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Infectious Disease > Upper Respiratory Tract Infections > Flashcards

Upper Respiratory Tract Infections Flashcards

1
Q

Examples of Upper Respiratory Infections

A

Acute otitis media
Sinusitis
Pharyngitis

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2
Q

Most Specific Sign of Acute Otitis Media

A

Bulging tympanic membrane

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3
Q

Common bacteria that cause acute otitis media

A

Streptococcus pneumoniae

Haemophilus influenzae

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4
Q

Non-Severe Acute Otitis Media (AOM)

A

Presence of mild otalgia (earache) < 48 hrs and temperature < 39 degrees C

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5
Q

Severe Acute Otitis Media (AOM)

A

Presence of moderate to severe otalgia or temperature at least 39 degrees C or otorrhea

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6
Q

Treatment of Mild to Moderate Otalgia

A

Acetaminophen

Ibuprofen (only in > 6 months)

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7
Q

Treatment of Moderate to Severe Otalgia

A

Tylenol #3

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8
Q

Topical Options of Otalgia

A

Benzocaine, lidocaine, procaine (only for ages 2+ and do not use in children with tympanic membrane perforation)

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9
Q

Treatment of AOM in < 6 months

A

ALWAYS give antibiotic therapy in patients in < 6 months regardless of severity

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10
Q

Treatment of Severe AOM + Otorrhea

A

Give antibiotic therapy, regardless of age

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11
Q

Treatment of Bilateral AOM without Otorrhea in 6 months to 2 years

A

Give antibiotic therapy

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12
Q

Treatment of Bilateral AOM without Otorrhea > 2 years

A

Observe for 48-72 hours before giving antibiotics

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13
Q

Treatment of Unilateral AOM without Otorrhea in > 6 months

A

Observe for 48-72 hours before giving antibiotics

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14
Q

DOC for AOM

A

High-dose amoxicillin (90 mg/kg/day in divided doses q12h)

DOC because overcomes S. pneumo resistance

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15
Q

Tx of AOM if Recent Beta-Lactam Therapy, Conjunctivitis, or Hx of Prior AOM

A

Augmentin (90 mg/kg/day of amoxicillin + 6.4 mg/kg/day of clavulanate in divided doses q12h)

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16
Q

Tx of AOM if PCN Allergy

A

2nd gen PO CEPHS: Cefuroxime, Cefpodoxime, Cefdinir

Ceftriaxone IM

17
Q

Treatment Failure of AOM After 48-72 Hours

A

If initially treated with high-dose amoxicillin: Augmentin

If initially treated with Augmentin or PO Cephalosporin: Ceftriaxone 50 mg IM or IV x 3 days

18
Q

Duration of Therapy for AOM

A

10 days if < 2 yo or severe sxs
7 days if 2-5 years without severe sxs
5-7 days if at least 6 years without severe sxs

19
Q

Recurrent Otitis Media

A

Definition: At least 3 episodes in 6 months or at least 4 episodes in 1 year
Vaccination (pneumococcal, H. influenzae)
NO antibiotic prophylaxis
Tympanostomy Tube

20
Q

Common pathogens causing sinusitis

A

Strep pneumo

H. influenzae

21
Q

DOC for Sinusitis

A

Augmentin (500/125 mg PO TID or 875/125 mg PO BID)

22
Q

Tx of Sinusitis if PCN Allergy

A

Doxycycline (avoid in children)
PO 2nd gen cephs: Cefixime or Cefpodoxime +/- clindamycin
Levofloxacin or moxifloxacin

23
Q

Duration of Tx for Sinusitis

A

Adults: 5-7 days
Children: 10-14 days

24
Q

Tx Failure of Sinusitis After 48-72 Hours

A

Augmentin -> doxycycline or respiratory fluoroquinolone (levofloxacin or moxifloxacin)

25
Q

Adjunctive Therapy for Sinusitis

A

Intranasal corticosteroids for pts with hx of allergic rhinitis
Nasal irrigation for congestion sxs
NO systemic or oral corticosteroids

26
Q

DOC for Pharyngitis/Strep Throat

A

Penicillin VK x 10 days

27
Q

Alternative Tx for Pharyngitis/Strep Throat

A

Amoxicillin x 10 days

Penicillin G IM x 1 dose

28
Q

Tx for Pharyngitis/Strep Throat if PCN Allergy

A

Cephalexin x 10 days
Clindamycin x 10 days
Z Pak x 5 days
Clarithromycin x 10 days

29
Q

Common Pathogens Causing Acute Exacerbation of COPD

A

H. influenzae
S. pneumoniae
P. aeruginosa

30
Q

Indications for Antibiotic Therapy of Acute Exacerbation of COPD

A 
At least 65 yo
History of exacerbations
Presence of comorbidities
Prior antibiotic use
Culture data from past exacerbations
31
Q

Outpatient Tx of Acute Exacerbation of COPD if Low Risk of Pseudomonas

A

Beta-lactam (Augmentin, 2nd gen PO CEPH - cefuroxime, cefpodoxime, cefdinir)
Tetracycline
Macrolide

32
Q

Outpatient Tx of Acute Exacerbation of COPD if High Risk of Pseudomonas

A

If recent antimicrobial therapy, recent hospitalization, or bronchiectasis
Levofloxacin or ciprofloxacin

33
Q

Duration of Outpatient Tx of Acute Exacerbation of COPD

A

5-7 days

34
Q

Prevention of Acute Exacerbation of COPD

A

Vacciniations (pneumococcal, influenza)

If > 2 exacerbations/year despite optimal management, antimicrobial prophylaxis: azithromycin or erythromycin x 1 year

Infectious Disease (15 decks)

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