week 10

Question 1

pharengitis

Answer 1

inflammation of the throat mucousa

Question 2

GABHS

Answer 2

most comomon cause of acute threp throat that is bacteria (35%) ages 5-11 years

Question 3

viral vs bacteria pharengitis symtptoms

Answer 3

same except viral includes : diarrea, rhinitis, stridor, rash, cough etc.

Question 4

look of bacterial vs viral pharyngitis

Answer 4

bacterial gahs: swollen uvula, swollen tonsils, petichia, gray furry tongue

viral: red twollen tonsils, throat redness,

Question 5

CENTOR criteria to determine what?

Answer 5

GAHS only for ADULTS, but there is a modified version for kids
looking at
-fever
- swollen lymphs,
-tonsillar exudate,
-absence of cough

Question 6

RADT criteria

Answer 6

not under 3
need culture confirmation
negative should be cultured

Question 7

ASO titer

Answer 7

rises one week after infection, peaks 3-5 weeks
- for determining phumatic fever and acute glomularnephritis
-detects GAHS in the system from a previous infection

Question 8

treatment for strep throat

Answer 8

Amoxacillin or penicillin

Amox: more easily taken by the kids, 50mg/kg/day

Penicillin: low cost, 250mg 2-3 times per day for 10 days

Question 9

alternative therpies for pen. allergy

Answer 9

• cephalexin (NOT for kids with immediate-type hypersensitivity to penicillin)
• clindamycin
  -azithromycin
  -clarithromycin

Question 10

school rule for antibiotics

Answer 10

at least 12-24 hours of abx and no fever

Question 11

retropharengeal absess and peritonsillar absess

Answer 11

retropharengeal absess: <6 years of age

pertonsilar absess: peaks ar age 13.5 years

Question 12

suppurative complications og GAHS VS nonsuppurative complication

Answer 12

suppurative: cervical adenitis, mastoiditis, AOM, rhinosinusitis, absesses

nonsuppurative: rheumatic fever, post-streptococcal reactive arthritis
actute glomularnephritis

Question 13

T and A removal indication

Answer 13

infection:
-7 infections in last year,
-5 in the last 2 years,
-or three or more per year in the past 3 years
-Infections have to meet GAHS test, have fever and lymph involvment

noninfection:
-recurrent tonsilitis
-sleep apnea
-peritoneal abscess
-periodic fever with aphthous -ulcers
-adenopathy

Adenoid removal:
- severe nasal obstruction for > 1 year
- hyponasal speech
- chronic mouth breathing

Question 14

Croup is also known as

Answer 14

laryngotracheobronchitis

Question 15

croup symtoms

Answer 15

• barky cough
  -inspirtorytridor
  -resp distress

Question 16

cause of croup

Answer 16

human para influenze virus

Question 17

peak age croup

Answer 17

5 mo-5 years

Question 18

tx for croup

Answer 18

typically self limiting but sometimes require supportive tx

Question 19

physical exam croup findings

Answer 19

• irritability
• audible inspiratory stridor
• brassy barky cough
• restrictions
• prolonged inspiration

Question 20

xray findings croup

Answer 20

• steeple sign (subglottal narrowing)

Question 21

diff diagnosis for croup

Answer 21

• acute epiglotits
• bacterial tracheitis
• forign body aspiration
• abscesses
• extrinsic compression
• angioedema
• infectious monoculcosis
• psychogenic stridor

Question 22

how to rule out absess? when trying to detemine croup or absess?

Answer 22

CT scan

Question 23

mild, moderate and severe croup

Answer 23

mild: no retractions, no stridor at rest
moderate, retractions and stridor at rest
severe: respirtory distress

Question 24

TX croup

Answer 24

single dose .15 mg/kg oral dexamethasone

OTHERS
nebulized budesonide
IM dexamethasone
oral prednisolone

Question 25

epiglottis

Answer 25

MEDICAL EMERGENCY
rapid inflammation of the epiglottis

Question 26

epiglottitis HX

Answer 26

increasing resp distress, toxic looking, horse muffled voice, abrupt fever, drooling, insp and expiratory stridor, sniffing posture

Question 27

tx abx for epiglottis

Answer 27

• bs ABX
  ampicillin
  cefotaxime
  ceftriaxone
  clindamycin

10 days post extubation

Question 28

household contacts abx for epiglotitis

Answer 28

refampin 20mg/kg 4 days
if there are young children or unimmunized children in house

Question 29

chronic rhinosinusitis

Answer 29

12 weeks or longer of sx

Question 30

uri vs acute sinusitis

Answer 30

uri: 3-6 days (improve by 7-10 days)
Sinusitis: >10 days of symptoms

Question 31

abx choice for acute sinusitis

Answer 31

mild-moderate >2 years: amox
mod-severe <2 years: amox/clavulanate

Question 32

acute sinusitis with eye involvment

Answer 32

hospitalization and IV abx

Question 33

pots puffy tumor

Answer 33

frontal sinus swelling- ent consult, surgical consult and infectious disease

Question 34

bronchiolitis

Answer 34

most common LOWER resp illness. 80% are due to RSV.

Question 35

inital sx of RSV

Answer 35

cough, conjestion, rhinitis

Question 36

progression of RSV

Answer 36

worse cough, apnea, resp distress, copious mucous, poor feeding

Question 37

duration RSV

Answer 37

2-3 weeks
peak 3-5 days of illlness

Question 38

RSV vs bac pnumonia

Answer 38

symmetric vs asymmetric breathe sounds

Question 39

rsv immunization for infant

Answer 39

1 st week of life oct-march

Question 40

rsv immunization for infant

Answer 40

32-36 weeks

Question 41

bacterial indicators pnumonia

Answer 41

abrupt high fever temp >103, chest pain, lethargy and dyspnea