CDM 1
What is the treatment for Pneumonia? What are the most common pathogens? - ANS
-Children: Amoxicillin, cephalosporins, macrolides
Geriatrics: Macrolide or Doxycycline
Bacteria: Streptococcus pneumonia (most common), Haemophilus influenzae, Klebsiella
pneumonia, Staphylococcus aureus
What is the treatment for Mastoiditis and the most common pathogens? - ANS -w/ recurrent
AOM :Vancomycin PLUS Ceftazidime , IV antibiotics 7-10 days
Streptococcus pneumoniae and pyogenes
Treatment for Acute Otitis Media - ANS -Amoxicillin
Cephalosporins (cefdinir)
If pt has severe penicillin allergy(anaphylaxis, angioedema) = Macrolides (erythromycin,
azithromyocin), however doesn't protect against H. Influenzae
Surgical: tympanostomy tubes
Treatment for Otitis media with effusion - ANS -wait and watch for 3-6 months
Surgical if necessary: tympanostomy tube, myringotomy
Treatment for recurrent otitis media - ANS -non Rx: educate pt on lifestyle changes -
importance of vaccines
Rx: amoxicillin
Surgical: tubes
Treatment for otitis externa - ANS -Non rx: proper cleaning and removal or cerumen
Rx: acetic acid - hydrocortisone
Moderate / severe: topical Cipro-HC or cortisporin
Oral Cirproflaxacin
Treatment for Chronic Otitis Media and what pathogens cause it? - ANS -Rx: topical
ciproflaxacin drops
perforation should heal spontaneously
Pathogens: Pseudomonas aeruginosa and Staphylococcus aureus
drainage for 6 months
Treatment for strep throat and how do we dx? - ANS -1st line: Penicillin/Amoxicillin
Azithromycin
, 1st gen Cephlasporins (Cephalexin, cefadroxil, cerfuroxime)
Dx: McIssac criteria; throat culture is gold standard
rapid antigen --> if negative and b/w 5-15, throat culture
Treatment for epiglottitis and most common pathogen - ANS -Ceftriaxone and vancomycin
IV corticosteriods
H. Influenzae Type B
Most common in children 3mo-6yo
Sx: 3D's Dysphagia, Droolings. Distress
Dx:Laryngoscopy = cherry red spot on epiglottis and swelling
Radiographs: thumbprint sign
Tx: maintaining airway is most important
Pertussis - ANS -highly contagious - caused by Bordetella (gram-neg)
most common children <2
Sx: Catarhhal phase: URI sx 1-2 wks, most contagious
Paroxysmal phase: severe paroxysmal coughing fits with inspriatory whooping sound after (2-4
wks)
Convalescent phase: resolution of cough (cough can last 6 wks)
Dx: clinical; throat culture and PCR
Tx:Macrolides: Erythromycin, azithromycin, clarithromycin (to make pt less contagious)
Supportive: oxygen, nebulizer,
Prevention: DTaP
What is croup? caused by what? treatment? - ANS -Croup is viral inflammation of larynx and
subglottic airway predominately caused by Parainfluenza type 1
Sx: seal-like barking cough, inspiratory stridor, hoarseness, low grade fever, dyspnea
Dx: exclude epiglottis
Radiograph: steeple sign
nonRx: illness is self limited (cool humidified air mist)
Moderate: dexamethasone , nebulized epinephrine
Severe: Dexamethasone (sterioid)/ nebulized epi and hospitalization
Cough should resolve on its own
Treatment for sepsis and associated pathogens? - ANS -Broad spectrum antibiotics:
piperacillin-tazobactam, cefepime, meropenem (important within 1st 3 hours)
Hemodynamic support: Fluid resuscitation, Vasopressors
Resp management: O2 and mechanical ventilation
Pathogens: Staphylococcus aureus (20%), Pseudomonas (20%), and Escherichia coli (16%)
What drugs can cause osteoporosis? - ANS -Cortico/glucocorticoid steroids (most common
secondary cause)
Antiepileptic Drugs-phenytoin, phenobarbital, carbamazepine, primidone
Heparin-long term high dose therapy
What is the treatment for Pneumonia? What are the most common pathogens? - ANS
-Children: Amoxicillin, cephalosporins, macrolides
Geriatrics: Macrolide or Doxycycline
Bacteria: Streptococcus pneumonia (most common), Haemophilus influenzae, Klebsiella
pneumonia, Staphylococcus aureus
What is the treatment for Mastoiditis and the most common pathogens? - ANS -w/ recurrent
AOM :Vancomycin PLUS Ceftazidime , IV antibiotics 7-10 days
Streptococcus pneumoniae and pyogenes
Treatment for Acute Otitis Media - ANS -Amoxicillin
Cephalosporins (cefdinir)
If pt has severe penicillin allergy(anaphylaxis, angioedema) = Macrolides (erythromycin,
azithromyocin), however doesn't protect against H. Influenzae
Surgical: tympanostomy tubes
Treatment for Otitis media with effusion - ANS -wait and watch for 3-6 months
Surgical if necessary: tympanostomy tube, myringotomy
Treatment for recurrent otitis media - ANS -non Rx: educate pt on lifestyle changes -
importance of vaccines
Rx: amoxicillin
Surgical: tubes
Treatment for otitis externa - ANS -Non rx: proper cleaning and removal or cerumen
Rx: acetic acid - hydrocortisone
Moderate / severe: topical Cipro-HC or cortisporin
Oral Cirproflaxacin
Treatment for Chronic Otitis Media and what pathogens cause it? - ANS -Rx: topical
ciproflaxacin drops
perforation should heal spontaneously
Pathogens: Pseudomonas aeruginosa and Staphylococcus aureus
drainage for 6 months
Treatment for strep throat and how do we dx? - ANS -1st line: Penicillin/Amoxicillin
Azithromycin
, 1st gen Cephlasporins (Cephalexin, cefadroxil, cerfuroxime)
Dx: McIssac criteria; throat culture is gold standard
rapid antigen --> if negative and b/w 5-15, throat culture
Treatment for epiglottitis and most common pathogen - ANS -Ceftriaxone and vancomycin
IV corticosteriods
H. Influenzae Type B
Most common in children 3mo-6yo
Sx: 3D's Dysphagia, Droolings. Distress
Dx:Laryngoscopy = cherry red spot on epiglottis and swelling
Radiographs: thumbprint sign
Tx: maintaining airway is most important
Pertussis - ANS -highly contagious - caused by Bordetella (gram-neg)
most common children <2
Sx: Catarhhal phase: URI sx 1-2 wks, most contagious
Paroxysmal phase: severe paroxysmal coughing fits with inspriatory whooping sound after (2-4
wks)
Convalescent phase: resolution of cough (cough can last 6 wks)
Dx: clinical; throat culture and PCR
Tx:Macrolides: Erythromycin, azithromycin, clarithromycin (to make pt less contagious)
Supportive: oxygen, nebulizer,
Prevention: DTaP
What is croup? caused by what? treatment? - ANS -Croup is viral inflammation of larynx and
subglottic airway predominately caused by Parainfluenza type 1
Sx: seal-like barking cough, inspiratory stridor, hoarseness, low grade fever, dyspnea
Dx: exclude epiglottis
Radiograph: steeple sign
nonRx: illness is self limited (cool humidified air mist)
Moderate: dexamethasone , nebulized epinephrine
Severe: Dexamethasone (sterioid)/ nebulized epi and hospitalization
Cough should resolve on its own
Treatment for sepsis and associated pathogens? - ANS -Broad spectrum antibiotics:
piperacillin-tazobactam, cefepime, meropenem (important within 1st 3 hours)
Hemodynamic support: Fluid resuscitation, Vasopressors
Resp management: O2 and mechanical ventilation
Pathogens: Staphylococcus aureus (20%), Pseudomonas (20%), and Escherichia coli (16%)
What drugs can cause osteoporosis? - ANS -Cortico/glucocorticoid steroids (most common
secondary cause)
Antiepileptic Drugs-phenytoin, phenobarbital, carbamazepine, primidone
Heparin-long term high dose therapy
