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CCFP 3 > URTI + PNA ** > Flashcards

URTI + PNA ** Flashcards

1
Q

Sinusitis vs rhinosinusitis

A

Sinusitis: inflammation of 1 or more paranasal sinuses
Rhinosinusitis: inflammation of nasal mucosa + sinuses

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2
Q

RF for sinusitis

A

CF, immunodeficiency, irritants, deviated septum, polyps, cocaine use, trauma

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3
Q

Acute vs chronic vs ped causes of sinusitis

A

Acute causes: s pneumonia, H influenza
Chronic causes: S aureus, pseudomonas, enterobacteriaceae
Child causes: moraxella catarrhalis

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4
Q

Sx + complications of sinusitis

A

Sx: persistent URTI sx, no improvement in 10d
PODS: facial PAIN, nasal OBSTRUCTION, nasal DISCHARGE, SMELL disorder
Complications: periorbital cellulitis, meningitis, intracranial abscess, sepsis
Preseptal Cellulitis
Postseptal Cellulitis
Abscess (Sinus, Orbital, Subperiosteal, Brain)
Meningitis
Cavernous Sinus Thrombosis
Osteomyelitis

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5
Q

Rx for:
Acute mild/ mod
Severe
Chronic w/o nasal polyps
Chronic w/ nasal polyps

A

Acute mild/ mod: intranasal steroids, abx if no improvement
Severe: intranasal steroid + amoxicillin
Chronic w/o nasal polyps: intranasal steroids
Chronic w/ nasal polyps: intranasal steroids + oral steroids + amox/clav x3w

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6
Q

Sx + complications of EBV

A

Complications: airway obstruction with large tonsils, encephalitis, myocarditis, splenic rupture, lymphoma
Sx: fatigue, sore throat, fever, nausea, anorexia, cough, photophobia, lymphadenopathy

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7
Q

Ix + Rx EBV

A

Ix: EBV serology, ESR
Rx: consider steroids if impending airway obstruction, off sports x3w

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8
Q

Sx of EBV

A

Sx: erythema, edema of pharynx, tonsillar exudate, lymphadenopathy, scarlet fever (sandpaper rash), strawberry tongue

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9
Q

FeverPAIN criteria

A

FeverPAIN criteria: temp >38, tonsillar exudate, severely inflamed tonsils, absence of cough
2-3 = FU or delayed script
4 = abx

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10
Q

Ix, rx + when to refer for surgery for pharyngitis

A

Ix: throat culture or rapid antigen test
Rx: Pen V 300mg TID or amoxicillin 500mg BID
Refer for tonsillectomy: >7/yr, >5 in 2yr, >3 in 3yr

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11
Q

How to manage high risk groups

A

Flu + pneumococcal vaccine
Treat early with oseltamivir phosphate, amantadine

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12
Q

qSOFA score

A

RR >22, altered MS, systolic BP <100

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13
Q

DDx for PNA

A

PJP, TB, Mycobacterium avium complex, influenza, toxoplasmosis

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14
Q

What abx partially treat TB?

A

Fluoroquinolones

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15
Q

Dx of PJP

A

bronchoscopy

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16
Q

Factors affecting abx choice

A

interaction (warfarin), allergy, COPD co-treatment, what bugs cover (ie aspiration)

17
Q

PNA bugs in pts w/ no comorbidities

A

mycoplasma + chlamydophilia

18
Q

PNA bugs in pts w/ comorbidities

A

staph aureus, h. Influenza, moraxella catarrhalis

19
Q

Kids PNA rx

A

amox, FU exam

20
Q

PSI score components

A

PNA severity index:
age, sex, nursing home resident, neoplastic dz, liver dz, CHF, CVD, renal dz, altered MS, RR >30, systolic BP <90, temp <35 or >39.9, pulse >135, pH <7.35, BUN >11, Na <130, glucose >14, hematocrit <30, ppO2 <60, pleural effusions on XR

21
Q

Common cold prevention

A

zinc sulphate, hand washing

22
Q

Common cold treatment

A

NSAIDs, antihistamine, intranasal ipratropium, honey (if >12mo)

23
Q

Otrovent use in rhinomedicomosa can cause what serious SE?

A

thunderclap headache secondary to vasoconstriction

24
Q

Sinusitis sx

A

PODS (pain/ pressure, obstruction, discharge, lack of smell)

25
Q

Sinusitis ALARM features

A

persistent fever >39, periorbital edema, cranial nerve palsies, abnormal extraocular movements, proptosis, vision changes, severe HA, altered MS, meningeal signs

26
Q

Sinusitis dx + rx

A

dx clinically, start w/ amox for 5-10 days, nasal rinse in shower, IN steroids, decongestants, analgesics, anti-inflammatories

27
Q

FEVERPAIN components

A

fever in last 24hrs, purulent tonsils, no cough, tonsil inflammation, <3 days onset

28
Q

Mono sx + how it is spread

A

spread by saliva, sx: lymphadenopathy, fever, pharyngitis, malaise, fatigue, HA

29
Q

Mono labs

A

lymphocyte count, AST, ALT, monospot

30
Q

Mono spleen counselling

A

splenomegaly in 50%, rupture 1 in 1000, no contact sports x3wks, can last up to 8wks

31
Q

Influenza antivirals

A

osetlamivir, if high risk start within 12 hrs of sx

CCFP 3 (67 decks)

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