The most common pediatric infectious disease; otherwise known as the
common cold Right Ans - Acute viral rhinitis
How long can symptoms of acute viral rhinitis last? Right Ans - 14 days
What are the symptoms of acute viral rhinitis? Right Ans - sudden onset
clear or mucoid rhinorrhea
nasal congestion
fever
sore throat and cough
erythematous nose, throat, and TMs
What are the common pathogens of acute bacterial rhinosinusitis Right
Ans - S. Pneumoniae
H influenza
M catarrhalis
B-hemolytic strept
What are the symptoms of acute bacterial rhinosinusitis? Right Ans - Nasal
congestion
purulent nasal discharge
facial pain/pressure
cough
headache
fever
How long does acute bacterial rhinosinusitis last? Right Ans - <30 days
Is onset of acute bacterial rhinosinusitis gradual or sudden? Right Ans -
Can be either
The general rule of thumb when considering tx for acute bacterial
rhinosinusitis is that diagnosis should not be made until symptoms last longer
than ___ days without improvement OR worsening of symptoms within 10
days after initial improvement of symptoms Right Ans - 10
,What should the NP do if the pt presents with focal signs of acute bacterial
rhinosinusitis such as periorbital edema, severe sinus tenderness, or severe
headache? Right Ans - Treat with abx immediately
T or F: Routine sinus X rays are recommended for uncomplicated acute
sinusitis Right Ans - False
All pts with acute bacterial rhinosinusitis should receive pain/fever control
with what meds? Right Ans - NSAIDS or acetaminophen
How long can nasal decongestants be used to help symptoms? Right Ans -
<3 days
Use of ______________ sprays are recommended in all adults and may be useful
for children with underlying allergic sinusitis Right Ans - intranasal
corticosteroids
Use of OTC oral decongestant, antihistamines and cough/cold preps are NOT
recommended in children <_____ years of age. Right Ans - 4
A child comes in with acute nasal congestion and rhinosinusitis x10 days. The
NP understands this is most likely an upper respiratory tract infection (viral).
What would the tx regimen consist of? Right Ans - Pain medication
humidified air
saline nose drops
A child comes to the clinic with acute nasal congestion and rhinosinusitis with
mild symptoms x10-14 days without any improvement. The NP understands
this is likely bacterial sinusitis. What is the first line abx and duration of tx?
Right Ans - Amoxicillin 80-90 mg/kg/day divided bid or amoxicillin-
clavulanate 80-90 mg/kg/day divided bid for x10-14 days
A child with bacterial rhinosinusitis is being treated with amoxicillin and
symptoms have not improved after 3 days. What is the second line abx that
would be initiated? Right Ans - cephalosporin or amoxicillin-clavulanate
A child with severe symptoms or immunosuppressed has acute bacterial
rhinosinusitis. What is the abx of choice? Right Ans - Beta-lactamase stable
abx
, Defined as successive episodes of bacterial infections of the sinuses, each
lasting less than 30 days & separated by intervals of at least 10 days Right
Ans - Recurrent sinusitis
Defined as episodes of inflammation of the paranasal sinuses lasting more
than 90 days Right Ans - Chronic sinusitis
Tx for chronic and recurrent sinusitis is the same as for acute, except the
duration of tx is ______ weeks. Right Ans - 3-4 weeks
Contributes to development of sinusitis and asthma exacerbations. Also
known as hay fever. Right Ans - Allergic rhinitis
What is known as the triad? Right Ans - Most common in children with red
hair. Allergic rhinitis, asthma, and eczema
What are the common symptoms of allergic rhinitis? Right Ans - sneezing
rubbing nose
allergic shiners
clear nasal drainage
tearing and redness of the eyes
While performing a physical exam on a child, the NP notes pale boggy and
swollen nasal turbinates, clear nasal secretions, conjunctival injection, tearing,
periorbital edema and enlarged tonsils. What is the diagnosis?
1. Acute rhinosinusitis
2. Allergic Rhinosinusitis
3. Tonsilitis Right Ans - 2. Allergic rhinosinusitis
What is the tx of choice for allergic rhinosinusitis? Right Ans - Non-sedating
antihistamines (loratadine, cetirizine)
Intranasal corticosteroids
Mast cell stabilizers (Cromolyn)
Montelukast
Avoid triggers
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