ENT Module 3

Question 1

What is the causative organism that causes group a strep pharyngitis?

Answer 1

S pyogenes (gram-positive cocci)

Question 2

In group a strep pharyngitis what are the symptoms? Do they get fever?

Answer 2

Set an onset of sore throat, fever, headache, abdominal pain, nausea, and vomiting especially in children.

Question 3

When can a patient go back to work or school? When they have strep

Answer 3

Until they are afebrile and 12 hours after started anabiotic therapy.

Question 4

Children who developed group a strep or at risk for developing what?

Answer 4

Acute rheumatic fever

Question 5

What is the treatment for group a strep?

Answer 5

Penicillin v or amoxicillin

Question 6

What is the treatment course for patients who have a penicillin allergy when receiving treatment for group a strep?

Answer 6

Take cephalexin, cefadroxil, clindamycin, azithromycin

Question 7

What is the current Initial management for pediatric acute sinusitis?

Answer 7

Watchful waiting for three days maybe offer for children with a cute bacterial sinusitis the persistence symptoms

Question 8

What is the first pharmacological line of treatment for pediatric acute sinusitis?

Answer 8

Amoxicillin or Augmentin remains for sign therapy

Question 9

What is the second line of therapy for pediatric children that are allergic to penicillins who have acute sinusitis?

Answer 9

A single dose of ceftriaxone (Rocephin) can be used and then switch to oral anabiotics, if improving.

Question 10

For acute otitis media in children, in mild cases what is the recommendation per CDC guidelines?

Answer 10

In children 6 to 23 months of age or unilateral or bilateral symptoms in children less than two years may be appropriate for water waiting based on shared decision making

Question 11

What is the first line therapy for a cute otitis media in pedi population?

Answer 11

Amoxicillin remains first-line therapy for children who have not received amoxicillin within the past 30 days.

Question 12

In acute otitis media the recommendation for children who have had amoxicillin within the past 30 days or has concurrent Purulent conjunctivitis present should be given what ?

Answer 12

Augmentin

Question 13

For children who have acute otitis media that are allergic to penicillin, what is the next line of meds they should be given?

Answer 13

Cefdinir
Cefuroxime
Ceftriaxone

Question 14

What is the pediatric treatment for pharyngitis? List 2 meds

Answer 14

Amoxicillin and penicillin V remain first line therapy

Question 15

For children or pediatric pharyngitis, what is the treatment if there is a hypersensitivity to penicillin?

Answer 15

Cephalexin, cefadroxil,, myosin, clarithromycin, or azithromycin are recommended.

If there is a type one hypersensitivity to penicillin give Clindamycin, clarithromycin or azithromycin.

Question 16

In adults with acute rhinosinositis what is the initial recommendation for uncomplicated cases for management?

Answer 16

Watch for waiting is encourage for uncomplicated cases for retro to follow up is available 

Question 17

What is the first line therapy for acute rhinosinusitis in adult patients?  What is the second line?

Answer 17

First line therapy is amoxicillin or Augmentin. Second line therapy For penicillin allergic patient is doxycycline or a respiratory fluoroquinolone such as levofloxacin.

Question 18

For adults who test positive for group a strep pharyngitis, what is the first line therapy?

Answer 18

Amoxicillin and penicillin V remain first line therapy due to their reliable antibiotic activity against group a strep.

Question 19

For adults that are allergic to penicillin, what is

The second line treatment for group a strep?

Answer 19

Cephalexin, cefadroxil, clindamycin, or macrolides are recommended

Question 20

Is it viral or bacterial pharyngitis?

Cough rhinorrhea hoarseness and Coryza 

Answer 20

Viral pharyngitis

Question 21

Is is viral or bacterial pharyngitis?

Answer 21

Fever, tender anterior cervical lymphadenopathy, tonsillar erythema with or without exudate and swelling

Question 22

 What are the two post infection syndromes of group A Beta hemolytic strep?

Answer 22

Acute rheumatic fever and acute poststreptococcal glomerulonephritis

Question 23

What is some findings of acute poststreptococcal glomerulonephritis?

Answer 23

Occurs one or two weeks after group a strep pharyngitis. Important findings are edema hematuria proteinuria and hypertension

Question 24

When is a tonsillectomy indicated?

Answer 24

When a patient has four or more episodes of severe pharyngitis in a year

Question 25

What are the three main symptoms of infectious mononucleosis?

Answer 25

Severe sore throat, fever, lymphadenopathy

Question 26

Patients diagnosed with mononucleosis should avoid what?

Answer 26

They should avoid contact sports and heavy lifting for four weeks due to risk for splenic rupture

Question 27

Patients who are given amoxicillin or penicillin when they have mononucleosis can expect what

Answer 27

A rash

Question 28

Based on the symptoms what would be the diagnosis:

Fever, malaise, severe sore throat that is worse on one side, dysphasia, ipsilateral otalgia 

Answer 28

Peritonsillar abscess

Question 29

What is lemierre syndrome?

Answer 29

Septic thrombophlebitis of internal jugular vein

Question 30

Remember these things about Lemierre syndrome

Answer 30

It is rare, potentially life-threatening cause of a sore throat. Positive agent is anaerobic gram negative rod F necrophorium. Nonspecific symptoms of sore throat neck tenderness or swelling or both and fever. CT scan of neck is best diagnostic modality. They don’t like them antibiotics clindamycin Flagyl or antibiotics to treat this. Surgery may be needed.

Question 31

Sensorineural hearing loss associated with what part of the ear?

Answer 31

The inner ear

Question 32

Mechanical conduction hearing loss is associated with what part of the ear?

Answer 32

Middle ear, issues are often reverseible

Question 33

What disease process has fluctuating here in loss, usually unilateral, associate with tinnitus and vertigo?

Answer 33

Menieres disease

Question 34

What differential diagnosis is this? Do you know lateral, constant or progressive hearing loss possibly associated with a headache, facial weakness, tingling, loss of taste and dysphasia. Cranial nerve 8 affected

Answer 34

Acoustic neuroma

Question 35

What differential is this : high frequency hearing loss that is bilaterally symmetrical?

Answer 35

Indicator Prebycusis 

Question 36

Describe the weber test

Answer 36

Please the tuning fork on the midline of the patient’s skull.

The sound is heard equally in both ears by the patient which is a normal result

Question 37

In doing the Weber test, sensorineural hearing loss is heard loudest in what ear?
SUA

Answer 37

The unaffected ear

Question 38

In doing the Weber test, conductive hearing loss is heard loudest in what ear?
CA

Answer 38

The sound is louder in the affected ear 

Question 39

What is the differential for reoccurring attacks of tinnitus, vertigo and progressive hearing loss.

Answer 39

Ménière’s disease

Question 40

What do Patients need to be educated about for meniere’s disease?

Answer 40

Acute attacks are best treated with quiet bedrest and careful protection from falls.
Patient should not drive, climb ladders, work near operate dangerous machinery, walk without assistance, read or look at glaring lights

Question 41

Dysphonia is a cardinal sign of what type of cancer?

Answer 41

Laryngeal cancer