MVU NURS 629 EXAM 3 QUESTIONS AND ANSWERS
LATEST SOLUTION GUIDE
What is otitis media? - ✔✔Inflammatory fluid and pathogenic respiratory bacteria that reflux into the
middle ear space- does not drain normally. 75% are viral infections
most common bacterial etiologic agents: streptococcus pneumoniae 49%, H influenzae 29%, moraxella
catarrhalis 28%
What are the signs/symptoms of otitis media? - ✔✔fever, pain, d/c from ear, tugging/batting at ear,
irritability, crying lethargy, decreased appetite, decreased sleep, recent URI
Red, bulging TM, possible-retracted w/ pus, decreased translucency, no movement of TM, no normal
landmarks,hole in TM
What is considered recurrent otitis media? - ✔✔3 or more in 6 months OR 4 in one year
How do you treat otitis media in babies <6 months? - ✔✔antibiotics, no matter what
How do you treat otitis media in children 6 months to 2 years? - ✔✔antibiotics if certain or severe
symptoms like high fever, bilateral infections, severe pain, more than 7 days; observe if not certain or
not severe
How do you treat otitis media in children 2 years or older? - ✔✔antibiotics if severe, observe 2-3 days if
not severe
What antibiotics do you use to treat otitis media? - ✔✔Amoxicillin 80-90 mg/kg/day BID x 10 days;
Augmentin 80-90 mg/kg/day BID x 10 days; if PCN allergy- cefdinir, cefuroxime- non type 1 reaction or if
type 1 reaction then azithromycin, clarithromycin, ceftriaxone
What is otitis externa? - ✔✔inflammatory process that involves the structure of the outer ear,
specifically the external auditory canal
,can be from trauma, glandular obstruction, repeating ear cleansing, prolonged exposure to standing
water, increased sweating, or stress
What are the s/sx of otitis externa? - ✔✔tenderness of pinna or tragus, boggy canal
What is the treatment for otitis externa? - ✔✔ototopical antimicrobial-steroid solution containing
neomycin, polymyxin B, and hydrocortisone 4x/day x 7-10 days
topical fluoroquinolone ciprofloxacin, ofloxacin
What is malignant otitis externa? - ✔✔necrotizing, invasive infection of the external auditory canal
usually caused by P aeuginosa and can lead to osteomyelitis
What is otitis media with effusion? - ✔✔non-infected fluid in middle ear without s/sx of acute otitis
media
What is mononucleosis? - ✔✔caused by epstein-barr virus and spread by saliva; incubation of 2-5
weeks; 50% of kids with mono also have strep
s/sx fever, exudative pharyngitis, POSTERIOR cervical adenopathy, malaise, headache, anorexia,
spleno/hepatomegaly
How do you treat mono? - ✔✔symptomatic treatment, f/u in 1-2 weeks, avoid contact sports x 1 month
or until spleen no longer palpable
What are symptoms of group A beta-hemolytic strep pharyngitis? - ✔✔rapid onset sore throat, fever
103-104, swollen glands, abdominal pain, usually no URI symptoms, headache, decreased appetite,
dysphagia, irritability
,exudate tonsils, anterior cervical lymphadenopathy, strawberry tongue, rash
How do you treat strep pharyngitis? - ✔✔Amoxicillin 50-80 mg/kg/day x 10 days, if PCN allergy-
cephalosporins or macrolide
warm water gargles, tylenol/nsaids
Contagious- no school x 24 hours, discard toothbrush
What is impetigo? - ✔✔contagious bacterial infection caused by staphylococci or streptococci, spread by
contact
pruritic rash that won't go away, yellow-crusted lesions, if crust removed- becomes inflammed/red
How do you treat impetigo? - ✔✔wash face BID with soap and water, no school for 24-48 hours, wash
sheets/pillow cases, monitor for serous sequalae
treat with mupirocin/bactroban TID x 7-14 days or bacitracin TID x 7-14 days, or erythromycin,
cephalexin
What is fifth's disease? - ✔✔caused by human parvovirus B19, most common in 5-15 yo; symptomatic
treatment
has low-grade fever, malaise, sore throat, "slap cheek" facial redness in first 4 days, then fishnet/racey
rash within 2 days after initial onset, then fever/itching/petechiae to hands/feet
What is tinea corporis? - ✔✔ringworm- pink, scaly, round with raised border
treat with topical antifungal cream for 2-6 weeks, avoid contact with lesion, no contact sports x 48 hrs of
tx
, What is pityriasis rosea? - ✔✔common, benign rash- usually viral with 29% having recent URI
starts as herald patch, 2-10 cm oval/round lesion first then changes; often on trunk
How do you treat pityriasis rosea? - ✔✔antihistamines, topical steroids, avoid sun exposure, moisturize;
may take up to 3 months to resolve
What is eczema? - ✔✔inflammatory response to allergen, chemical, or unknown etiology; increased
serum IgE
itchy, red, burning/tinging, dryness; pruritc, papulovesicular lesions that ooze and crust,
erythematous,edematous dry patches with cracking/fissuring, indistinct borders, lichenification,
excoriations
How do you treat eczema? - ✔✔avoid harsh soaps, may use antihistamines and corticosteroids; bleach
bath?
What is Kawasaki disease? - ✔✔idiopathic multisystem disease with vasculitis of small/medium blood
vessels, viral, non-contagious
75% are less than 5 yo, more common in boys and winter/early spring
What are the symptoms of Kawasaki? - ✔✔high fever at least 5 days, changes in extremities- edema,
erythema, desquamation, polymorphous exanthem, usually truncal, conjunctival injections, erythema
and/or fissure of lips/oral mucosa, cervical lymphadenopathy (must have 4/5 of these with fevers)
coronary artery aneurysms develop in 15-25% if untreated, may lead to ischemic heart disease or
sudden death
How do you treat Kawasaki? - ✔✔IVIG, aspirin, echo, and cards consult
LATEST SOLUTION GUIDE
What is otitis media? - ✔✔Inflammatory fluid and pathogenic respiratory bacteria that reflux into the
middle ear space- does not drain normally. 75% are viral infections
most common bacterial etiologic agents: streptococcus pneumoniae 49%, H influenzae 29%, moraxella
catarrhalis 28%
What are the signs/symptoms of otitis media? - ✔✔fever, pain, d/c from ear, tugging/batting at ear,
irritability, crying lethargy, decreased appetite, decreased sleep, recent URI
Red, bulging TM, possible-retracted w/ pus, decreased translucency, no movement of TM, no normal
landmarks,hole in TM
What is considered recurrent otitis media? - ✔✔3 or more in 6 months OR 4 in one year
How do you treat otitis media in babies <6 months? - ✔✔antibiotics, no matter what
How do you treat otitis media in children 6 months to 2 years? - ✔✔antibiotics if certain or severe
symptoms like high fever, bilateral infections, severe pain, more than 7 days; observe if not certain or
not severe
How do you treat otitis media in children 2 years or older? - ✔✔antibiotics if severe, observe 2-3 days if
not severe
What antibiotics do you use to treat otitis media? - ✔✔Amoxicillin 80-90 mg/kg/day BID x 10 days;
Augmentin 80-90 mg/kg/day BID x 10 days; if PCN allergy- cefdinir, cefuroxime- non type 1 reaction or if
type 1 reaction then azithromycin, clarithromycin, ceftriaxone
What is otitis externa? - ✔✔inflammatory process that involves the structure of the outer ear,
specifically the external auditory canal
,can be from trauma, glandular obstruction, repeating ear cleansing, prolonged exposure to standing
water, increased sweating, or stress
What are the s/sx of otitis externa? - ✔✔tenderness of pinna or tragus, boggy canal
What is the treatment for otitis externa? - ✔✔ototopical antimicrobial-steroid solution containing
neomycin, polymyxin B, and hydrocortisone 4x/day x 7-10 days
topical fluoroquinolone ciprofloxacin, ofloxacin
What is malignant otitis externa? - ✔✔necrotizing, invasive infection of the external auditory canal
usually caused by P aeuginosa and can lead to osteomyelitis
What is otitis media with effusion? - ✔✔non-infected fluid in middle ear without s/sx of acute otitis
media
What is mononucleosis? - ✔✔caused by epstein-barr virus and spread by saliva; incubation of 2-5
weeks; 50% of kids with mono also have strep
s/sx fever, exudative pharyngitis, POSTERIOR cervical adenopathy, malaise, headache, anorexia,
spleno/hepatomegaly
How do you treat mono? - ✔✔symptomatic treatment, f/u in 1-2 weeks, avoid contact sports x 1 month
or until spleen no longer palpable
What are symptoms of group A beta-hemolytic strep pharyngitis? - ✔✔rapid onset sore throat, fever
103-104, swollen glands, abdominal pain, usually no URI symptoms, headache, decreased appetite,
dysphagia, irritability
,exudate tonsils, anterior cervical lymphadenopathy, strawberry tongue, rash
How do you treat strep pharyngitis? - ✔✔Amoxicillin 50-80 mg/kg/day x 10 days, if PCN allergy-
cephalosporins or macrolide
warm water gargles, tylenol/nsaids
Contagious- no school x 24 hours, discard toothbrush
What is impetigo? - ✔✔contagious bacterial infection caused by staphylococci or streptococci, spread by
contact
pruritic rash that won't go away, yellow-crusted lesions, if crust removed- becomes inflammed/red
How do you treat impetigo? - ✔✔wash face BID with soap and water, no school for 24-48 hours, wash
sheets/pillow cases, monitor for serous sequalae
treat with mupirocin/bactroban TID x 7-14 days or bacitracin TID x 7-14 days, or erythromycin,
cephalexin
What is fifth's disease? - ✔✔caused by human parvovirus B19, most common in 5-15 yo; symptomatic
treatment
has low-grade fever, malaise, sore throat, "slap cheek" facial redness in first 4 days, then fishnet/racey
rash within 2 days after initial onset, then fever/itching/petechiae to hands/feet
What is tinea corporis? - ✔✔ringworm- pink, scaly, round with raised border
treat with topical antifungal cream for 2-6 weeks, avoid contact with lesion, no contact sports x 48 hrs of
tx
, What is pityriasis rosea? - ✔✔common, benign rash- usually viral with 29% having recent URI
starts as herald patch, 2-10 cm oval/round lesion first then changes; often on trunk
How do you treat pityriasis rosea? - ✔✔antihistamines, topical steroids, avoid sun exposure, moisturize;
may take up to 3 months to resolve
What is eczema? - ✔✔inflammatory response to allergen, chemical, or unknown etiology; increased
serum IgE
itchy, red, burning/tinging, dryness; pruritc, papulovesicular lesions that ooze and crust,
erythematous,edematous dry patches with cracking/fissuring, indistinct borders, lichenification,
excoriations
How do you treat eczema? - ✔✔avoid harsh soaps, may use antihistamines and corticosteroids; bleach
bath?
What is Kawasaki disease? - ✔✔idiopathic multisystem disease with vasculitis of small/medium blood
vessels, viral, non-contagious
75% are less than 5 yo, more common in boys and winter/early spring
What are the symptoms of Kawasaki? - ✔✔high fever at least 5 days, changes in extremities- edema,
erythema, desquamation, polymorphous exanthem, usually truncal, conjunctival injections, erythema
and/or fissure of lips/oral mucosa, cervical lymphadenopathy (must have 4/5 of these with fevers)
coronary artery aneurysms develop in 15-25% if untreated, may lead to ischemic heart disease or
sudden death
How do you treat Kawasaki? - ✔✔IVIG, aspirin, echo, and cards consult
