EENT

Question 1

What symptoms indicate an Acute BACTERIAL Rhinosinusitis?

Answer 1

1) Persistent and not improving (10 days or more).
2) Severe for 3 or more days (Temp 102 F or higher, sinus pain, purulent drainage).
3) Worsening or double-sickening (3 or more days).

Question 2

What 5 things make someone at risk for antibiotic resistance?

Answer 2

1) Age 65, daycare.
2) Prior ABX in the past month.
3) Hospitalization in the past 5 days.
4) Comorbidities.
5) Immunocompromised

Question 3

What is the FIRST-line antimicrobial for acute bacterial rhino sinusitis (ABRS) in adults?

Answer 3

Amoxicillin-clavulanate 500mg/125mg or 875mg/125mg PO BID

Question 4

What is the SECOND-line antimicrobial for ABRS in adults?

Answer 4

Amoxicillin-clavulanate 2000mm/125mg PO BID or Doxycycline 100mg PO BID or 200mg PO daily.

Question 5

What risk is involved when prescribing Doxycycline for ABRS in adults?

Answer 5

Risk of treatment failure if drug-resistant streptococcus pneumoniae (DRSP) is involved.

Question 6

When treating and adult with ABRS using Amoxicillin-clavulanate, how would you change your script if you suspect drug-resistant strep pneumo (DRSP)?

Answer 6

High-dose (HD, 3-4 g/d) Amoxicillin is needed against DRSP.

Question 7

If your patient with ABRS has a beta-lactam allergy (PCN, cephalosporins), what are your antimicrobial choices?

Answer 7

Doxycyline, Levofloxacin, Moxifloxacin

Question 8

Which antimicrobials are appropriate when treating ABRS with a risk for antibiotic resistance or failed initial therapy?

Answer 8

Amoxicillin-clavulanate 200mg/125mg PO BID
Levofloxacin 500mg PO daily
Moxifloxacin 400mg PO daily

Question 9

What is FIRST-line therapy for treatment of Allergic rhinitis?

Answer 9

Allergen avoidance/environmental control

Question 10

The combination approach to the treatment of allergic rhinitis consists of what two types of drug therapy?

Answer 10

Controller therapy & Reliever therapy

Question 11

Controller therapy for allergic rhinitis consists of which classes of drugs?

Answer 11

Intranasal corticosteroids
Leukotriene receptor antagonist
Mast cell stabilizers

Question 12

Reliever therapy for allergic rhinitis consists of which classes of drugs?

Answer 12

Oral, nasal and ophthalmic antihistamines
Oral and nasal decongestants
Intranasal anticholinergics
Short-term oral systemic corticosteroids

Question 13

What 3 things indicate an ophthalmic emergency?

Answer 13

1) Red eye
2) Painful eye
3) Vision change

Question 14

What are 2 characteristics of a normal fundoycopic exam?

Answer 14

Sharp optic disc margins

Retinal veins wider than arteries

Question 15

In a fundoycopic exam, a deeply cupped optic disc where the physiologic cup is over 50% the size of the optic disc indicates:

Answer 15

Angle-closure glaucoma

Question 16

A/V nicking on a fundoscopic exam indicates:

Answer 16

Hypertensive retinopathy

Question 17

Central vision loss is likely due to:

Answer 17

Macular degeneration

Question 18

Peripheral vision loss is likely due to:

Answer 18

Untreated open-angle glaucoma

Question 19

A need for increased illumination is and indication of:

Answer 19

Normative aging

Question 20

An Amsler grid is used to evaluate:

Answer 20

Early signs of macular degeneration.

Question 21

A slit-lamp is used to evaluate:

Answer 21

Anterior eye structures including cornea, conjunctiva, sclera, and iris.

Question 22

Two main goals in the treatment of Glaucoma are:

Answer 22

Relieve intraocular pressure by:
Reducing the production of intraocular fluid
Increasing fluid outflow

Question 23

FIRST-line antimicrobial for suppurative conjunctivitis (non-gonococcal, non-chlamydial) is:

Answer 23

Ophthalmic treatment with a fluoroquinolone such as Gatifloxacin, Levofloxacin, and Moxifloxacin.

Question 24

Milder cases of Otitis externa can be treated with:

Answer 24

Acetic acid with propylene glycol and hydrocortisone drops.

Question 25

Moderate to severe cases of otitis externa should be treated with:

Answer 25

Otic drops with ciprofloxacin with hydrocortisone

Question 26

If a punctured tympanic membrane is suspected, do not use products containing:

Answer 26

Neomycin

Question 27

FIRST-line therapy for exudative pharyngitis is:

Answer 27

Penicillin V PO x 10d or

Benzathine penicillin IM x 1 dose