Question 1

Jaheem is a 10-year-old low-risk patient with sinusitis. Treatment for a child with sinusitis is:&#10;A) Amoxicillin&#10;B) Azithromycin&#10;C) Cephalexin&#10;D) Levofloxacin&#10;

Accepted Answer

Amoxicillin is the recommended treatment for pediatric patients with acute bacterial sinusitis who are otherwise healthy and low-risk. Azithromycin, cephalexin, or levofloxacin may be used in special circumstances such as allergy or resistance, but amoxicillin is the first-line choice.

Question 2

The length of treatment for sinusitis in a low-risk patient should be:&#10;A) 5-7 days&#10;B) 7-10 days&#10;C) 14-21 days&#10;D) 7 days beyond when symptoms cease&#10;

Accepted Answer

The length of treatment for sinusitis in a low-risk patient should be 5-7 days. Shorter courses of antibiotics have been shown to be equally effective and reduce the risk of antibiotic resistance. In cases where the symptoms do not resolve after 5-7 days, a longer course may be considered.

Question 3

Rose is a 3-year-old patient with an upper respiratory infection (URI). Treatment for her URI would include:&#10;A) Amoxicillin&#10;B) Diphenhydramine&#10;C) Pseudoephedrine&#10;D) Nasal saline spray&#10;

Accepted Answer

Since Rose is only 3 years old, it is not recommended to use medications such as Amoxicillin (an antibiotic), Diphenhydramine (an antihistamine), or Pseudoephedrine (a decongestant) as first-line treatment for URI. Instead, the use of nasal saline spray can help relieve nasal congestion and improve breathing.

Question 4

Jacob has been diagnosed with sinusitis. He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is:&#10;A) Azithromycin 500 mg q day for 5 days&#10;B) Amoxicillin-clavulanate 500 mg bid for 7 days&#10;C) Ciprofloxacin 500 mg bid for 5 days&#10;D) Cephalexin 500 mg qid for 5 days&#10;

Accepted Answer

Amoxicillin-clavulanate is the best choice for sinusitis in an adult who has a child in daycare because it covers both typical and atypical bacteria that can cause sinusitis. Additionally, it has a broader spectrum of coverage than other options listed and is generally well-tolerated. Azithromycin is also effective but may not provide coverage for all potential pathogens. Ciprofloxacin is typically reserved for more severe infections or those caused by resistant organisms. Cephalexin is effective in some cases but may not provide adequate coverage for atypical bacteria commonly found in daycare settings.

Question 5

Patient education for a patient who is prescribed antibiotics for sinusitis includes:&#10;A) Use of nasal saline washes&#10;B) Use of inhaled corticosteroids&#10;C) Avoiding the use of ibuprofen while ill&#10;D) Use of laxatives to treat constipation&#10;

Accepted Answer

The use of nasal saline washes can help with sinusitis symptoms by clearing out mucus and reducing inflammation in the nasal passages. Inhaled corticosteroids are not typically used for sinusitis and avoiding the use of ibuprofen while ill is not specifically related to the use of antibiotics for sinusitis. Use of laxatives to treat constipation is also not directly related to the use of antibiotics for sinusitis.

Question 6

Myles is a 2-year-old patient who has been diagnosed with acute otitis media. He is afebrile and has not been treated with antibiotics recently. First-line treatment for his otitis media would include:

A) Azithromycin
B) Amoxicillin
C) Ceftriaxone
D) Trimethoprim/sulfamethoxazole

Accepted Answer

Amoxicillin is the first-line treatment for acute otitis media in children without severe symptoms or recent antibiotic use. Azithromycin or trimethoprim/sulfamethoxazole may be used in patients with an allergy to penicillin, and ceftriaxone is reserved for severe cases or treatment failures.

Question 7

Alyssa is a 15-month-old patient who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her?

A) Continue the amoxicillin for the full 10 days.
B) Change the antibiotic to azithromycin.
C) Change the antibiotic to amoxicillin/clavulanate.
D) Change the antibiotic to trimethoprim/sulfamethoxazole.

Accepted Answer

Since Alyssa is still febrile and there is no change in her tympanic membrane examination after 2 days of amoxicillin treatment, it is likely that the infection is resistant to the antimicrobial agent. Amoxicillin/clavulanate is a good alternative treatment option for acute otitis media in children and would provide broader coverage against resistant organisms. It is recommended to continue treatment for the full 10 days to ensure complete resolution of the infection. Azithromycin and trimethoprim/sulfamethoxazole are not first-line treatment options for acute otitis media in children.

Question 8

A child that may warrant "watchful waiting" instead of prescribing an antibiotic for acute otitis media includes patients who: A) Are low risk with temperature of less than 39^oC or 102.2^oF B) Have reliable parents with transportation C) Are older than age 2 years D) All of the above

Accepted Answer

All of the above criteria would make a child a good candidate for watchful waiting rather than immediate antibiotic treatment for acute otitis media. The child should be low risk with a temperature less than 102.2F, have reliable parents with transportation, and be older than 2 years old. Watchful waiting involves close monitoring of the child's symptoms and only prescribing antibiotics if symptoms worsen or persist. This approach can help reduce unnecessary antibiotic use and the development of antibiotic-resistant bacteria.

Question 9

First-line therapy for a patient with acute otitis externa (swimmer's ear) and an intact tympanic membrane includes:&#10;A) Swim-Ear drops&#10;B) Ciprofloxacin and hydrocortisone drops&#10;C) Amoxicillin&#10;D) Gentamicin ophthalmic drops&#10;

Accepted Answer

Ciprofloxacin and hydrocortisone drops are the first-line therapy for acute otitis externa with an intact tympanic membrane. Swim-Ear drops and gentamicin ophthalmic drops are not appropriate for treating an ear infection, and amoxicillin is not effective against the bacteria that commonly cause otitis externa.

Question 10

Patients who should be cautious about using decongestants for an upper respiratory infection (URI) include:&#10;A) School-age children&#10;B) Patients with asthma&#10;C) Patients with cardiac disease&#10;D) Patients with allergies&#10;

Accepted Answer

Patients with cardiac disease should be cautious about using decongestants for an upper respiratory infection because these medications can increase blood pressure and heart rate, potentially exacerbating cardiac conditions.

Question 11

Caleb is an adult with an upper respiratory infection (URI). Treatment for his URI would include:&#10;A) Amoxicillin&#10;B) Diphenhydramine&#10;C) Phenylpropanolamine&#10;D) Topical oxymetazoline&#10;

Accepted Answer

The answer of Caleb is an adult with an upper...

Question 12

Whether prescribing an antibiotic for a child with acute otitis media or not, the parents should be educated about:&#10;A) Using decongestants to provide faster symptom relief&#10;B) Providing adequate pain relief for at least the first 24 hours&#10;C) Using complementary treatments for acute otitis media, such as garlic oil&#10;D) Administering an antihistamine/decongestant combination (Dimetapp) so the child can sleep better&#10;

Accepted Answer

The answer of Whether prescribing an antibiotic for a child...

Deck 46: Upper Respiratory Infections, Otitis Media, and Otitis Externa