CMN 568 Exam Test Bank 232 Questions and Answers (All are Correct)
8 views 0 purchase
Course
CMN 568
Institution
CMN 568
CMN 568 Exam Test Bank 232 Questions and Answers (All are Correct)
How long does effusion behind TM last post AOM? - Answer up to 3 months; if longer than 3mo, refer for hearing test and possible PE tubes
SNAP approach to AOM - Answer Safety Net Abx Prescription; watchful waiting for 48-72hr ...
CMN 568 Exam Test Bank
232 Questions and
Answers (All are Correct)
How long does effusion behind TM last post AOM? - Answer ✔ up to 3 months; if longer
than 3mo, refer for hearing test and possible PE tubes
SNAP approach to AOM - Answer ✔ Safety Net Abx Prescription; watchful waiting for
48-72hr to see if symptoms improve or worsen; allows many children to avoid abx use
and let infection clear on its own
treatment for AOM - Answer ✔ first line: amoxicillin 90mg/kg/day divided BID
if failed: augmentin 90mg/kg/day divided BID
mild PCN allergy: cefdinir
severe PCN allergy: macrolides: Bactrim or Zithromax
if cannot swallow PO meds: Rocephin IM
antibiotic failure of AOM - Answer ✔ patient has taken amoxicillin in the past 30 days or
has failed to improve 48-72hrs on amoxicillin, OR has AOM with purulent
conjunctivitis.... give augmentin for this (90mg/kg/day divided BID) or ceftriaxone
50mg/kg/day x3 days
how to treat child with PE tubes and otorrhea, but no systemic symptoms - Answer ✔
fluoroquinolone otic drops are first line
recurrence of AOM greater than 4 weeks apart - Answer ✔ likely a new pathogen, start
treating with amoxicillin first line
why shouldnt you prescribe macrolides such as azithromycin or clarithromycin after
failure of amoxicillin? - Answer ✔ due to high resistance of h. influenza and strep
mastoiditis - Answer ✔ infection that spreads from middle ear space to the mastoid
portion of temporal bone; bony destruction with mastoid air cells can occur; early
findings are severe pain on mastoid palpation; CT is best way to determine extent
,pathogens of mastoiditis - Answer ✔ strep, followed by h. influenza and s. pyogenes
treatment for mastoiditis - Answer ✔ IV abx treatment alone if no evidence of abscess
on CT; surgical intervention if no improvement after 24-48hr of abx; always check for
nuchal rigidity
otitis media with effusion (OME) - Answer ✔ MEE with decreased TM mobility; not
treated with abx; observe uncomplicated cases for 3mo before consideration of PE
tubes; TM may be neutral or retracted and may be whitish; fluid and/or air bubbles may
be visible
indications for PE tubes - Answer ✔ - hearing loss greater than 40dB
- TM retraction pockets
- ossicular erosion
- adhesive atelectasis
- cholesteatoma
Pediatric acute bacterial rhinosinusitis (ABR) pathogens - Answer ✔ strep, H. in, m.
catarrhalis, B-hemolytic strep
symptoms of pediatric ABR - Answer ✔ nasal congestion, purulent nasal discharge,
facial pain/ pressure, cough, headache, fever; symptoms must ;ast 10days or longer
without improvement or worsening of symptoms within 10 days after initial improvement;
if patient presents with focal signs of periorbital edema, severe sinus tenderness, or
severe headache, DO NOT wait 10 days to treat
abx for pediatric ABR - Answer ✔ - first line: amoxicillin or augmentin
- mild PCN allergy: cefdinir
- if h. influenza or strep: include clindamycin (dont use bactrim or azithromycin)
recurrent sinusitis - Answer ✔ successive episodes of bacterial infections, each lasting
less than 30 days and separated by interval of at least 10 days
chronic sinusitis - Answer ✔ episodes of inflammation of paranasal sinuses lasting more
than 90 days; need to rule out esophagitis; anaerobic or staph organisms; treatment is
nasal corticosteroids and nasal irrigation
rhinitis medicamentosa - Answer ✔ rebound congestion from long-term use of nasal
decongestants like phenylephrine (neo-synephrine or afrin); limit use to only 3 days to
avoid rebound
, foreign bodies in nose - Answer ✔ causes unilateral foul-smelling rhinorrhea, halitosis,
or nasal obstruction and bleeding; refer if not easily removable; electrical current
generated by disk type batteries cause necrosis of mucosa and cartilage destruction in
less than 4hr due to the moist cavity of the nose.....emergency!
treatment for epistaxis - Answer ✔ have patient sit up and lean forward, pinching soft
part of the nose to prevent arterial blood flow for at least 5min; administer one time dose
of afrin or neo-synephrine to stop bleeding; refer to ER after 15 minutes if still bleeding;
can use gelfoam on site; polysporin daily to prevent re-occurance until all crusting has
healed; avoid ASA and NSAIDs; consider VonWillebrand if needed
diagnosing pediatric pharyngitis - Answer ✔ patient complains of sore throat or has
pharyngeal erthyema; viral 90% of the time and associated with cough and rhinorrhea
hand foot and mouth - Answer ✔ ulcers on the tongue and oral mucosa; vesicles,
pustules, and papules on the palms, soles, between fingers, buttocks; caused by
enterovirus
herpangina - Answer ✔ 2-3mm ulcers on anterior pillars and soft palate and uvula;
caused by coxsackie virus
mononucleosis - Answer ✔ exudative tonsils; palpable spleen; fever; cervical and
axillary adenopathy; viral from EBV
pharyngoconjunctival fever - Answer ✔ exudative tonsils; conjunctivitis; enlarged nodes
and fever; caused by adenovirus
pediatric acute bacterial pharyngitis - Answer ✔ pathogen is GABHS; treat with PenV or
amoxicillin; for pcn allergy, use cephalexin, clinda, or azith
; if you do a rapid strep test in the office and its negative, follow up with C&S due to
untreated strep causing acute rheumatic fever/ heart disease, glomerulonephritis, and
cervical adenitis
retropharyngeal abscess in child - Answer ✔ cuased by GABHS and staph; presents
with fever, respiratory symptoms, neck hyperextension, dysphagia, drooling, gurgling
respirations; confirm with imaging showing RP tissues wider than c4 vertebral body;
SURGICAL EMERGENCY
ludwigs angina - Answer ✔ swelling of the floor of the mouth; upward dislpacememt of
tongue; fever; airway obstruction; rpaidly progresses to cellulitis of submandibular
space; caused by dental disease and group A strep; treat with high dose IV clinda or
ampicillin until c&s return; refer
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Scholarsstudyguide. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.89. You're not tied to anything after your purchase.
