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Bugs and Drugs HEENT
| Question | Answer |
|---|---|
| Criteria for diagnosing GAS? | No cough Tender cervical LN Erythematous Exudates Fever >38 |
| Complications of GAS tonsillopharyngitis | bactremia peritonsillar abscess meningitis Rheumatic fever GN reactive arthritis |
| When to treat AOM? | <6mo: ALWAYS TREAT >6 mo: abx if severe, complicated (perf, unwell) >24 months: observe, tx if unwell |
| Diagnosis of AOM | 1) TM Effusion 2) TM Inflammation 3) Acutely unwell |
| Treatment regimen AOM? | Simple: 5 days Amoxil Complicated: 10 d Amoxil 2nd line: 2nd gen cephalosporin/macrolide |
| Tx meningitis | Full septic workup +/- CT IV vanco/Cefotax or ceftriaxone |
| Complicating factors for AOM | Daycare, recent <3 mo, perforation, unwell |
| Dental abscess treatment | IV Cefazolin/Flagyl (anaerobes and GPB) Dental referral |
| Diptheria treatment | ABCS, antitoxin |
| Diptheria physical exam | psuedomembrane sore throat fever |
| Sinusitis treatment | Amoxil 10 d |
| Diptheria complications | cardiac arrythmias, myocarditis, nerve palsies |
| Orbital cellulitiis tx | Cefazolin/Keflex |
| photophobia, chemosis, pain on EOM, | periorbital cellulitis |
| Treatment orbital cellulitis | Admit, CBC, blood culture, CT head, Vanco/Ceftriaxone ENT/optho consult |
| Viral prodrome Fever Generalized LN (vs localized) Hepatosplenomegaly Sore throat Tonsillar exudates Diagnosis? | Mononucleosis (EBV or CMV) |
| Lab findings for mono? | Atypical lymphocytes (Downey cells) anemia, thrombocytopenia, elevated liver enzymes |