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42 Cards in this Set

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What are the most common viral URI etiologies?
Rhinovirus
Influenza
Parainfluenza
Adenovirus
obstruction of this structure causes impaired drainage and leads to an acute purulent sinusitis
obstruction of the sinus ostia
what are 2 common ingredients in nasal decongestants?
pseudoephedrine (Sudafed)
phenylpropanolamine
what is the main ingredient in expectorants?
guaifenesin
Why shouldn't you give ASA to children?
Causes Reye's Syndrome
what is the most frequent nosocomial infection in intensive care units
Sinusitis secondary to NG tube placement >48 hrs
The MC organisms that cause sinusitis
S.pneumoniae or H.flu causes 70% of cases

others:
M.Cat
Staph Aureus
Gram - organisms in ICU
Which sinus is MC affected in sinusitis?
maxillary sinusitis
what is the preferred imaging method for sinusitis?
CT scan, but only use in cases of treatment failure or chronic disease
what is rhinitis medicamentosa?
rebound nasal congestion brought on by extended use of decongestants
why do you not give antihistamines to treat sinusitis?
they thicken secretions
when are Abx indicated for treating sinusitis?
when there's purulent D/C, worsening Sx(fever, leukocytosis, tender sinuses) > 5-10 days
How do you treat sinusitis in the ICU?
Remove tubes
Give ofloxocillin or vanco c 3rd Gen. Ceph or Unasym
What can happen if you don't treat sinusitis adequately?
Can progress to:
Chronic Sinusitis
Meningitis
Periobital/nasal cellulitis
Osteomyelitis
Brain abscess
Pt presents with soft, doughy, swelling around the sinuses
Osteomyelitis; you need a CT or MRI to confirm
where can you find Charcot Leyden Crystals?
In the sputum of a pt with Fungal or allergic sinusitis

These crystals are proteins that originate in the cytoplasms of eosinophils
How do you treat chronic invasive sinusitis?
IV amphotericin B
This disease is assoc. with the common bread mold and usually affects diabetics and immunocompromised pts
Phycomycosis

Tx: rapid, debridement, IV amphotericin
which viruses frequently cause pharyngitis?
chlamydia
mycoplasma
streptococci
T/F The presence of exudates differentiate viral and bacterial causes
False: exudates can be caused by both
what are the Centor criteria for GABHS
Fever
Exudates
Absence of cough
Lynphadenopathy
How do you Dx rheumatic fever?
requires 2 major Jones criteria or 1 major plus 2 minor
Name the Jones criteria
Major:
J-polyarthritis
0-carditis
N-nodules subq
E-erythema marginatum
S-syndenham's chorea

Minor: FAPPA
Fever
Arthralgia
Previous rheumatic fever
Prolonged P-R interval
Acute phase reactions(>ESR, C-reactive protein, leukocytosis)
A pt comes in with edema, gross Hematuria, and HTN two weeks after having a sore throat, what do you suspect?
Post-strep glomerulonephritis
vesicles on the hands and feet (hand-foot-and-mouth disease)is assoc. with this virus
coxsackievirus
T/F syphillis can cause pharyngitis
TRUE
A pt with a foul smelling gray-white pharyngeal membrane and a whitish-blue pharyngeal exudate; what's the organism?
Corynebacterium diptheriae
this disease presents w/cheesy, white-creamy exudate with an erythematous base on the tongue or buccal mucosa
Oral candidiasis

Common in HIV pts
what is Vincent's angina?
This is trench mouth, an infection with ulceration, swelling and sloughing off of dead tissue from the mouth and throat due to the spread of infection from the gums
what is the DOC for bacterial laryngitis?
Augmentin
what are the S/Sx of epiglottitis?
Muffled voice
Drooling
Stridor
Tripod position
Sore throat
A “Thumb print” sign on X-ray is indicative of?
Epiglottitis
Which organisms often cause epiglottitis?
H.flu type B
S pneumoniae
H parainfluenzae
S aureus
GABHS
How do you treat epiglottitis?
Cephalosporin
A young child with a barking cough
croup
Causes of laryngitis
Infection
GERD
Environmental insults (pollution)
Vocal trauma
Use of asthma inhalers
Causes of wheezing
Asthma
COPD
Chronic heart failure
Pneumonia
A sound with a snoring quality suggestive of secretions in large airways
Rhonchi
low pitched ronchi is called?
sonorous
Ronchi with a high pitched, whistling or squeaky quality
Sibilant
These sounds are most often heard in pleurisy, also called crepitations or crackles, they sound like brief bursts of popping bubbles, and are often assoc. with early CHF, pneumonia, and brochitis
Rales
An infection that causes pus to accumulate in the pleural space
Empyema