 13

least expensive broad spectrum: Sulfa or erythromycin

cheap and no difference between value of one abx over the other when used empirically

Question 14

The overuse of intraocular corticosteroids increases the virulence of which kind of viral infection?

Answer 14

herpes simplex virus

varicella virus

Question 15

Pseudoephedrine (decongestants) should be used in caution with which preexisting disorders and why?

Answer 15

watch: heart disease, htn, thyroid, DM, prostatic hypertrophy, urinary retention, glaucoma. Pseudoephedrine is an a-adrenergic receptor agonist. “vasoconstriction of arterioles, leading to increased blood pressure, dilation of pupils, intestinal relaxation, bladder sphincter contractions”

Question 16

Exceeding the recommended daily dose of intranasal steroids risks an increase in which endocrine dysfunction?

Answer 16

adrenal insufficiency
insufficient cortisol secretion from adrenal gland
(reduces the HPA axis)

Question 17

Dextromethorphan is contraindicated in:

Answer 17

children less than 4.

Question 18

Effective treatment for thinning airway secretions?

Answer 18

Expectorant.
Guiafenesin or Mucinex
(encourage fluid intake)

Question 19

Which drugs should be avoided with dextromethorphan?

Answer 19

antidepressants

furazolidone, meperidine, subutramine, MAOIs within 2 wks

Question 20

What is rebound rhinitis or rhinitis medicamentosa?

Answer 20

loss of feeling of nasal congestion for what nasal decongestants were initially prescribed. Must wean patient off or utilize nasal saline spray.

Question 21

Which drug is used for routine maintenance for asthma symptoms present once or twice a month?

Answer 21

rapid acting inahled B 2 antagonist

Question 22

Cardinal points of treatment of both asthma and COPD involve the use of which immunizations?

Answer 22

influenza

pneumoccocal

Question 23

Characterize the three key pathophysiolgical features of asthma which therapy is prescribed.

Answer 23

1. airway hyperresponsiveness - abnormal reaction to triggers
2. airway inflammation - present after exposure producing allergic response
3. airway obstruction - bronchoconstriction, decreased forced expiratory volume

Question 24

A positive skin TB test while awaiting cultures would be recommended how many anti tubercular drugs?

Answer 24

4

isoniazid, rifampin, pyrazinamide, ethambutol

Question 25

Why do all long acting bronchodilators have a black box warning? LABAs

Answer 25

increased chance of severe asthma episode. LABAs should be used as additional therapy with inhaled glucocorticoid

Question 26

Latent TB treatment consists of:

Answer 26

Isoniazed daily for 9 months

Question 27

What is therapeutic range for Theophylline

Answer 27

5-15 mcg/ml

Question 28

What therapy for treatment of respiratory disorders has a narrow therapeutic index?

Answer 28

Theophylline -narrow index, requires serum monitoring.