Term
| URI's account for what percentage of doctor visits? |
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Definition
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Term
| URI's are most commonly bacterial, fungal, parasitic, or viral? |
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Definition
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Term
| What age range is streptococcal pharyngitis incidence highest? |
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Definition
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Term
| What are the common bacterial causes of URI's? |
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Definition
| Strep. pyo., and group C and G beta - hemolytic streptococci |
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Term
| What are the common viral causes of URI's? |
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Definition
| ROACH - Rhino, Other (influenza, parainfluenza), Adeno, Corona, Herpes simplex |
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Term
| What % of URI's have unknown cause? |
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Definition
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Term
| Pharyngitis occurs in ~ 50% of which viral syndromes? |
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Definition
| rhino, influenza A, adeno, corona |
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Term
| Pharyngitis occurs in ~ 80% of which viral syndromes? |
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Definition
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Term
| What are the possibly severe complications resulting from extracellular factors in Strep. pyo. infection? |
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Definition
| gas RRIG - Rheumatic fever (acute), Related to virulence factors, Invasive infection, Glomerulonephritis (acute) |
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Term
| What are the clinical criteria for automatic treatment of Strep. Pyo? |
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Definition
| HALT - History of fever, Anterior cervical lymph nodes (swollen, tender), Lack of cough, Tonsillar exudates |
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Term
| How many of how many clinical criteria require RADT for suspected GAS? |
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Definition
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Term
| What signs and symptoms are generally present in severe Strep. pyo. pharyngitis? |
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Definition
| S.PYOGENES - Screaming red pharyngeal mucosa, Pharyngeal Pain, Yucky feeling (malaise), Over the neck ache (headache), Gray-yellow tonsillar exudate, Edema of uvula, Nodes (ellarged cervical lymph _), Eosinophil and other leukocytes > 12000/mm^3, Severe fever >= 39.4 C |
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Term
| What virus is indirectly cytopathic via symptoms mediated by bradykinin? |
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Definition
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Term
| What viruses directly invade pharangeal mucosa? |
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Definition
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Term
| Which viruses less commonly cause pharyngitis? |
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Definition
| "CHEECh would never lose his voice to these bugs" - Coxsackie-, HSV, EBV, Echo-, CMV |
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Term
| What might severe S. pyogenes pharyngitis clinical presentation look like? |
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Definition
| "S. PYOGENES" - Screaming red pharyngeal mucosa, Pharyngeal pain, Yucky (malaise), Over the neck ache (headache), Gray - yellow tonsillar exudate, Edema of uvula, Nodes (enlarged cervical lymph _), Eosinophils and other Leukocytes > 12000 / mm^3, Sever fever >= 39.4 C |
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Term
| What percentages are associated with infectious mononucleosis? |
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Definition
| 85% pharyngitis, 50% splenomegaly, 5% rash, ~100% of patients exhibit pruritic macupapular rash when administered ampicillin / amoxicillin |
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Term
| Which viruses are implicated in infectious mononucleosis? |
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Definition
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Term
| What is the DOC for S. pyo. pharyngitis? |
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Definition
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Term
| What should be used in case of penicillin allergy for S. pyo. pharyngitis? |
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Definition
| erythromycin (newer macrolide in areas of erythromycin resistance) or 1st gen. ceph. |
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Term
| What are the goals of treatment when treating S. pyo. pharyngitis? |
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Definition
| 1) prevent rheumatic fever, 2) prevent suppurative complications, 3) improve and shorten course, 4) decrease infectivity |
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Term
| What are the antibacterial treatments for S. pyo. pharyngitis (include dosing)? |
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Definition
| all orals (pen VK [or amox], erythromycin, cephalexin) may be given 250 mg qid 10 d, pen VK [or amox] may also be dosed 500 mg bid 10 d. Pen G is dosed IM with 1.2 X10^6 units once |
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Term
| Children incur a lower incidence of otitis media if breastfead at least how long? |
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Definition
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Term
| What age range has the highest incidence of otitis media? |
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Definition
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Term
| Boys or girls have more otitis media? |
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Definition
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Term
| Is there a race / ethnic prediliction for otitis media? |
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Definition
| Native Americans, Eskimos, Australian Aborigines |
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Term
| What are the main bacterial pathogens involved in otitis media in order of prevalence? |
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Definition
| Strep. pneumo., H.flu, Moraxella catarrhalis, S. pyo, Staph. aureus |
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Term
| 7-valent vaccine covers what % of pneumococccal serotypes? |
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Definition
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Term
| What are the serotypes covered in 7-valent pneumococcal vaccine? |
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Definition
| 4, 6B, 9V, 14, 18C, 19F, 23F |
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Term
| H.flu otitis media is more common in what populations? |
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Definition
| older children and adults |
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Term
| Most M. catarrhalis produce what virulence factor? |
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Definition
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Term
| How is otitis media diagnosed? |
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Definition
| Presence of fluid in middle ear (detected by loss of mobility) accompanied by signs and symptoms of acute illness |
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Term
| What are the signs and symptoms of acute illness in otitis media diagnosis? |
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Definition
| "OTITIS M" - Otic pain (ear pain), Tympanic membrane redness, Increased hearing loss, Temperature (fever), Irritability, Seepage (drainage), Malaise (lethargy) |
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Term
| Which organisms are covered in empiric treatment of typical otitis media? |
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Definition
| Strep. pneumo, H.flu, M. catarrhalis |
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Term
| In what populations do we need to think about covering Gram negative bacilli for otitis media? |
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Definition
| neonates and immunocompromised |
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Term
| What might some suppurative complications of chronic otitis be? |
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Definition
| mastoiditis and meningitis |
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Term
| What is the DOC for otitis media? |
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Definition
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Term
| What is the failure rate for amoxicillin due to beta lactamase produced by some H.flu and M. catarrhalis in otitis media? |
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Definition
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Term
| What is amoxicillin dosing for otitis media? |
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Definition
| 80 mg / kg / day X 10 days |
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Term
| What antibacterial alternatives to DOC are there for otitis media? |
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Definition
| Augmentin 80 - 90 mg / kg / day bid, cefuroxime, cefdinir, IM ceftriaxone, macrolides (azithromycin, clarithromycin) if beta lactam allergic, Bactrim |
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Term
| What constitutes recurrent episodes of otitis media that might warrant prophylaxis? |
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Definition
| 2 in 1st 6 months, 3 in 6 months, 4 in 12 months |
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Term
| What is the prophylaxis dosings for otitis media? |
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Definition
| amoxicillin 20 - 40 mg / kg / day qd or sulfisoxazole 50 mg / kg / day qd |
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Term
| What are the 2 biggest classifications that sinusitis is broken into? |
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Definition
| infectious, non - infectious |
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Term
| What is the classification breakdown of infectious sinusitis? |
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Definition
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Term
| What is the classification breakdown of non - infectious sinusitis? |
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Definition
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Term
| What are the beta lactam antibacterial treatments for sinusitis? |
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Definition
| "Let's have PO' AUGie and FLOR over FUR DINner next time we have sinusitis" - Augmentin 875 mg q12h X10 days, cefdinir 600 mg qd X10 days, cefpodoxime proxetil 200 mg q12h X10 days, cefuroxime axetil 250 mg q12h X10 days |
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Term
| What are the non - beta lactam antibacterial treatments for sinusitis? |
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Definition
| "Let's have PO' AUGie and FLOR over FUR DINner next time we have sinusitis" - levofloxacin 500 mg qd X10 days, levofloxacin 750 mg qd X5 days, moxifloxacin 400 mg qd x10 days |
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Term
| Where is initial observation in otitis media practiced extensively? |
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Definition
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Term
| What extensively used otitis media therapies have failed to show benefit in clinical trials? |
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Definition
| decongestants, antihistamines, and steroids |
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Term
| What bacterial species nasal colinizations increase the risk for nosocomial sinusitis? |
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Definition
| Staph. aureus, Pseudomonas aerugnosa, Serratia marcescens, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter spp. |
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Term
| What bacterial species nasal colinizations increase the risk for nosocomial sinusitis? |
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Definition
| Staph. aureus, Pseudomonas aerugnosa, Serratia marcescens, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter spp. |
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Term
| What are the fungal causes of sinusitis? |
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Definition
| Aspergillus spp., Pseudallescheria boydii, Schisophyllum commune, Phaeohyphomycetes, Zygomcetes (Rhizopus spp., Mucor spp., Phizomucor spp., Cunninghamella bertholetiae) |
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Term
| What are possible complications of sinusitis? |
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Definition
| menigitis, brain abscess, subdural empyema, cavernous sinus, cortical vein thrombosis, orbital cellulitis, orbital abscess, subperiosteal abscess, onset of exacerbation of asthma and bronchitis |
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Term
| What is entailed in antifungal treatment of fungal sinusitis? |
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Definition
| surgical debridement of affected sinuses, and antifungal agents (amphotercin B, echinocandin agents, triazole agents) depending on pathogen |
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