respiratory infections ACUTE RHINOSINUSITIS Flashcards Preview

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Flashcards in respiratory infections ACUTE RHINOSINUSITIS Deck (17)
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1

what is an acute inflammation of the mucosal lining of the nasal passage and paranasal sinuses

acute rhinosinusitis

2

how long can acute rhinosinusitis last

up to 4 weeks

3

what normally causes acute rhinosinusitis

virus
(antibiotics are often prescribed unnecessarily)

4

what can cause acute rhinosinusitis

1. allergens
2. environmental irritants
3. infection (viral 90-98% of time)

5

what bugs can cause acute bacterial rhinosinusitis (five total)

1. S. pneumonia
2. H influenza
3. S. Pyrogenes
4. S. aureus
5. M. catarrhalis

6

what bugs can cause acute bacterial rhinosinusitis but be prevented with vaccinations

1. S. pneumonia
2. H influenza

7

what are the 3 pathophysiological steps of ABRS

1. starts as a viral infection
2. inflammation causes obstruction
3. mucosal secretions become trapped and infection proliferates

8

what is the greatest barrier to efficient use of antibiotics in ABRS?

lack of simple diagnostic test

9

what is the gold standard for ABRS diagnosis

sinus puncture (very costly invasive and painful)

10

what are the 3 clinical presentations of ABRS

1. onset with persistant symptoms for longer than 10 days
2. onset with severe symptoms w/ fever of 102 or greater
3. facial pain lasting 3 or 4 consecutive days
4. "double sickening"- symptoms get better for a bit then much worse

11

what are the risk factors for antibiotic resistance for treating ABRS (five of them)

1. age less than 2 or older than 65
2. prior antibiotics that month
3. prior hospitalization in past 5 days
4. comorbidities (diabetes...)
5. immunocompromised

12

what is the first line therapy for ABRS

amoxicillin clavulanate

13

if someone has risk factors for antibiotic resistance, what should be used for ABRS

amoxicillin clavulanate
or
doxycycline

14

If a patient has a B-lactam allergy, what should be used to treat ABRS

doxycycline
levofloxacin
moxifloxacin

15

why is ciprofloxacin not used for ABRS

decreased spectrum against strep., a common bug in ABRS

16

if someone has a severe ABRS infection requiring hospitalization, what treatment should be used

levofloxacin PO or IV
moxifloxacin PO or IV
ceftriaxone IV
cefotaxime IV

17

what are 3 treatment considerations for ABRS treatment

1. decongestants and antihistamines can worsen infection (do not recommend)
2. intranasal saline irrigations may not work but may be recommended (won't hurt)
3. intranasal corticosteroids are recommended for patients with a history of allergic rhinitis