BRONCHITIS Clinicians should not perform testing or initiate antibiotic therapy in patients with
________ unless pneumonia is suspected.
Group A Streptococcal pharyngitis persistent fevers
anterior cervical adenitis
tonsillopharyngeal exudates
rapid antigen detection Clinicians should test patients with symptoms suggestive of group A streptococcal
pharyngitis (for example, persistent fevers, anterior cervical adenitis, and
tonsillopharyngeal exudates or other appropriate combination of symptoms) by
__________________ test and/or culture for group A Streptococcus. Clinicians
should treat patients with antibiotics only if they have confirmed streptococcal
pharyngitis.
acute rhinosinusitis Clinicians should reserve antibiotic treatment for _______________ for patients
with persistent symptoms for more than 10 days, onset of severe symptoms or
signs of high fever (>39 °C) and purulent nasal discharge or facial pain lasting for at
least 3 consecutive days, or onset of worsening symptoms following a typical viral
illness that lasted 5 days that was initially improving (double sickening).
Common cold Clinicians should not prescribe abx for patients with the ___________.
purulent ________ secretions in the nares and throat (commonly reported and seen in
patients with an uncomplicated, URI neither predict bacterial infetion nor benefit
from abx use.
GABHS The benefits of abx tx of adult pharyngitis are limited to those pts with _________
infection. all patients with pharyngitis should be offered appropriate doses of
analgesics, antipyretics, and other supportive care
Hx of fever Clincally screen all adult pts with pharyngitis for the presence of the 4 centor criteria
tonsillar exudates which include?
no cough
tender anterior cervical lymphadenopathy
2 Test pts for GABHS with ____ or more criteria using a rapid antigen test. Limit
antibiotic therapy to pts with a positive test
Throat cultures __________ are not recommended for the routine primary evaluation of adults with
pharyngitis, nor for the confirmation of negative rapid antigen tests.
Penicillin What is the preferred abx tx for acute GABHS pharyngitis?
or
Erythromycin for a PCN allergic patient
Acute rhinosinusitis Most cases of __________ diagnosed in ambulatory care are due to uncomplicated
viral, URI.
7 The clinical diagnosis of acute bacterial rhinosinusitis should be reserved for
patients with rhinosinusitis symptoms lasing _____ days or more and who have
maxillary facial/tooth pain or tenderness and purulent nasal secretions.
Symptomatic tx What is the preferred, initial management strategy for patients with mild symptoms
of acute bacterial rhinosinusitis?
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, MN 568 Unit 2 Exam - Question and Answers (Correct Answers)
pneumonia In the healthy, non-elderly adult, ______ is uncommon in the absence of vital sign
abnormalities or asymmetrical lung sounds, and chest radiography is usually not
indicated.
3 In patients with a cough lasting ____ weeks or longer, chest radiography is
warranted in the absence of other known causes.
Nasal saline ______________ solutions can be given safely to infants and children to help
relieve symptoms of upper respiratory tract infection and are recommended by the
American Academy of Pediatrics over OTC cough/cold products
Croup Results from a narrowing of the subglottic airway secondary to inflammation
associated with certain viral respiratory tract infections and is represented by the
sudden onset of a barking cough.
spasmodic or allergic croup recurrent episodes of croup
6mos-3yr When does croup typically occur in children
Peak at 2 yoa
Foreign body obstruction What mimics the symptoms of croup and has to be ruled out before a diagnosis of
croup can be made?
Epiglottitis What is a medical emergency and must also be considered in children presenting
with signs and symptoms of croup?
High fever and toxic appearance What symptoms can help you distinguish between croup and epiglottitis?
Epiglottitis High fever, toxic appearance, sore throat, drooling, sitting or leaning forward
Haemophilus influenzae Which vaccine can help prevent epiglottitis?
Bacterial tracheitis Presents like croup, usually presents as an abrupt deterioration following a
moderate illness. It does not respond to racemic epinephrine and requires tx with
abx
parainfluenza viruses What is the most common cause of croup today?
Rhinovirus This coinfection is common in croup
Parainfluenza type 1 peak season: autumn of odd numbered years
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