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AGNP Board Exam > ENT disorders > Flashcards

ENT disorders Flashcards

1
Q

What percentage of URIs are viral in nature?

A

98%

*<2% of URIs are complicated by ABRS

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2
Q

Acute rhinosinusitis definition?

A

Inflammation of the mucosal lining of nasal passages & paranasal sinuses lasting up to 4 weeks caused by allergens, environmental irritants, and/or infection

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3
Q

Acute bacterial rhinosinusitis (ABRS) definition?

A

Secondary bacterial infection of paranasal sinuses, usually following viral URIs

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4
Q

Causative pathogens in ABRS (by order rank)?

A
  1. S. pneumoniae (gram +)
  2. H. influenzae (gram - )
  3. M. catarrhalis (gram - )
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5
Q

S. pneumonia & H. influenzae common causes (Hint: COMPS pneumonic)

A

Conjunctivitis
Otitis media
Meningititis
Pneumonia
Sinusitis

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6
Q

Majority of antibiotic treatment regimen for ABRS lasts for __ to __ days?

A

5-7 days

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7
Q

“Double sickening” can be indicative of ABRS (true/false)?

A

True
*“Double sickening” –> initial symptom improvement and then worsening of symptoms

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8
Q

Fever & symptom duration of more than __ days may be indicative of ABRS?

A

10 days

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9
Q

True/False: Give the highest dose for shortest amount of time when considering antimicrobial therapy?

A

True
*Need drug to be able to concentrate med enough to optimize treatment success & minimize development of resistant pathogens

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10
Q

Most common risk factors for antibiotic resistance?

A

Age <2 or >65 yrs, daycare attendance
Prior systemic antibiotics within PAST MONTH
Hospitalization within past 5 days
Comorbidities
Immunocompromised

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11
Q

Biggest risk with fluroquinolones (ex: -floxacin)?

A

Tendon rupture

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12
Q

First line treatment for ABRS?

A

Amoxicillin
or
Amoxicillin-clavulanate (Augmentin)
*may be more effective against ABRS due to H. influenzae & M. catarrhalis coverage

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13
Q

Second line treatment if beta-lactam allergy for ABRS?

A

If no anaphylaxis hx: Cefdinir, Cefpodoxime, or Cefuroxime

If anaphylaxis history: Levofloxacin, moxifloxacin, or doxycycline (category D pregnancy risk)

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14
Q

Substrate, Inhibitor, or Inducer: A medication that is metabolized/biotransformed by the isoenzyme, utilizing this enzyme in order to be modified so it can reach the drug site of action and/or be eliminated?

A

Substrate (CYP450)
Ex: Statins, OCP, benzos, sildenafil

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15
Q

Substrate, Inhibitor, or Inducer: A drug or other substance that blocks that activity of the isoenzyme, limiting substrate excretion (increased risk of toxicity)
(hint: doesn’t allow medication to leave the body)

A

Inhibitor
Ex: grapefruit juice, clarithromycin
clarithromycin + simvastatin = statin-induced rhabdo risk

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16
Q

Substrate, Inhibitor, or Inducer: accelerates the activity of the isoenzyme (pushes med out of body, resulting in decreased effectiveness of med)
(Hint: “jet pack”)

A

Inducer
Ex: St. John’s wort
St. John’s wort + COC = potential contraceptive failure

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17
Q

What is presbyopia?

A

Age-related visual change (hardening of lens); near vision is affected (decreased ability to read small print at close range)

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18
Q

What is blepharitis?

A

Inflammation of the edges of the eyelids where eyelashes grow

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19
Q

Kiesselbach’s plexus location?

A

Anterior inferior aspect of nose (lower one-third)

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20
Q

Color and appearance of nasal turbinates seen in allergic rhinitis?

A

Bluish, pale, and/or boggy

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21
Q

White-to-light gray patch that appears on tongue, floor of mouth, inside cheek.

A

Leukoplakia

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22
Q

Aphthous stomatitis

A

Canker sore

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23
Q

Geographic tongue

A

Tongue surface has maplike appearance; benign

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24
Q

Torus palatinus

A

Painless bony protuberance midline on hard palate; benign

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25
Q

Optic nerve cupping is associated with ____?

A

Glaucoma

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26
Q

HTN or DM: Copper & silver wire arterioles?

A

Hypertensive retinopathy

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27
Q

HTN or DM: Arteriovenous nicking

A

Hypertensive retinopathy

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28
Q

HTN or DM: Cotton-wool spots

A

Diabetic retinopathy

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29
Q

Clusters of small red papules with white centers inside cheeks by lower molars (Hint: pathognomonic for measles (rubeola)

A

Koplik’s spots

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30
Q

First line treatment for nasal polyps?

A

Intranasal glucocorticoids (ex: fluticasone or budesonide BID)

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31
Q

Condition of tongue caused by Epstein-Barr virus (EBV)

A

Hairy leukoplakia

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32
Q

Excessive constriction of the pupil

A

Miosis

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33
Q

Drooping of upper eyelid

A

Ptosis

34
Q

Legal blindness vision (Snellen test result)

A

20/200 (ex: patient can see at 20 feet what a person with normal vision can see at 200 feet)

35
Q

Vision chart used to measure distance (eye sight)

A

Snellen chart

*Numerator never changes (20/X)

36
Q

Tuning fork midline on forehead

A

Weber test

*Normal = no lateralization.
*Abnormal = lateralization/louder in one ear

37
Q

Tuning fork on mastoid process

A

Rinne test

*Normal = air conduction lasts longer than bone conduction (ex: can hear longer in front of ear than on mastoid bone)

38
Q

Types of sensorineural hearing loss (Inner ear)

A

Aging, damage
Ex: Presbycusis, Meniere’s disease

39
Q

Types of conductive hearing loss (Outer/middle ear)

A

Obstruction
Ex: Otitis media, ceruminosis, perforation of tympanic membrane

40
Q

Sensorineural or conductive hearing loss: Rinne AC>BC

A

Sensorineural

41
Q

Sensorineural or conductive hearing loss: Rinne BC>AC

A

Conductive

42
Q

True/False: Use topical opthalmic abx with pseudomonal coverage if patient is contact lens user

A

True
Ex: ciprofloxacin, ofloxacin, trimethoprim-polymyxin B

43
Q

Abscess of a hair follicle and sebaceous gland in upper or lower eyelid

A

Hordeolum (stye)

44
Q

Gradual onset of increased IOP >22 mmHg due to blockage of the drainage of aqueous humor inside eye

A

Primary open-angle glaucoma

45
Q

Sudden blockage of aqueous humor with elevated IOP, resulting in ischemia & permanent damage to optic nerve

A

Primary angle-closure glaucoma

46
Q

Gradual damage to pigment of macula (area of central vision) that results in severe visual loss or blindness (hint: leading cause of blindness in elderly)

A

Age-related macular degeneration

47
Q

Amsler grid is used to test vision for central vision loss commonly seen in _______ _________?

A

Macular degeneration

48
Q

First-line treatment for allergic rhinitis?

A

Topical nasal sprays (ex: Fluticasone, Nasacort)

49
Q

Tonsillar exudate, tender anterior cervical adenopathy, hx of fever, absence of cough

A

Strep throat symptoms

50
Q

First-line treatment for strep throat?

A

Oral penicillin V (500 mg 2-3x/day x10 days)
or
Amoxicillin BID x 10 days

51
Q

Strep treatment if penicillin or beta-lactam allergy?

A

Azithromycin (Z-Pak) x5 days

52
Q

First-line treatment for acute otitis media (AOM) for any age group?

A

Amoxicillin

53
Q

Second-line treatment for AOM (if no response to initial treatment in 48-72 hrs)?

A

Amoxicillin-clavulanate (Augmentin), cefdinir or cefprozil, or levofloxacin or moxifloxacin

54
Q

First-line treatment for acute bacterial rhinosinusitis (ABRS)?

A

Amoxicillin-clavulanate (Augmentin)

55
Q

Acute onset of severe headache that interferes with sleep, abnormal neuro exam, confusion, febrile. Life threatening emergency with high mortality (Hint: serious complication of AOM and rhinosinusitis).

A

Cavernous sinus thrombosis

56
Q

Infectious mononucleosis is caused by what virus?

A

EBV

57
Q

Classic triad of mono symptoms?

A

Fever, pharyngitis, lymphadenopathy (<50% of cases)

58
Q

Diagnostic test to confirm mono?

A

Monospot

59
Q

Type of vertigo caused by disorders of the vestibular apparatus of the inner ear or by inflammation of CN VIII?

A

Peripheral vertigo

60
Q

Type of vertigo associated with stroke (cerebellar or brainstem bleeding), MS, infections, or tumor (Hint: can be life-threatening)

A

Central vertigo

61
Q

Gold-stand clinical test for benign paroxysmal positional vertigo disease (BPPV)

A

Dix-Hallpike maneuver

62
Q

Type of vertigo: abrupt onset w/ brief episodes (<1 min) induced by sudden head movements. Due to calcium carbonate crystals trapped in semicircular canals

A

BPPV

63
Q

Diagnostic tool to check for corneal abrasion and keratitis?

A

Fluorescein strip

64
Q

Reliever therapy for allergic rhinitis?

A

2nd generation oral antihistamines (ex: loratidine/Claritin, cetirizine/Zyrtec)

65
Q

“Rope-like” eye discharge most consistent with?

A

Allergic conjunctivitis

66
Q

Most common type of oral cancer? (Hint: can be related to HPV 16)

A

Squamous cell carcinoma

67
Q

Potent risk factors for oral squamous cell carcinoma?

A

Longstanding HPV infection (HPV 16), tobacco use, alcohol misuse
Other risk factors: male gender, advancing age (>55 yrs)

68
Q

True/False: Retinal veins are always wider than arteries

A

True

69
Q

Myopia

A

Nearsightedness

70
Q

Tonometry reading tests for which vision disorder?

A

Glaucoma

71
Q

Gradual onset blurring of near vision?

A

Presbyopia (normative age-related finding in eye, lens becomes less flexible)

72
Q

Gradual peripheral vision loss?

A

Glaucoma
Risk factors: older, African ancestry, DM2

73
Q

Central vision loss?

A

Macular degeneration

*most problematic, no cure
*Risk factors: >50, smoking, HTN
*Dry (develops slowly); Wet (develops quickly)

74
Q

Presbycusis?

A

Age-related hearing loss; loss of CN VIII sensitivity

75
Q

Eye condition with following risk factors: tobacco use, poor nutrition, sun exposure, systemic corticosteroid therapy

A

Senile cataracts (lens clouding)

*progressive vision dimming, distance vision problems

76
Q

Common pathogens for suppurative conjunctivitis (non-gonococcal, non-chlamydial)

A

S. aureus, S. pneumoniae, H. influenzae

77
Q

First-line treatment for suppurative conjunctivitis?

A

Opthalmic cipro ocular solution
or
polymyxin B with trimethoprim opthalmic solution

78
Q

Viral conjunctivitis (“pink-eye”) typically caused by _____ ?

A

Adenovirus

79
Q

1:2 mixture of white vinegar/rubbing alcohol eardrops can help decrease reinfection of _____?

A

Otitis externa (Swimmer’s ear)

80
Q

Common pathogen for otitis externa?

A

Pseudomonas, S. aureus

81
Q

True/False: Otitis media with effusion (serous otitis) typically needs antimicrobial therapy

A

False; usually resolves in 1-3 weeks without intervention

AGNP Board Exam (2 decks)

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