Question 1

The length of treatment for sinusitis should be:

Accepted Answer

The length of treatment for sinusitis should be 7 days beyond when symptoms cease. While a course of antibiotics for 7-14 days may be prescribed initially, the duration of treatment should be continued for an additional 7 days after symptoms have resolved to ensure complete eradication of the infection.

Question 2

Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Accepted Answer

Using nasal saline washes can help to clear out the sinuses and improve symptoms of sinusitis. Inhaled corticosteroids are not typically used to treat sinusitis. Avoiding ibuprofen while ill may be recommended for some patients, but it is not a universal instruction. Using laxatives to treat constipation is not relevant to the treatment of sinusitis with antibiotics.

Question 3

Jaheem is a 10 year old with sinusitis.Treatment for a child with sinusitis is:

Accepted Answer

In children with sinusitis, the first line of treatment is typically amoxicillin or amoxicillin/clavulanate. Azithromycin, cephalexin, and levofloxacin may also be used in certain cases, but amoxicillin is the most commonly prescribed and effective antibiotic for this condition in children.

Question 4

First-line therapy for a patient with acute otitis externa (swimmer's ear)and an intact tympanic membrane includes:

Accepted Answer

Ciprofloxacin and hydrocortisone drops are the first-line therapy for acute otitis externa with an intact tympanic membrane. Swim-Ear drops may be used as well, but are not typically considered first-line. Amoxicillin and gentamicin ophthalmic drops are not appropriate treatments for otitis externa.

Question 5

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:

Accepted Answer

Amoxicillin is the first-line antibiotic choice for uncomplicated sinusitis in adults. This is supported by the Infectious Diseases Society of America's guidelines. Cephalexin and azithromycin are also options, but azithromycin should only be used if the patient is allergic to penicillin. Ciprofloxacin is not recommended for uncomplicated sinusitis.

Question 6

Rose is a 3 year old with an upper respiratory infection (URI).Treatment for her URI would include:

Accepted Answer

Since Rose is only 3 years old, she should not be given medications such as amoxicillin, diphenhydramine, or pseudoephedrine without first consulting with a healthcare provider. The best treatment option for her URI would be using a nasal saline spray to help relieve congestion and ease her symptoms.

Question 7

Caleb is an adult with an upper respiratory infection (URI).Treatment for his URI would include:

Accepted Answer

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

Question 8

Alyssa is a 15 month old 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?

Accepted Answer

Since there has been no improvement in Alyssa's symptoms after two days of treatment, changing the antibiotic to amoxicillin/clavulanate (augmentin) would be the best choice as it has a broader spectrum of coverage against the most common bacteria that cause acute otitis media. It is also recommended by the American Academy of Pediatrics for children who fail to improve on amoxicillin alone. Continuing the amoxicillin alone is not likely to be effective, changing to azithromycin or trimethoprim/sulfamethoxazole may be considered, but amoxicillin/clavulanate would be the best choice due to its effectiveness and safety profile.

Question 9

Patients who should be cautious about using decongestants for an upper respiratory infection include:

Accepted Answer

Patients with cardiac disease should be cautious about using decongestants as these medications can increase blood pressure and heart rate, potentially exacerbating their condition.

Question 10

Whether prescribing an antibiotic for a child with acute otitis media or not,the parents should be educated about:

Accepted Answer

Whether or not an antibiotic is prescribed for a child with acute otitis media, it is important to provide adequate pain relief for the first 24 hours. This can help the child feel more comfortable and sleep better. Decongestants, antihistamines, and complementary treatments like garlic oil have limited evidence of effectiveness for treating acute otitis media and may not be appropriate for every child.

Question 11

Myles is a 2 year old 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:

Accepted Answer

Amoxicillin is the first-line treatment for acute otitis media in children who are afebrile and have not had recent antibiotic treatment. Azithromycin, ceftriaxone, and trimethoprim/sulfamethoxazole may be used as alternative treatments if the child is allergic to amoxicillin or if there is treatment failure with amoxicillin. However, they are not the first-line choices.

Question 12

A child that may warrant "watchful waiting" instead of prescribing an antibiotic for acute otitis media includes patients who:

Accepted Answer

All the options mentioned are factors that may indicate a child who can be observed without immediate antibiotics for acute otitis media. Children who are low risk with a temperature less than 39°C (102.2°F), have reliable parents with transportation and are older than 2 years can be monitored for a few days and prescribed antibiotics if their condition worsens or does not improve.

Quiz 46: Upper Respiratory Infections: Otitis Media and Otitis Externa