Treatments for Midterm

Question 1

What vaccines can help prevent otitis media

Answer 1

pneumococcal and influenza

Question 2

2 primary treatments for acute otitis media if antibiotic therapy required

Answer 2

1. amoxicillin 80-90 mg/kg/day in 2 doses
2. augmentin 90 mg/kg/day with 6.4 mg/kg/day clavulanate in 2 divided doses

Question 3

Alternative treatment for acute otitis media if a penicillin allergy

Answer 3

cephalosporins

Question 4

if a patient is receiving treatment for 48-72 hours for acute otitis media and not having improvement, what are further options

Answer 4

Previous options but added option of Clindamycin

Question 5

Duration of treatment for acute otitis media
-if severe
-if less than 2
-if 2-5 years old
-if >/= 6 years old

Answer 5

10 days if severe
10 days if < 2
7 days if 2-5 years old
5-7 days if >/= 6 years old

Question 6

when to treat rhinosinusitis

Answer 6

when persistent and not improving >10 days
if severe and worsening > 3 days

Question 7

first line treatment for rhiosinusitis

Answer 7

augmentin 45-90 mg/kg/day in 2 doses (500 mg TID or 875 mg BID if adult)

Question 8

alternative treatments for rhinosinusitis

Answer 8

doxycycline 100 mg BID (adult only)
clindamycin + 3rd gen ceph
unasyn

Question 9

duration of treatment for rhinosinusitis
-if adult
-if pediatric
-if chronic

Answer 9

5-7 days if adult
10-14 days for pediatric
>/= 21 days if chronic

Question 10

First line treatments for Pharyngitis

Answer 10

Amoxicillin 1000 mg daily for 10 days
Penicillin V or G

Question 11

treatment options for Pharyngitis if penicillin allergy

Answer 11

cephalexin 500 mg BID for 10 days
azithromycin 500mg for 1 day then 250 mg daily for 4 day

Question 12

Treatment for laryngotracheobronchitis

Answer 12

-cool mist or steam
-nebulized racemic epinephrine 0.05-0.1 ml/kg q20 mins prn
-dexamethasone 0.6 mg/kg

Question 13

Prevention methods for RSV

Answer 13

RSV vaccine Abrysvo or passive immunity with nirsevimab or palivizumab

Question 14

Treatment for RSV

Answer 14

supportive care with fever and pain management and fluids

Question 15

Treatment for epiglottits

Answer 15

-Maintain airway
-Rocephin (3rd gen ceph) + vanc or clindamycin (anti staph agent)

Question 16

Treatment for rhinovirus

Answer 16

symptomatic relief with decongestants, antihistamines, and analgesics

Question 17

How to prevent influenza virus

Answer 17

Vaccine against type A and B strands

Question 18

treatment options for influenza

Answer 18

Neuraminidase inhibitors Oseltamivir (tamiflu)
Zanamivir (Relenza Diskhaler)

Question 19

Treatment for acute bronchitis

Answer 19

supportive care
-dextromethorphan or guaifenesin for cough
-antihistamine/decongestant for cold
-APAP or NSAIDS for aches and pains
-antibiotics if pertussis

Question 20

Antibiotic treatments for treatment of acute bronchitis due to pertussis

Answer 20

Macrolides (specifically azithromycin if < 1 month)
Bactrim (alternative)

Question 21

How to prevent acute bronchitis

Answer 21

stop smoking
flu and pneumococcal vaccines

Question 22

Treatment option for outpatient CAP if no comorbid conditions or risk factors for MRSA or Pseudomonas

Answer 22

Monotherapy with
Amoxicillin
Doxy
Macrolides
For 7-10 days

Question 23

Treatment option for outpatient CAP if comorbid conditions

Answer 23

-Cephalosporin or augmentin plus macrolide or doxy
-monotherapy with respiratory FQ
for 7-10 days

Question 24

Treatment option for inpatient CAP if non severe

Answer 24

-B-lactam + macrolide
-respiratory FQ
-B-lactam + doxy
ADD MRSA or Pseudomonas coverage if needed

Question 25

Treatment option for inpatient CAP if severe

Answer 25

B-lactam + macrolide B-lactam + respiratory FQ ADD MRSA or Pseudomonas coverage if needed

Question 26

Treatment options for Ventilator associated pneumo if low MRSA and single antipseudomonal agent has >90% activity

Answer 26

-cefepime -primaxin -levo -meropenem -zosyn 7 day treatment duration

Question 27

Treatment options for Ventilator associated pneumo if MRSA and single antipseudomonal agent has <90% activity

Answer 27

-Anti-pseudomonal B-lactam + antipseudomonal FQ -Aminoglycoside +/- MRSA coverage 7 day treatment duration

Question 28

Treatment options for non ventilator associated hospital acquired pneumonia if not in septic shock and without IV antibiotic use within 90 days and low MRSA

Answer 28

antipseudomonal B-lactam

Question 29

Treatment options for non ventilator associated hospital acquired pneumonia if not in septic shock and without IV antibiotic use within 90 days and MRSA prevalence

Answer 29

-antipseudomonal B-lactam + antipseudomonal FQ -aminoglycoside +/- MRSA coverage

Question 30

t or f? add MRSA coverage if septic shock

Answer 30

true

Question 31

Treatment options for community acquired parapneumonic effusion and empyema

Answer 31

-cefotaxime or ceftriaxone + metronidazole -amp/sul -levaquin or aztreonam +metronidazole (if allergy to pen) -imipenem or meropenem (if allergy to pen)

Question 32

Treatment options for hospital acquired parapneumonic effusion and empyema

Answer 32

-vancomycin + metronidazole and cefepime or ceftazidime -pip/tazo -ticarcillin/clavulanate -metronidazole + cipro (if pen allergy) -imipenem or meropenem (if pen allergy)

Question 33

inpatient and outpatient treatments for COVID

Answer 33

remdesivir for inpatient Paxlovid for emergency use outpatient

Question 34

preferred antibiotics for acute COPD exacerbation

Answer 34

augmentin azithromycin doxycycline respiratory FQ