Question 1

A 3-year-old patient presents with a URI. Treatment for their URI would include:&#10;A)Amoxicillin&#10;B)Diphenhydramine&#10;C)Pseudoephedrine&#10;D)Nasal saline spray&#10;

Accepted Answer

Nasal saline spray is a safe and effective treatment for symptomatic relief in young children with upper respiratory infections (URI). Antibiotics like amoxicillin are not indicated for viral URIs, and medications like diphenhydramine and pseudoephedrine are not recommended for children under 4 years old due to potential side effects.

Question 2

First-line therapy for a school-age child with group A streptococcal pharyngitis is:&#10;A)Azithromycin 10 mg/kg on day one, then 5 mg/kg/day on days 2 to 5&#10;B)Amoxicillin 80 mg/kg/day (maximum of 2 g/day) for 10 days&#10;C)Clindamycin 20 mg/kg/dose b.i.d. for 10 days&#10;D)Amoxicillin 50 mg/kg/day (maximum 1,000 mg/day) for 10 days&#10;

Accepted Answer

Amoxicillin 50 mg/kg/day (maximum 1,000 mg/day) for 10 days is the recommended first-line therapy for group A streptococcal pharyngitis in children.

Question 3

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

Accepted Answer

Amoxicillin is the first-line antibiotic treatment for acute bacterial sinusitis in children who are considered low-risk. It is preferred due to its effectiveness against the most common bacteria causing sinusitis and its safety profile in children.

Question 4

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

Adequate pain relief is crucial in managing acute otitis media in children, as it helps alleviate discomfort and ensures the child's comfort during the infection. Decongestants, complementary treatments like garlic oil, and antihistamine/decongestant combinations are not recommended as standard care for acute otitis media due to lack of evidence of efficacy or potential side effects.

Question 5

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

Accepted Answer

For low-risk adult patients with sinusitis, the recommended length of treatment is typically 5 to 7 days, as shorter courses are often effective and help reduce antibiotic resistance.

Question 6

Patients who should be cautious about using decongestants for a 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 as these medications can increase blood pressure and heart rate, potentially exacerbating heart conditions.

Question 7

Treatment for sinusitis in an adult who has a child in daycare is:&#10;A)Azithromycin 500 mg a day for five days&#10;B)Amoxicillin-clavulanate 500 mg bid for seven days&#10;C)Ciprofloxacin 500 mg bid for five days&#10;D)Cephalexin 500 mg qid for five days&#10;

Accepted Answer

Amoxicillin-clavulanate is the recommended first-line treatment for acute bacterial sinusitis in adults, especially considering potential resistance and the need for coverage against β-lactamase–producing bacteria. Azithromycin, ciprofloxacin, and cephalexin are not the first choices for this condition due to less effectiveness against the common pathogens causing sinusitis or inappropriate spectrum of activity.

Question 8

An adult presents 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

Topical oxymetazoline is a nasal decongestant that can help relieve nasal congestion associated with an upper respiratory infection.

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

First-line therapy for acute otitis externa (AOE), commonly known as swimmer's ear, especially when the tympanic membrane is intact, includes topical antibiotics with or without steroids. Ciprofloxacin and hydrocortisone drops are a common choice as they provide both antibacterial coverage and reduce inflammation.

Question 10

A child may warrant "watchful waiting" instead of an antibiotic prescription for acute otitis media if they: 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 two years D)All of the above

Accepted Answer

Watchful waiting for acute otitis media is considered appropriate for children who are low risk, have a temperature less than 39°C (102.2°F), have reliable parents with transportation, and are older than two years. This approach is based on guidelines that aim to reduce unnecessary antibiotic use and its associated risks.

Question 11

First-line treatment for an afebrile 2-year-old with otitis media would include:&#10;A)Azithromycin&#10;B)Amoxicillin&#10;C)Ceftriaxone&#10;D)Trimethoprim/sulfamethoxazole&#10;

Accepted Answer

The answer of First-line treatment for an afebrile 2-year-old with...

Question 12

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 answer of Patient education for a patient who is...

Question 13

A 15-month-old patient has been on amoxicillin for two 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 the child?

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

The answer of A 15-month-old patient has been on amoxicillin...

Deck 49: Upper Respiratory Infections, Pharyngitis, Sinusitis, Otitis Media, and Otitis Externa