Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
UTI
|
E. coli (75-95%) occasionally proteus mirabillis, klebsiella pneumoniea or staphylococcus saprophyticus
|
TMP-SMX- bactrim (resistance >20%)
Ampicillin (resistance >20%) Fluoroquinolones (resistance <10%) Amoxicillin + Clavulinic acid (resistance < 10%) |
|
|
Pharyngitis causes
|
Major cause viral- influenza, parainfluenza, coronavirus, rhinovirus, HSV, EBV, HIV
Group A Strep, Mycoplasma pnuemaniae, Chlamydophila pneumoniae, N. gonorrhoeae, groups C and G, etc. Allergy |
|
|
|
Bacterial Sinusitis vs Viral Sinusitis diagnosis
|
Bacterial lasts greater than 10 days or onset with severe symptoms (fever >102 and purulent nasal discharge ro facial pain) lasting 3 consecutive days at the beginning of illness or onset with worsening symptoms following a viral URI that lasted 5-6 days and was improving
|
|
|
|
Non purulent Cellulitis causes
|
Beta hymolytic streptococci and S. aureus are most common
treat with |
adults; kids
Dicloxacillin 500 mg every 6 hours; 25-50 mg/kd in four doses Cephalexin- 500 mg every 6 hours; 25-50 mg/kg in 3-4 doses Clindamycin-300-450 mg every 6-8 hours; 20-30 mg/kg in 4 doses |
|
|
Rhus dermatitis topical treatment
|
Topical
Topical astringents such as aluminum acetate or aluminum sulfate calcium acetate may be used to dry weekping lesions. High potency topical corticosteroids (avoid on thin skin of face, genitals, or intertriginous areas), clobetasol propionate 0.05% cream |
Systemic treatment
Sedating antihistamines do not reduce the pruritis but do help with sleep. Nonsedating antihistamines should not be used Systemic corticosteroids- oral prednisone taper 2-3 weeks (60-40-20 mg). IM dose of 1 mg/kg triamcinolone acetonide + betamethasone (0.1 mg/kg) Antibiotics if infection is suspected |
|
|
Streptococcal tonsillopharyngitis treatment
|
Penicillin V- 10 days
Amoxicillin is often used for children b/c it tasted better Penicillin G (IM)- single dose |
|
|
|
Otitis media adult
|
Mild to moderate Amoxicillen 500 mg every 12 hours or 250 mg every 8 hours. 5-7 days
Severe disease (fever, significant hearing loss, severe pain or marked erythema)- Amoxicillen 875 mg every 12 hours or 500 mg every 8 hours. 10 days |
|
|
|
Otitis externa
Topical treatment |
Topical
Antibiotics- ofloxacin, ciprofloxacin, polymyxin B, neomycin, tobramycin, gentamicin Glucorticoids to reduce inflammation- hydrocortisone |
Oral treatment
In mild to moderate cases no difference in clinical response between a topical and TMP-SMX Deeper tissue infections- ciprofloxacin (500mg BID 7-10 days) or ofloxacin Pain- NSAIDs |
|
|
Streptococcal pharyngitis in a beta lactam sensitive pt
|
Cephalosporins- cefuroxime, cefpodoxime, cefdinir and ceftriaxone
Macrolides (clarithromxin, azithromycin, erythromycin) for pencillin allergic pts |
|
|
|
Acute viral rhinosinusitis
|
NSAIDs and acetaminophen
Saline (or STERILE water) irrigation Intranasal glucocorticoids- decrease inflammation (systemic glucocoritcoids are recommended against) Topical decongestants- oxymetazoline--use sparingly to avoid rebound congestion Oral decongestants Mucolytics- guaifenesin |
|
|
|
Acute bacterial rhinosinusitis
|
Amoxicillen-clavulanate 5-7 days (according to UptoDate) 500mg/125mg TID or 875mg/125mg BID
What about penicillin sensitive pts? |
Doxycycline or levofloxacin or moxifloxacin
|
|
|
Purulent cellulitis
|
Suspect MRSA
|
Treat empirically with clindamycin, TMP-SMX, Tetracycline (doxycycline or minocycline) linezolid or tedizolid
|
|
|
Otitis media adult penicillin allergy
|
Pts who report an allergy but did not experience urticaria or anaphylaxis
Cefdinir- 300 mg BID or 600 mg 1x/day Cefpodoxime- 200 mg BID Cefuroxime- 500 mg BID Ceftriaxone- 2 g IM or IV 1x |
Pts with a severe allergy to beta lactam antibiotic
Macrolide- erythromycin + sulfisoxazole or Azithromycin or Clarithromycin TMP-SMX may be used in regions where pneumococcal resistance is not a concern |
