ENT, Allergy, Immunology Flashcards

1
Q

Aspirin exacerbated respiratory disease typically presents with a triad of asthma, chronic rhinosinusitis with […], and bronchospasm after ingestion of aspirin/NSAIDs.

A

Aspirin exacerbated respiratory disease typically presents with a triad of asthma, chronic rhinosinusitis with nasal polyposis, and bronchospasm after ingestion of aspirin/NSAIDs.

nasal polyps may cause bilateral nasal obstruction, nasal discharge, and anosmia

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2
Q

Meniere disease typically presents with a triad of […], […], and […].

A

Meniere disease typically presents with a triad of tinnitus, episodic vertigo, and sensorineural hearing loss.

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3
Q

Most infections during months 1 - 6 following liver transplantation are due to […] pathogens.

A

Most infections during months 1 - 6 following liver transplantation are due to opportunistic pathogens.

due to high-dose immunosuppressants; after 6 months, patients are primarily at risk for community-acquired pathogens

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4
Q

Most infections within the first month following liver transplantation are due to […] pathogens.

A

Most infections within the first month following liver transplantation are due to bacterial pathogens.

differentiated from acute transplant rejection by the presence of significant leukocytosis

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5
Q

Sialadenosis is often seen in patients with dietary/nutritional disorders or advanced […] disease.

A

Sialadenosis is often seen in patients with dietary/nutritional disorders or advanced liver disease.

e.g. diabetes, bulimia and alcoholic/non-alcoholic cirrhosis

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6
Q

The major toxicities/side effects associated with azathioprine are dose-related diarrhea, leukopenia, and […].

A

The major toxicities/side effects associated with azathioprine are dose-related diarrhea, leukopenia, and hepatotoxicity.

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7
Q

The major toxicity/side effect associated with mycophenolate is […].

A

The major toxicity/side effect associated with mycophenolate is bone marrow suppression.

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8
Q

The PCV13 conjugate polysaccharide vaccine induces immunization via a […] response (mechanism).

A

The PCV13 conjugate polysaccharide vaccine induces immunization via a T-cell dependent B-cell response (mechanism).

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9
Q

The PPSV23 pneumococcal polysaccharide vaccine induces immunization via a […] response (mechanism).

A

The PPSV23 pneumococcal polysaccharide vaccine induces immunization via a T-cell independent B-cell response (mechanism).

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10
Q

The symptoms of meniere disease are due to elevated […].

A

The symptoms of meniere disease are due to elevated endolymphatic pressure.

“endolymphatic hydrops”; likely due to defective resorption of endolymph

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11
Q

What anti-hypertensive medication is associated with hearing loss?

A

Loop diuretics (e.g. furosemide)

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12
Q

What immunosuppressive agent has side effects including nephrotoxicity, hyperkalemia, gingival hypertrophy, and hirsuitism?

A

Cyclosporine

tacrolimus has similar side effects except for hirsutism and gingival hypertrophy

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13
Q

What is the likely diagnosis in a 30-year-old woman that presents with recurrent episodes of pneumonia and diarrhea over the past 3 years? History and physical exam are otherwise unremarkable.

A

Common variable immunodeficiency

CVID should be suspected in adults with recurrent bacterial infections

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14
Q

What is the likely diagnosis in a 70-year-old man that complains of difficulty hearing? He has difficulty hearing in noisy, crowded environments.

A

Presbycusis

i.e. age-related, sensorineural hearing loss

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15
Q

What is the likely diagnosis in a healthcare worker that presents with itchy, dry skin on the hands for the past month? Examination shows dry and irritated skin with erythema at the fingers, finger webs, and dorsum of the hands (pictured below).

A

Irritant contact dermatitis

likely due to excessive hand washing

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16
Q

What is the likely diagnosis in a patient that presents with right-sided ear pain that increases in severity when chewing food? Physical examination is normal.

A

Temporomandibular joint dysfunction (TMJ)

17
Q

What is the likely diagnosis in a patient with a significant smoking and drinking history that presents with a granular, non-indurated lesion on the buccal mucosa (pictured below)? The lesion is not removed by scraping with a tongue depressor.

A

Leukoplakia

pre-malignant; squamous cell carcinoma typically presents with nodular, erosive, or ulcerative lesions with erythema or induration +/- regional lymphadenopathy

18
Q

What is the likely diagnosis in a patient with a three day history of fever and sore throat that develops difficulty swallowing and a muffled voice? Physical exam reveals left-sided cervical lymphadenopathy with rightward deviation of the uvula.

A

Peritonsillar abscess

19
Q

What is the likely diagnosis in a patient with unilateral hearing loss with a dull, hypomobile tympanic membrane on otoscopic exam?

A

Serous otitis media (otitis media with effusion)

i.e. middle ear effusion without signs of active infection

20
Q

What is the likely diagnosis in an elderly patient that presents with worsening severe left-sided ear pain with an edematous auditory canal and purulent discharge/granulation tissue visible on otoscopic exam?

A

Malignant (necrotizing) otitis externa

usually caused by Pseudomonas aeruginosa; presence of granulation tissue, elevated ESR, and severe pain distinguish MOE from typical otitis externa

21
Q

What is the recommended initial treatment for patients with allergic rhinitis?

A

Intranasal glucocorticoids

oral antihistamines, antihistamine or cromolyn nasal sprays, and leukotriene modifiers can be considered as well

22
Q

What is the recommended treatment for malignant (necrotizing) otitis externa?

A

IV ciprofloxacin

other anti-pseudomonal agents may be used if fluoroquinolone resistance is suspected

23
Q

What is the recommended treatment for peritonsillar abscess?

A

incision & drainage and IV antibiotics

24
Q

What test is used to diagnose common variable immunodeficiency (CVID)?

A

Quantitative measurement of serum immunoglobulins

typically reveals significantly reduced serum IgG with low levels of IgA and/or IgM

25
Q

What type of hearing loss is suggested by the hearing test results below in a patient with left-sided hearing loss?

Rinne: air > bone conduction in both ears

Weber: lateralizes to the right ear

A

What type of hearing loss is suggested by the hearing test results below in a patient with left-sided hearing loss?

Rinne: air > bone conduction in both ears

Weber: lateralizes to the right ear

Sensorineural hearing loss

26
Q

What type of hearing loss is suggested by the hearing test results below in a patient with left-sided hearing loss?

Rinne: bone > air conduction in the left ear; air > bone in the right

Weber: lateralizes to the left ear

A

What type of hearing loss is suggested by the hearing test results below in a patient with left-sided hearing loss?

Rinne: bone > air conduction in the left ear; air > bone in the right

Weber: lateralizes to the left ear

Conductive hearing loss

27
Q

What type of hearing loss occurs with otosclerosis?

A

Conductive hearing loss

28
Q

What type of hearing loss typically occurs with ototoxic antibiotics (e.g. aminoglycosides)?

A

Sensorineural hearing loss

29
Q

[…] is a benign, non-inflammatory enlargement of the salivary glands.

A

Sialadenosis is a benign, non-inflammatory enlargement of the salivary glands.