This is not an exhaustive list of what you may see on the final exam. You are responsible for all readings and content covered in the course. This is the only blueprint that will be provided for the final exam. Used the guide and the questions at the bottom were exact. Made a 93.6 not sure which ones were wrong…the asthma question is tricky because it says step one but also calls it persistent…also there are two right answers for strep A question….. 60 Questions Otitis externa (swimmers ear) – administration of topical agents are indicated for 7 days. Choose medication such as fluoroquinolone abx. Clinical presentation- acute pain on outside with 48 hours With feelings fullness, itching, drainage, hearing loss. Physical exam- tenderness palpation to tragus, canal erythematous and edematous enlarged periauricular lymph nodes. Chronic externa- Dry Cerumen absent OE with swollen or occluded car canal. What intervention??? Last student choose ear wicking. Ear wick Sometimes, particularly if the ear canal is very swollen and blocked, you may be treated with a wick. This is a piece of gauze soaked in treatment drops and pushed gently into the ear canal between the swollen walls. This makes sure that the treatment is held in contact with the sore skin for as long as possible. The wick is usually changed every 2-3 days until things have settled. Tx: antibiotic drops, corticosteroid drops to reduce swelling, antifungal ear drops if underlying fungal infection, and acidic drops to help kill bacteria. 1.gently remove debris 2- NSAIDS 3- Topical anesthetic (IF TM IS INTACT) a. Benzocaine otic solution (recheck 2 daysish)4- Topical antibiotics cover to cover both P. aeruginosa & S. aureus. a. Fluoroquinolone ofloxacin, ciprofloxacin BID x 7 days. b. combo ciprofloxacin & hydrocortisone. c. Aminoglycoside neomycin (S. aures not P ) combine w/polymyxin (ototoxicity INTACT TM). Fungal- acetic acid (white vinegar) vinegar to alcohol is effective 1:1 or 1:2 EENT – differentials, assessment Acute bronchitis- symptom management no abx (cough meds, allergy meds etc. ) an old study says symptomatic tx of augmentin or amox. Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. Bacterial conjunctivitis – education, counseling. Patient should avoid touching eyes, throw away makeup and purchase new after infection resolves, if not could re infect. (old guide says Return to work when symptoms clear completely). Intervention that is not appropriate – guide stays clean all linens--- but As one of the first steps you should take when discovering that either yourself or your child has pink eye is to wash all of your sheets and linens in hot water. Wash pillowcases, sheets, washcloths, and towels often in hot water and detergent; wash ... There is no vaccine that prevents all types of conjunctivitis.*******maybe this is incorrect***** because CDC says to wash all linens. Group A Strep- incubation period is 2-5 days. 24-72 hours is a previous option. Spreads through respiratory secretions/droplet. Influenza/Bronchitis – risk factor, treatment-which patient was NOT at risk for complications of the flu? Options were pregnancy, young kids, ppl with chronic illness and one other. National Asthma Education and Prevention Program – Stepwise Treatment What is the step 1 treatment for persistent asthma? SABA PRN (guide says low dose of ICS + LABA but that is actually step 2) COPD – assessment, education, treatment What is the dx of increased AP diameter, exp wheezing, and chronic bronchitis etc? COPD There is one other question on test about COPD Common complaint- dyspnea on exertion, dx by spirometry COPD stages & GOLD tx: Stage I-Mild, FEV1/FVC<70>30, respiratory failure, cor pulmonale (increase jvp, edema), QOL Impaired How does FEV1 decrease: inflammation, narrowing of peripheral airway, airway collapse in severe emphysema Education for COPD: Smoking cessation is the MOST important intervention to stop the rapid decline in lung function. Education on medication, oxygen therapy, smoking cessation, nutrition, exercise, breathing techniques to minimize dyspnea, and health promotion should be stressed. JNC 8 – Treatment recommendations What would prescribe if patient failed to reach 6 week BP goal with just HCTZ? ACE-I/ARB A 60 to white male with HTN? HCTZ