Archive

Acute Sinusitis

1. DDx:

    1. Bacterial: >10 days last, >39 C fever, Relapse after temporary healing

    2. Viral

2. Imaging

    1. Water X-ray

    2. Coronal PNS CT scan without contrast

3. Treatment for children

    1. Syrup amoxicillin 250mg/4cc #1 2*w/3 cc tds (90mg/kg/day)

        1. or cap amoxicillin 500 mg tds #28

        2. or Tab co-amoxiclav 625mg tds #28 (45mg/kg/day)

        3. or syrup farmentin 643 w/3 bid #1

    2. Susp acetaminophen 120mg/5cc #1 qid w/2cc (10mg/kg)

        1. or tab acetaminophen 325mg qid #30

    3. Nasal drop NaCl 0.65% #1

        1. or serum N/S for irrigation

    4. Nasal drop pseudoephedrine #1 2drops for 3-5days

        1. do not prescribe for bacterial forms

    5. Elixir diphenhydramine tds #1

4. Ab therapy for adults

    1. cap amoxicillin 1gr q8h

        1. or tab co-amoxiclav 625 tds

    2. for hypersensitivity

        1. tab azithromycin 250 mg

DDx
April 16, 2026 (0)

Acute bacterial prostatitis

1. Symptoms:

    1. urinary symptoms

    2. perineal pain

    3. myalgia

2. Treatment:

    1. Tab SMP-TMX 800-160mg bid for 6 weeks

        1. or tab ciprofloxacin 500mg bid

        2. or tab levofloxacin 500mg qd

    2. in high risk for gonorrhea

        1. Amp ceftriaxone 250mg IM

        2. Tab doxycycline 100mg bid for 1m

    3. for fever:

        1. Tab acetaminophen 500mg qid

    4. for pain:

        1. Tab ibuprofen 400mg tds

DDx
April 16, 2026 (0)

Acid-base ingestion

1. internist consult

2. avoid charcoal and vomiting

3. if Hydrocarbon ingestion, observe for 6 hrs. at least and look for arrhythmias

4. if ingestion of washing fluids: dilute it with PO water or Milk

DDx
April 16, 2026 (0)

Acetaminophen poisoning

1. Toxic dosage in:

    1. adults: 7.5 gr

    2. children: 150 mg/kg

2. check:

    1. AST, ALT, ALKP, PT, PTT, INR, BUN, Cr, VBG, Ca, P

    2. if AST/ALT >1000 ⇒ check them q6h

    3. if AST/ALT< 500 ⇒ check them daily

3. N-acetylcysteine 150 mg/kg in 1 hour then 50 mg/kg in 4 hours then 100 mg/kg in 16 hours IV

    or  N-acetylcysteine 140 mg/kg PO stat then 70 mg/kg PO q4h for 17 days

4. H.D if serum level AST/ALT >1000 or comatose or severe acidosis

5. Liver transplantation if pH< 7.3, PT>100 or Cr>3.3

DDx, Drugs
April 16, 2026 (0)

Prenatal Care

1. Lab tests:

    1. CBC, diff

    2. FBS

    3. Blood group, Rh

    4. BUN, Cr

    5. VDRL, HBS Ag, Rubella titer Ag, HIV Ab

    6. U/A, U/C

2. Prophylaxis:

    1. Tab acid folic 0.4mg #100 daily for 3 months

    2. Cap hematinic # qd

    3. Cap multivitamin  mineral #100 qd

    4. Amp rhogam 300unit IM in 28th week and after pregnancy

Pediatrics
April 16, 2026 (0)

Pediatric supplements

1. for Formula

    1. Cow’s protein base:

        1. Bebelac

        2. NAN

    2. For hypersensitive child

        1. Aptamil pepti

    3. Based on age

        1. <6m/o ⇒ 1

        2. 6-12 m/o ⇒ 2

        3. >1y/o ⇒ 3

    4. suffix:

        1. Pepti ⇒ cow’s protein hypersensitivity

        2. HA ⇒ food reaction

        3. Pre ⇒ premature

        4. LF ⇒ lactase deficiency

        5. AR ⇒ reflux

Drugs, Pediatrics
April 16, 2026 (0)

Drugs in Pregnancy

1. GI drugs: B/C

    1. Safe:

        1. Bisacodyl

        2. Famotidine

        3. Metoclopramide

    2. Unsafe:

        1. Clinidium C

        2. Loperamide

        3. Diphenoxylate

        4. Dicyclomine

        5. Hyoscine

2. Respiratory drugs: B/C/D

    1. safe:

        1. diphenhydramine

    2. unsafe:

3. Antibiotics: B/C/D

    1. Safe:

        1. Cephalosporin

        2. Amoxicillin

        3. Ampicillin

        4. Erythromycin

        5. Azithromycin

        6. Penicillin

    2. Unsafe:

        1. Doxycycline

        2. Furazolidone

        3. Cotrimoxazole

        4. Tetracycline

4. Other drugs:

    1. safe:

        1. Acetaminophen

        2. Levothyroxine

        3. Ferrous sulfate

        4. Multivitamin mineral

        5. Folic acid

        6. Vit B1, A, B6, E, D, C

Drugs
April 16, 2026 (0)