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Pediatrics > URTI > Flashcards

URTI Flashcards

1
Q

Acute otitis media (AOM)

A

Bulging TM
Middle ear effusion (MEE)
Inflammation
Acute onset of sx

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2
Q

AOM RF

A 
Airborne particle allergies
Attend daycare
Bottle feeding
Craniofacial abnormalities
Food allergies
Immunodeficiency
Low SES
Male
Nasopharyngeal colonization with bacterial pathogens
Native American, Eskimo, Australian ethnicities
Pacifier use
Predisposition
Recent viral illness
Sick household member
Tobacco smoke exposure
Under 2 yo
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3
Q

Anatomy of eustachian tube by age

A

Adults - 45 degrees

Infants - 10 degrees

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4
Q

Presentation of AOM

A 
MEE with acute sx onset:
Fever
Irritability
Otalgia
Pulling ears
Rhinorrhea
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5
Q

AOM otoscopic examination

A

TM appearance

TM changes

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6
Q

AOM TM appearance

A

Cloudy
Erythematous
Pale yellow
White

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7
Q

AOM TM changes

A

Fullness
Immobility
Otorrhea

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8
Q

AOM complications

A

Temporary hearing loss
TM perforation
Brain abscess or meningitis

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9
Q

What delays are seen with hearing loss d/t AOM?

A

Cognitive abilities
Language
Speech

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10
Q

Common causes of AOM

A

Bacterial (80%): S pneumonia, H flu, M catarrhalis

Viral: RSV, rhinovirus, influenza, adenovirus

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11
Q

AOM prevention

A 
PCV 13 (3 vaccine series starting at 2 months)
Hib (3 vaccine series starting at 2 months)
Annual influenza (after 6 months old)
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12
Q

AOM recurrence definition

A 
>/= 3 episodes in 6 months
>/= 4 episodes in 12 months
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13
Q

AOM recurrence prevention

A

Abx (AAP argues against but does not have recommendation)

Tympanostomy tube placement)

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14
Q

Pharyngitis

A

Inflammation of the mucous membrane of throat

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15
Q

Types of pharyngitis

A

Nasopharyngitis
Tonsillitis
Tonsillopharyngitis

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16
Q

Pharyngitis general s/sx

A

Throat pain (not required)
Erythema - required
Exudate - required
Ulceration - required

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17
Q

Pharyngitis causes

A

Bacterial: s pyogenes (GAS) most common
Viral: adenovirus, CMV, enteroviruses, EBV, HSV, Influenza

18
Q

Bacterial pharyngitis s/sx

A 
Autumn, winter, spring
Ab pain
Cervical adenopathy
Fever
HA
Nausea
Sore throat
Tonsillar exudate 
Vomiting
19
Q

Viral pharyngitis s/sx

A 
Summer, Autumn
Anterior stomatitis
Conjunctivitis
Coryza
Cough
Diarrhea
Rash (in children not adults)
Ulcerative colitis
20
Q

Diagnosis of bacterial pharyngitis

A

Throat culture

Rapid antigen detection test (RADT)

21
Q

RADT

A

Never used alone unless positive

If it is positive, it is accurate. Negative does not mean you do not have it.

22
Q

Treatment of viral pharyngitis

A

Self-limiting

Sx treatment

23
Q

Treatment of bacterial pharyngitis

A 
Abx for sx GAS
Sx resolution: 3-4 day mark
Beta-lactams
Clindamycin
Macrolides
Sx treatment
24
Q

Beta lactams in pharyngitis

A

PCN (enteral/IV)
Amox
Duration: 10 days

25
Q

Clinda in pharyngitis duration of therapy

A

10 days

26
Q

Macrolides pharyngitis duration of therapy

A

5 days

27
Q

Pharyngitis symptomatic treatment

A

Treat the pain

Do NOT use antihistamines or decongestants

28
Q

Rhinosinusitis

A

Inflammation of the mucous membranes:
Nose
Paranasal area

29
Q

Rhinosinusitis viral causes

A 
Most common - common cold
Rhinovirus
Influenza
Parainfluenza
Respiratory syncytial virus
Adenovirus
Enterovirus
30
Q

Rhinosinusitis bacterial causes

A

Secondary infections
S pneumonia
H influenza
M catarrhallis

31
Q

Rhinosinusitis duration classifications

A

< 30 days = acute
30-90 days = subacute
> 90 = chronic

32
Q

Bacterial sinusitis diagnosis

A

Persistent illness lasting > 10 days (wait)
Worsening course after implementation (abx)
Severe onset for 3 consecutive days

33
Q

Bacterial sinusitis: persistent illness lasting > 10 days

A

Daytime cough

Nasal discharge

34
Q

Bacterial sinusitis: worsening course after implementation

A

Daytime cough
Fever
New onset nasal discharge

35
Q

Bacterial sinusitis: severe onset for 3 consecutive days

A

Concurrent fever

Purulent nasal discharge

36
Q

Bacterial sinusitis treatments

A

Beta-lactams
Clinda + cefiximine
FQ
Sx treatment

37
Q

Bacterial sinusitis beta-lactam treatment

A 
Amox (dosing lower than in AOM)
Augmentin
Cefotaxime
Ceftriaxone
Duration of therapy - 10 days
38
Q

Bacterial sinusitis clindamycin + cefixime duration of therapy

A

10 days

39
Q

Bacterial sinusitis FQ duration of therapy

A

10 days

40
Q

Bacterial sinusitis sx treatment

A

Pain management
Antihistamines/decongestants (only if viral - decreases blood flow of where you want abx to go)
Saline spray/mist/drops are the only recommendation

Pediatrics (9 decks)

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