ENT

Question 1

Lidocaine

Answer 1

Amide

Question 2

Benzocaine

Answer 2

Ester; methemoglobinemia

Question 3

Tetracaine

Answer 3

Ester; long duration, spine and corneum

Question 4

Pneumothorax

Answer 4

O2 sat drops Rr and hr increases Subcutaneous crepitus

Question 5

cystitis drugs

Answer 5

1. ABX:
   - Bactrim, or
   - Fluoroquinolones - Cipro, Levo
2. Pyridium (phenazopyridine)
   - Stops bladder spasms
   - Urinary tract analgesic
   - Administered orally

Question 6

rhinorrhea medicamentosa

Answer 6

oxymetazoline -> inc alpha adrenergic receptors -> vasoconstriction -> relief

prolonged oxymetazoline (> 5 days) -> damaged vascular endothelium -> inc vascular permeability, inc edema

beefy red mucosa

nasal or oral steroids to help cessation

Question 7

singulair generic?

Answer 7

montelukast

Question 8

5 questions to ask pt with ear problem

Answer 8

acute hearing loss

vertigo

otorrhea

otalgia

tinnitus

Question 9

why is bleeding and dryness common after nose surgery

Answer 9

4 months to regenerate mucous

Question 10

U/L tonsillar mass in old pt vs young pt

Answer 10

old pt: head and neck SCC (most common cancer of h/n)

young pt: lymphoma

Question 11

young man, can’t breathe out of nose, recurrent nose bleeds

Answer 11

juvenile nasopharyngeal angiofibroma

Question 12

MCC chronic/recurrent infection of unilateral tonsil?

treatment w dosing?

Answer 12

actinomyces

penicillin V 500mg TID for 30 days

Question 13

generic dupixent?

MOA?

2 indications?

Answer 13

dupilumab

IL-2 inhibitor

Chronic sinusitis, nasal polyps

Question 14

why do cancer pts always have water with them

Answer 14

radiation destroys minor salivary glands - dry mouth

Question 15

atrovent generic?

MOA?

indications?

Answer 15

ipratropium

anticholinergic

SOB, wheezing secondary to asthma and/or COPD

Question 16

advair generic?

MOA?

indications?

Answer 16

fluticasone propionate, salmeterol

SOB, wheezing, coughing, chest tightness secondary to asthma and/or COPD

Question 17

inverted papilloma

RF?

presentation?

complications?

Answer 17

AKA schneiderian papilloma; benign epithelial tumor; inward growth (into underlying bone)

RF: HPV

presentation: middle-aged man with nasal congestion or obstruction, drainage or post-nasal drip, nose bleeds, a decreased sense of smell, or facial pain
complications: recurrence, malignant transformation into SCC

Question 18

merkel cell carcinoma

epidemiology

AEIOU

other RF

treatment

Answer 18

merkel cells= pain receptors on skin

sMCC death from skin cancer

asymptomatic, expanding, immunocompromised, old (> 50 yo), UV-exposure

pale skin, merkel cell polyomavirus

treatment: resection, immune modulators (activate killing by T cells)

Question 19

norco

generic?

dosing?

metabolism?

Answer 19

5-7.5 / 325

Question 20

percocet

generic?

dosing?

metabolism?

Question 21

augmentin

generic?

dosing?

metabolism?

coverage?

Answer 21

coverage: most gram positives, also methicillin-resistant staph, haemophilus, enterobacter

Question 22

keflex

generic?

dosing?

metabolism?

coverage?

Question 23

ancef/roseph

generic?

dosing?

metabolism?

coverage?

Question 24

bacitracin

Question 25

lacrilube

Question 26

tobrex

Answer 26

tobramycin eye drops

Question 27

when should you pay close attention to oral occlusion

Answer 27

jaw fractures

Question 28

small vessel disease

Question 29

cefazolin dosing

Answer 29

2g q8 hours

Question 30

IV fluids dosing

Answer 30

4/2/1 rule

4 mL/kg/hr for the first 10 kg of weight

2 mL/kg/hr for the next 10 kg

1 mL/kg/hr for each kilogram thereafter

Question 31

valtrex

Answer 31

valacyclovir

herpes zoster: 1000mg q8h x 7 days

Question 32

epidermal inclusion cyst

Answer 32

form at follicular infundibulum

RF:

familial colorectal polyposis (gardner syndrome)

medications- BRAF inhibitors, imiquimod, cyclosporine

foul-smelling, cheese-like