Pediatric Primary Care Burns

Sinusitis categories Acute 4weeks Chronic 12 weeks or longer Sinusitis Common Complaints Yellow or green nasal discharge Fever Sore Throat Facial Pain Pressure worse when bending forward Headache Toothache Nasal Congestion Snoring Periorbital Edema Nasal Sounding Speech Post-Nasal Drip Fatigue 00:00 01:24 Sinusitis Predisposing Factors Recent URI Allergens Smoke Deviated Septum Dental Abscess Trauma Change in altitude Adenoidal hypertrophy Sinusitis Pathogenesis Obstruction of mucus flow due to edema of the nasal mucosa from allergies Common Cold Recent URI Sinusitis Diagnosis Done on symptoms alone Can be seen on CT Sinusitis Bacterial Organisms Streptococcus pneumonia Haemophilus Influenzae Morzxella Catarrhalis Acute Viral Sinusitis Treatment Decongestants/Antihistamines 6 months or older no more than a few days Saline Sinus Rinses 3 times a day Hydration Warm Compress on Face Cool mist Humidifier Acute Bacterial Sinusitis Pediatric 1st line Amoxicillin 45mg/kg/day BID 10-14 days 2nd line Augmentin 80-90mg/kg/day BID Acute Sinusitis Bacterial Duration Symptoms for more than 10 day Sinusitis Differential Diagnosis Viral URI Allergic Rhinitis Headache Allergic Rhinitis Inflammatory Changes of the Nasal mucosa due to allergy, atopic family history. May have seasonal or daily symptoms Allergic Rhinitis Signs & Symptoms Nasal Congestion Clear nasal discharge Nasal Itching conjunctival itching periorbital edema Coughing worse when laying down Sore throat Dry mouth loss of smell or taste headache 00:03 01:24 Upgrade to remove ads Only $35.99/year Allergic Rhinitis Treatment Allergen Avoidance Antihistamine H1 receptor antagonists Flonase BID in Children older than 5 Zyrtec once daily Allergic Rhinitis Clinical Findings Posterior pharynx has thick mucus: clear, white, yellow or green Chronic or recurrent bilat nasal obstruction Mouth Breathing, snoring, nasal speech Pale to purplish and edema or nasal mucous membranes Nasal Crease: horizontal crease across the lower third of the nose Hoarseness or frequent attempts to clear throat Allergic Rhinitis Diagnostic Testing Done from History Wright Stain of nasal secretion looking for eosinophils to confirm allergy Skin testing Radioallergosorbent test (Rast) CBC looking for increased eosinophils to confirm allergy Acute Otitis Media Definition Inflammation of the meddle ear AOM Pathogenesis Obstruction of the Eustachian tube, usually fluid backup from nasopharyngeal secretions AOM Pathogen Streptococcus pneumonia Haemophilus influenzea Moraxella catarrhalis AOM Signs and Symptoms Ear pain Pulling on ears Fever may or may not be present Fussiness acute hearing loss URI symptoms Decreased appetite Diarrhea and/or vomiting AOM Clinical Finding Bulging TM Decreased translucency of the TM Redness of the TM AOM Treatment First line Amoxicillin 90mg/kg/day BID 10 days PCN allergy Cefdinir 14mg/kg/day Pharyngitis Definition Inflammation of the Pharynx and surrounding lymph tissue Pharyngitis viral agent coxackievirus enteric cytopathic human orphan (ECHO) virus Epstein Barr Virus Pharyngitis Bacterial agent Group A beta-hemolytic streptococcus Neisseria gonorrhoeae corynebacterium diphtheriae Pharyngitis Fungal agent candida albican Noninfectious pharyngitis allergic rhinitis mouth breathing post nasal drip Predisposing factors for pharyngitis smoking allergies URI oral sex antibiotic and immunosuppressant's cancer Viral Pharyngitis symptoms Fever pain myalgia sore throat dysphagia rhinitis cough acute onset of sore throat Viral pharyngitis Signs Erythema of the tonsils and pharynx reactive