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DAST 7 Exam 2 > Upper Resp Tract Inf - 5Qs > Flashcards

Upper Resp Tract Inf - 5Qs Flashcards

1
Q

Differentiate btw the common cold and influenza?

A

Common cold - occupies upper respiratory tract

Influenza - systemic dx involving upper respiratory tract

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2
Q

Define sinusitis.

A

Inflammation of the mucosa of the nose and paranasal sinuses

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3
Q

Define acute sinusitis

A

1 day - 3 weeks

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4
Q

Define chronic sinusitis

A

> 3 months

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5
Q

What is common predisposing condition for bacterial inf?

A

Viral infection

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6
Q

What is the most common pathogen that cuz sinusitis?

A

Viral

  • rhinovirus
  • influenza
  • parainfluenza

RIP

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7
Q

What the other cause of sinusitis?

A

Bacterial

  • community acquired
  • nosocomial (nasogastric tube)
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8
Q

What pathogens are resp 4 Community acquired bacterial sinusitis?

A

H. influenza
S. pneumonia
M. catarrhallis
Mouth anaerobes (dental infections)

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9
Q

What pathogens are resp nosocomial (nasogastric tube) bacterial sinusitis?

A

Gram tve e.g. S. aureus, S. pneumonia

Gram -ve e.g. Pseudomonas spp

Anaerobic bacteria

Yeast (C. albicans)

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10
Q

What are the clinical manifestations of sinusitis?

A

Mucopurulent nasal discharge, halitosis

Nasal congestion, fever

Facial pain eps when bending forward

Toothache

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11
Q

How do you diagnose Acute Maxillary Sinusitis?

A

Sx of sinusitis + 1 major sx or 2minor sx

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12
Q

What’s the gold standard for diagnosis Acute Maxillary Sinusitis?

A

Sinus puncture

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13
Q

What’s the goal of therapy?

A

Improve/ restore QOL

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14
Q

How do you treat mild sinusitis?

A

Usually self-limiting

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15
Q

How do you treat mod-severe sinusitis?

A

Therapy reserved for this type.

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16
Q

How do you treat sinusitis caused by viral inf?

A

1st gen antihistamines + NSAID +/ Pseudoepineohrine and/or Dextromethropan

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17
Q

What’s the 1st tx for peds?

A

Amoxicillin

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18
Q

What’s the 1st tx for peds if penicillin allergy is reported?

A

Cefuroxime

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19
Q

What’s the 1st tx for peds in amoxicillin failure/ severe dx?

A

Amoxicillin-Clavulanate

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20
Q

What’s the 1st tx for adults?

A

Amoxicillin

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21
Q

What’s the 1st tx for adults with mod dx or previous AB in 4-6 wks?

A

Amoxicillin-Clavulanate

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22
Q

What’s the 1st tx for chronic sinusitis?

A

ABs that cover s.aureus and anaerobes

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23
Q

Name the atypical m.o. that’s recently indicated for sinusitis?

A

Chlamidophila pneumoniae

24
Q

How do you deal with sinusitis of fungal origin?

A

Surgery intervention may be req

25
Q

Def pharyngitis.

A

Inflammation of the pharynx and surrounding tissue

26
Q

What’s the pathogen of most common that may cuz pharyngitis?

A

Streptococcus pyogenes (GABHS/GAS)

27
Q

How do u diagnose bacterial pharyngitis?

A

Sx in absence of cough, rhinorrhea

Hx of fever > 38.3C (101F)

Tonsillar exudate

Swollen tender anterior cervical nodes

28
Q

What action do you take if pt has 0-1 of diagnostic criteria?

A

Nothing

29
Q

What action do you take if pt has 2-3 of diagnostic criteria?

A

Culture, treat if tve

30
Q

What action do you take if pt has all 4 of diagnostic criteria?

A

Culture and Treat

31
Q

When is throat culture recommended?

A

Children 4-15, sore throat, high fever

Close contact of strep pts

Hx of rheumatic fever or heart dx

Epidemic of GABHs or corynebacterium diphtheriae

32
Q

What’s the preferred culture for sore throat?

A

Rapid antigen detection test

33
Q

List complications of GABHS.

A

Acute rheumatic fever

Glomerulonephritis

34
Q

What’s 1st line for peds and adults for pharyngitis?

A

Penicillin V X 10 days ( for all )

Amoxicillin (preferred becuz of taste)

Benzathine penicillin

35
Q

What’s 2nd line for peds and adults for pharyngitis?

A

Peds - 2nd gen cephalosporin X 10 days

Adults - 2nd gen cephalosporin X 4-6 days

36
Q

Name the types of bronchitis? In what age-grp do they occur?

A

Acute bronchitis - all age grps

Chronic bronchitis - gen in older adults

37
Q

What’s the main m.o. resp 4 bronchitis?

A

Viral (majority)

S. pneumoniae, S. aureus, H. influenzae

38
Q

What other issues may affect bronchitis?

A

Gastroesophageal reflux

Asthma/COPD

Post-nasal drip

GAP

39
Q

What’s the routine therapy for acute bronchitis?

A

No routine role of AB

Use aspirin, acetaminophen, ipratropium, and/or nasal decongestants

40
Q

What may be used for prolonged atypical dx?

A

Macrolides
Fluoroquinolones
Doxycycline

41
Q

How do you treat acute bronchitis.

A

It’s a viral dx and should not be treated with AB

42
Q

What may cause Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB)?

A

Acute exacerbation of chronic bronchitis may be caused by bacteria

43
Q

How do you define chronic exacerbation?

A

Coughing up of sputum on most days during at least 3 consecutive months for more than 2 successive years

44
Q

What factors contribute to chronic bronchitis?

A

Cigarette smoking

Inhaled dust/ toxins

Infections

45
Q

What are non-modifiable factors of chronic bronchitis?

A

Male

>40 yr

46
Q

What’s the clinical presentation of chronic bronchitis?

A

Incessant coughing + purulent sputum

47
Q

Name typical pathogens that cuz chronic bronchitis.

A

H. influenzae
H. parainfluenzae
S. pneumoniae
M. Catarrhallis

48
Q

What are the non-pharmacologic ways of handling chronic bronchitis?

A

Stop smoking

Avoid toxins, dust

49
Q

What should be considered b4 initiating pharmacotherapy options?

A

Pt may have had several treated episodes in the past, which may increase level of resistance

50
Q

When should ABs be given o pts with chronic bronchitis?

A

Pt with increased dyspnea + increased sputum volume + increased sputum purulence

Pt with increased sputum purulence + 1 other cardinal sx

Pt who req mech ventilation

51
Q

What factors should be considered b4 starting AB?

A

Number of occurrences

Previous hx treatment

52
Q

What AB is the most favored for chronic bronchitis?

A

Macrolides

53
Q

What AB should be considered if cost is an issue?

A

Doxycycline

Bactrim

54
Q

How do you treat viral bronchitis?

A

No AB

55
Q

How do you treat chronic mild bronchitis, FEV1 > 60%, < 60yrs, < 4 exacerbation/year?

A

Amoxicillin

Macrolide

56
Q

How do you treat chronic moderate bronchitis + FEV1 59%-40% + diabetes, chronic renal failure, chronic heart failure + at least 4 exacerbation/year?

A

Respiratory Fluoroquinolones

Amoxicillin/Clavulanate

Macrolides

57
Q

How do you treat chronic severe bronchitis + FEV1 < 40%

A

Treat for more resistant pathogens e.g. Pseudomonas, enterobacteriaceae

DAST 7 Exam 2 (9 decks)

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