Eye, Ear, Nose and Throat

Question 1

A common staphylococcal abscess on the upper or lower eyelid

Answer 1

hordeolum (stye)

Question 2

Hordeolums are _______ with an ______ onset

Answer 2

painful; abrupt

Question 3

A granulomatous (beady nodule) on the eyelid; infection or retention cyst of the meibomian gland

Answer 3

Chalazion

Question 4

How does a chalazion differ from a hordeolum?

Answer 4

chalazion are typically painless

Question 5

The most common eye disorder; an inflamattion/infection of the conjunctiva (“pink eye”) resulting from a variety of causes including allergies, chemical irritation, or infection

Answer 5

Conjunctivitis

Question 6

Treatment for bacterial conjuctivitis:

Answer 6

erythromycin, tetracycline, or polymyxin B solution

Question 7

What infectious organism causes conjuctivits and is considered an ophthalmic emergency?

Answer 7

Gonococcal

Question 8

Treatment for gonococcal eye infection

Answer 8

Neonatal: IV Pen G or IM ceftriaxone

Question 9

In allergic conjunctivitis, there is an increased _________

Answer 9

tearing

Question 10

Should steroid eyedrops ever be prescribed for conjunctivitis in primary care?

Answer 10

No, it can increase intraocular pressure and activate herpes simplex virus

Question 11

Viral conjunctivitis differs from bacterial conjunctivits how?

Answer 11

Viral = WATERY discharge not purluent

Question 12

An abnormal, UNIFORM, progressive opacity of the eye seen in children with comorbid syndromes (i.e. Down syndrome, diabetes, Marfan)

Answer 12

Cataracts

Question 13

Ocular misalignment as a result of uncoordinated ocular muscles. If acquired after 6 months of age, it usually is related to an underlying problem.

Answer 13

Stabismus

Question 14

When eyes deviate INWARD

Answer 14

Esotropia

Question 15

When eyes deviate OUTWARD

Answer 15

Exotropia

Question 16

When eyes deviate UPWARD

Answer 16

Hypertropia

Question 17

When eyes deviate DOWNWARD

Answer 17

Hypotropia

Question 18

When should you refer to ophthalmology

Answer 18

1. If fixed or continuous at six months of age or more

2. Immediately for HYPERTROPIA and HYPOTROPIA (likely a brain tumor)

Question 19

Inflammation of the external auditory meatus

Answer 19

Otitis externa (Swimmer’s Ear)

Question 20

Physical findings with otitis externa:

Answer 20

Purulent exudate, pain upon manipulation of auricle

Question 21

What does the tympanic membrane look like with Otitis Externa?

Answer 21

Normal

Question 22

Treatment option for otitis external if bacterial?

Answer 22

Ciprofloxacin and dexamethasone otic drops, Ofloxacin otic drops

Question 23

Bacterial infection of the mucosally lined air-containing spaces of the temporal bone in the ear.

Answer 23

Acute otitis media

Question 24

What is the most common bacterium associated with AOM?

Answer 24

S. Pnumoniae (30%)

Question 25

What is the second most common bacterium associated with AOM?

Answer 25

H. influenzae (20%)

Question 26

How does the TM look with AOM?

Answer 26

erythematous and edematous and bulging

Question 27

How long is the watchful waiting period for AOM?

Answer 27

48-72 hours

Question 28

1st line treatment for AOM?

Answer 28

Amoxicillin 80-90 mg/kg/day BID x 10 days

Question 29

What vaccines help prevent AOM? (3)

Answer 29

Hib, Pneumococcal, and Flu

Question 30

2nd hand smoke increases chances of AOM by __ times

Answer 30

4

Question 31

The presence of fluid in the middle ears without the signs or symptoms of AOM

Answer 31

Serous otitis media/otitis media with effusion (OME)

Question 32

OME typically occurs due to what?

Answer 32

Blocked eustachian tubes

Question 33

Signs/Symptoms of OME:

Answer 33

hearing loss, fullness in the ears, "popping" sensation

Question 34

Management for OME includes watchful waiting for __ months.

Answer 34

Watchful waiting for 3 months

Question 35

Do antihistamines and decongestants show efficacy with OME?

Answer 35

NO

Question 36

Decreased ability to conduct sound from the EXTERNAL to the INTERNAL ear

Answer 36

Conduction hearing loss

Question 37

In conductive hearing loss, Weber lateralizes sound to the _________ ear, and Rinne will be ______ in the effected ear.

Answer 37

effected | abnormal

Question 38

Impaired transmission of sound through the nervous system

Answer 38

Sensorineural hearing loss

Question 39

With sensorineural hearing loss: Weber lateralizes to the _________ ear

Answer 39

unaffected

Question 40

Viral rhinitis, a self-limiting upper respiratory tract infection

Answer 40

Common cold

Question 41

Treatment for the common cold?

Answer 41

Supportive care--rest and hydration

Question 42

Children should not be prescribed antitussives for children less than ___ years old.

Answer 42

Six

Question 43

Where should pressure be applied during epistaxis and for how long?

Answer 43

Kiesselbach's triange (Anterior inferior aspect of the nasal septum) for 10 minutes

Question 44

What is Centor criteria?

Answer 44

Specific criteria that suggest group A beta-hemolytic streptococci

Question 45

Centor Criteria uses FLEA, which stands for:

Answer 45

Fever Lack of cough Pharyngo-tonsillar EXUDATE Anterior cervical ADENOPATHY

Question 46

Treatment for strep throat:

Answer 46

Penicillin VK 250 mg PO TID x 10 days

Question 47

If allergic to PCN, what should be the treatment of choice?

Answer 47

Erythromycin 250 mg QID x 10 days

Question 48

Sudden, severe swelling of the epiglottis that occurs as a result of bacterial infection; can produce respiratory compromise in a matter of hours.

Answer 48

Epiglottitis

Question 49

Three common pathogens associated with epiglottitis

Answer 49

Streptococci Pneumococci H. Influenzae

Question 50

Peak incidence for epiglottis is __ and __ years

Answer 50

6 and 10 years

Question 51

Name two signs/symptoms of epiglottitis:

Answer 51

drooling | hyperextension of the neck

Question 52

The neck XR will reveal what if the patient is positive for epiglottitis?

Answer 52

Thumb sign--a thumb-shaped patch

Question 53

Parainfluenza viral infection of the larynx

Answer 53

Croup

Question 54

Peak incidence of croup is __ months to __ years

Answer 54

3 months to 6 years

Question 55

When is croup most common (2 seasons)?

Answer 55

fall and winter

Question 56

Neck XRay reveals what if patient has croup?

Answer 56

Steeple sign -- narrowing of the trachea

Question 57

Epiglottitis is a ______ infection and croup is a _____ infection.

Answer 57

Bacterial | Viral

Question 58

An acute infectious disease due to the Eptein-Barr virus, usually occurring over the age of 10 years

Answer 58

Infectious Mononucleosis

Question 59

Mode of transmission for mono:

Answer 59

Saliva

Question 60

What type of rash could be present with Mono?

Answer 60

maculopapular or petechial rash

Question 61

Patients with mono should avoid contact sports for how long? Why is this important?

Answer 61

3 weeks to several months to avoid splenic rupture

Question 62

Occurs when an undrained collection of pus accumulates in one or more of the paranasal sinuses in children

Answer 62

Sinusitis

Question 63

Sinusitis can be diagosed in children great than __ years old

Answer 63

9

Question 64

Which two sinus cavities are the most commonly affected in sinusitis

Answer 64

Maxillary and ethmoid

Question 65

Three typical pathogens (same as AOM)

Answer 65

S. pneumoniae H. influenzae M. catarrhalis

Question 66

Uncomplicated sinusitis is treated with?

Answer 66

Amoxicillin-clavulanate x10 days, if no improvement after 3 days, change to levaquin

Question 67

What should the PCP do for children with chronic, refractory or recurrent sinusitis?

Answer 67

Refer to otolaryngologist