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,Allergic Rhinitis Medication - correct ans:-diphenhydramine: sedating
-cetirizine (zyrtec)
-fexofenadine (allegra): most targeted, least SEs
-nasal steroids: for prevention, daily use, takes 1wk+ for full effect
-eye drops
Uncomplicated URI treatment - correct ans:-increased fluids
-saline spray
-nose frida
-honey - not in children under 1 yo
-NO vapor rub, cough suppressants, or cough medicine
-educate on s/sx of respiratory distress
ABRS vs URI - correct ans:-ABRS lasts for 10+ days w/ nasal discharge and/or daytime cough
-ABRS initially improves but then gets much worse
ABRS treatment - correct ans:-amox or augmentin 10-28 days
-wait for clinical response then add 7 days
-failure to respond to augmentin - consult ENT
-nasal steroids
-saline irrigation
-possible decongestants, mucolytics, antihistamines
severe ABRS - correct ans:fever >39 + 3 days purulent discharge (referral to ENT)
croup characteristics - correct ans:-viral: parainfluenza 1 and 3, influenza A, and RSV most common
-inflammation of larynx/trachea
-most common boys 6 mo-6 yo
, -begins as mild URI, progresses to sore throat, barky cough worse at night, +/- fever
-s/sx peak in 3-5 days
-moderate obstruction: stridor, retractions, tachycardia, nasal flaring
-severe obstruction: cyanosis, worried, lethargic, decreased LOC
moderate croup treatment - correct ans:-calm, distracted, position of comfort, hydration
-first-line: dexamethasone, then budesonide or prednisone
-cool mist/ cool air
-only xray if suspect FB or congenital problems
croup red flags - correct ans:-stridor at rest: send to ER for racemic epinephrine neb (potential for
rebound)
-toxic looking: send to ER for O2 and IV fluids
bacterial pneumonia - correct ans:-age: 2+
- high fever, tachypnea, cough
-high WBC + left shift (low WBC is ominous sign)
-x-ray may look normal in early illness
-tx: <5 - amox, augmentin
>5 - macrolide
-f/u in 2-3 weeks or 1-2 days if no improvement from abx
mycoplasma pneumonia - correct ans:-age: >5 years
-slow onset, fever, malaise, cough progressing to productive
-tx: azithromycin or cipro for 7-10 days
chlamydia pneumonia - correct ans:-age: newborn
-50% w/ vaginally infected mothers get it
-afebrile, staccato cough, tachypnea, crackles