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19 Cards in this Set
- Front
- Back
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Bacteria causing AOM
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H. influenza 50-70%
Strep. pneu 30% |
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Sxs relief of AOM (4 med cat, 2 other)
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1. NSAIDS/APAP po- mild/mod pain
2. Topical Benzocaine drops (Auralgam) >5yrs only or Oticon otic sol - naturopathic - short term relief 3. Narcotics c codeine - mod/sev pain, >2yrs 4. decongestants >2yrs only |
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ABX tx for AOM
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1. Amoxacillin for most
2. Augmentin for special cases (abx in last mo, otitis-conj synd), on amox as prophylaxis, adult c amox tx failure) |
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Guidelines to treat AOM c abx
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1. <6mo always abx
2. 6mo-2yr abx c certain dx or severe dx. Observe if dx uncertain & not severe. 3. >2yr abx c certain dx, severe dz or increased risk. Observe if uncertain dx or certain but not severe. 4. abx always for perf |
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Treatment of OME
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1. Observation.
2. Hearing text Q3mos 3. Abx only if AOM 4. Antihistamines/ decongestants not helpful, only >6yrs |
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Plan for persistent OME
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1. Audiogram if lang delay, learning problems or decreased hearing.
2. speech/lang eval 3. Tympanostomy/ myringotomy |
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Bacteriology of OE
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Common:
1. Staph aureus 2. gram +/- (pseudomonas), fungus (aspergillus) 3. polymicrobial uncommon: p. aeroginosa in immunocompromised & elderly |
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Treatment of OE
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1. Topical abx (Corticosporin Otic susp, Cipro-HC Otic)
2. Acidifying drops (Vosol, Otic Demeboro) to soften cerumen 3. Analgesics 4. Topical corticosteroids |
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Causative agents of viral pharyngitis
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Common: respiratory viruses (adenovirus, paraflu, rhinovirus)
Uncommon: coxsackie/herpangina, HSV (gingivostomatitis), EBV, HIV |
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Causes of bacterial pharyngitis
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Strep (GABHS), H. flu, Myco pneu, N. gon
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Strep pharyngitis treatment
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1) antipyretics-apap/nsaids
2) analgesics- lozenges, NaCl gargle, tea 3) Abx |
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Abx for strep pharyngitis
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Tx c +RSAT or while waiting for c/s and strong s/s profile.
1. 1st line: PCN (PCN V-K po, Bensocaine PCN IM). narrow spect. 2. Alt's Amox (broad spect), Macrolides (resistance, GI upset), Cephalosporins (cross-reactivity PCN allergy) |
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Treatment for Viral Rhinitis (Common Cold)
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Sxs Mgmt:
1. Decongestant spray (Afrin) short term only-causes rebound 2. Antihistamine (Claritin, Benedryl) 3. Antitussive (dextromethorphan, codeine) 4. Analgesics (NSAIDS, APAP) 5. hydration, humidification, fluids, Saline Spray 6. Herbals: zinc/ echinacea |
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Causative agents of viral rhinitis (from ppt)
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1. Rhinoviruses
2. Coronaviruses 3. RSV 4. Kids: flu viruses, paraflu's, adenoviruses. |
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Bacteria causing bacterial rhinosinusitis
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Secondary to viral rhinitis
1. H. flu and S. pneu (75% of cases) 2. M. cat not common |
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Abx tx for bacterial rhinosinusitis
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1. Amox if no risk for resistance
2. Aug if pos risk for resistance 3. Vantin, Ceftin (cephalosporins PCN Allergy: 1. Erythro 2. Macrolides (Zithromax) 3. TMP-SMX (Septra) 4. Clinda |
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Tx for bacterial rhinosinusitis
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1. nasal decongestants (Afrin)
2. Abx 10-14 days 3. Intranasal glucocorticoids 4. Saline spray |
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Treatment for allergic rhinitis
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1. saline spray
2. Nasal steroids start c if mostly nasal sxs, >2yrs only (fluticazone, triamcinalone, flumisolide). 3. Antihistamines (no kids) start c if lots of allergy sxs (2 gen): 1st gen H1 blockers: Chlor-Trimeton, Benedryl. 2nd gen H1 blockers: Claritin, Allegra. 4. topical decongestants (Afrin) 5. Cromolyn sodium ok for kids |
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Causative agents of rhinitis (bacterial and viral - per chart)
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Adults (rhinovirus, influenza virus, paraflu virus)
Kids also RSV, adenovirus |
