Exam 1 Flashcards
Treatment for Hordeolum?
Warm compress, erythromycin ointment (0.5% QIDx7 days) OR bacitracin (500 units/g apply q3-4hr)
Education: stop rubbing eyes, stop makeup, DON’T SQUEEZE, wash with water and gentle cleanser i.e. baby shampoo, should resolve spontaneously
Difference between blepharitis and hordeolum?
Hordeolum is a stye – a pustule at eyelid margin, unilateral, and no eye pain (just lid)
Blepharitis is bilateral EYE burning, itching, photophobia, and crust (infection of eyelid follicles)
Treatment for pharyngitis/tonsillitis?
Pen V 500mg BID-TID x10 days
Zpak 500: 500 mg x1 day, 250 mg days 2-5 ** this is explicit in the special packaging of zpak
Non-Pharm: salt water gargles, acetaminophen (4g/day max), lozenges, new toothbrush after antibiotics are complete, no sharing cups/cutlery
What diagnostics for suspected pharyngitis/tonsillitis?
Rapid strep
throat culture
CBC
** Use Centor score below –> 1 point for each, treat if score is 2 or more, no strep test necessary if score is 4 **
- Hx of fever
- No cough
- tonsillar exudate
- tender anterior cervical adenopathy
Clinical manifestations of viral conjunctivitis?
How to rule out other diagnoses?
- minor crusting
- water discharge
- when drainage is wiped away, it doesn’t immediately come back
- diffuse redness of conjunctiva
- NO photophobia
- NO change to visual acuity
- S/S of URI
- ipsilateral preauricular lymph
- palpebral conjunctiva may look bumpy
What usually causes mononucleosis?
EBV (Epstein-Barr Virus)
What are the clinical manifestations of mononucleosis?
And the objective findings?
Fatigue (82% of cases)
sore throat
swollen glands
fever
cervical & generalized lympahdenopathy (94%) pharyngitis (84%) Fever 100-106 lasts 1-2 weeks splenomegaly 1/2 the time
What is the treatment for an URTI?
Tylenol (max 4g/day)
NSAIDs
Decongestants (short term benefits)
Afrin spray (2 squirts each nostril BID x5 days)
NO antitussives, antihistamines, abx, goldenseal
What are the clinical manifestations of a peritonsillar abscess?
unilateral throat pain possible ipsilateral ear pain dysphagia (often severe) drooling fever/chills (often 102+) fatigue, malaise
Refer to ENT or ED IMMEDIATELY
What is the treatment for mononucleosis?
Corticosteroids for airway obstruction, severe thrombocytopenia (<20,000 platelets/mm30), hemolytic anemia
rest hydration analgesics antipyretics avoid sports activities 3-4 weeks until sx resolve (consider abd US for those returning to contact sports)
F/U 1-2 months to ensure symptoms resolve
What is the treatment for viral conjunctivitis?
wash hands frequently, do not share towels. HIGHLY contagious cold compresses artificial tears (systance, optive) ** put in fridge (more soothing)
this is self-limiting, lasts 2-3 weeks
What is the treatment for otitis media?
amoxicillin (500mg TID x5-7 days; up to 10 days for severe cases)
If no improvement after 48-72 hrs, switch to augmentin
If PCN allergic, use macrolide (azith/clarith)
Refer to ENT if recurrent or not resolving
Tylenol/Ibu for pain
Nasal spray to relieve otitis effusion symptoms
How does a cough happen?
When a neural receptor along the respiratory tree is stimulated, an afferent signal is transmitted to the “cough center” of the brain (in the medulla). The impulse is then sent down the efferent pathway to the expiratory musculature
What is c-reactive protein and why test for it?
C-reactive protein is created in the liver. Levels of c-reactive protein are elevated in the presence of inflammation.
What symptom does an ace inhibitor cause that is similar to a respiratory diagnosis?
A cough
