ENT 5

Question 1

MC organism for acute rhinosinusitis?

Answer 1

Strep pneumoniae

Question 2

Management for acute rhinosinusitis?

Answer 2

Augmentin

Question 3

MC cause of chronic sinusitis?

Answer 3

Aspergillus

Chronic is considered if symptoms for 12 weeks.

Question 4

Management for a severe invasive fungal infection that infiltrates the sinuses, lungs, or CNS on diabetics or immunocompromised patients.

Presents as rhino-orbital-cerebral infections and a black eschar on the palate, nasal mucosa, or face.

Biopsy shows non-septate broad hyphae with irregular right angle branching.

Answer 4

Mucormycosis (Zygomycosis)

IV amphotericin B + Surgical debridement

Question 5

Management for a patient with clear watery rhinorrhea. Pale or boggy turbinates, nasal polyps, or cobblestone mucosa.

Answer 5

Intranasal corticosteroids

Question 6

Intranasal decongestants used > 3-5 days may cause what?

Answer 6

Rhinitis medicamentosa

Question 7

What is viral rhinitis caused by and what does it look like on exam?

Answer 7

Rhinovirus (common cold)

Erythematous turbinates

Question 8

MC cause of acute pharyngitis/ Tonsilitis?

Answer 8

Viral MC overall

If bacterial, Group A strep pyogenes

Question 9

Dx and Tx of Group A strep pharyngitis?

Answer 9

Rapid strep with throat culture

Penicillin first line

Macrolides (Azithromycin, Clindamycin) if penicillin allergy.

Question 10

What are two important complications of Group A strep pharyngitis?

Answer 10

Rheumatic fever and acute glomerulonephritis

Question 11

Management for patient with painless lacy reticular leukoplakia (wickham striae). Patient has a hx of Hep C.

Answer 11

local glucocorticoids such as clobetasol, or betamethasone.

Question 12

Tx for a patient tender, symmetric swelling, woody induration and erythema of upper neck and chin.

Increased incidence in DM and HIV

Answer 12

Ludwig’s angina

Apicillin-sulbactam

or Cetriaxone + metronidazole

Question 13

Management for a patient with Thrush?

Answer 13

Nystatin mouthwash

Clotrimazole troches

If refractory use fluconazole.

Question 14

How do you dx Oral thrush other than clinical dx?

Answer 14

KOH shows budding yeast, and pseudohyphae.

Question 15

Management for a patient with a small painful, shallow round ulcer with an erythematous halo?

Answer 15

Apthous ulcers

topical oral glucocorticoids such as Clobetasol or Dexamethasone elixir swish.

Can use 2% viscous lidocane