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NURP 503 Exam 2' > Fitzgerald eye, ear, nose and throat problem questions > Flashcards

Fitzgerald eye, ear, nose and throat problem questions Flashcards

1
Q 
All of the following are components of the classic ophthamological emergency except
A. eye pain
B. purulent eye discharge
C. red eye
D. new onset change in visual acuity
A

B. Purulent eye discharge

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2
Q 
Mrs. Murphy is a 58 year old woman presenting with a sudden left sided headache that is most painful in her left eye.  Her vision is blurred, and the left pupil is slightly dilated and poorly reactive.  The left conjunctiva is markedly injected, and the eye ball is firm.  Vision screen with the Snellen chart is 20/30 OD and 20/90 OS.  The most likely diagnosis is:
A. unilateral herpetic conjunctivitis
B. open angle glaucoma
C. angle-closure glaucoma
D. anterior uveitis
A

C. Angle closure glaucoma

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3
Q

In caring for Mrs. Murphy, the most appropriate next action is:
A. prompt referral to an ophthalmologist
B. to provide analgesia and repeat the evaluation when the patient is more comfortable
C. to instill a corticosteroid ophthalmic solution
D. to patch the eye and arrange for follow up in 24 hours

A

A. prompt referral to an ophthalmologist

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4
Q 
A 48 year old man presents with new onset right eye vision change accompanied by dull pain, tearing and photophobia.  The right pupil is small, irregular and poorly reactive.  Vision testing is obtained by using the Snellen chart is 20/30 OS and 20/80 OD.  The most likely diagnosis is:
A. unilateral herpetic conjunctivitis
B. open angle glaucoma
C. angle closure glaucoma
D. anterior uveitis
A

D. anterior uveitis

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5
Q 
Mrs. Allen is a 67 year old woman with type 2 DM who c/o seeing flashing lights and floaters, decreased visual acuity and metamorphopsia in her left eye.  The most likely diagnosis is:
A. open angle glaucoma
B. central retinal artery occlusion
C. anterior uveitis
D. retinal detachment
A

D. retinal detachment

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6
Q

For Mrs. Allen, the most appropriate next course of action is:
A. placement of an eye shield and follow up in 48 hours
B. initiate treatment with an ophthalmic anti microbial solution
C. initiate treatment with a corticosteroid ophthalmic solution
D. immediate referral to an ophthalmologist

A

D. immediate referral

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7
Q

A 45 year old man presents with eye pain. He reports that he was cutting a tree with a chain saw when some wood fragments hit his eye. You consider all of the following except:
A. educating the patient on the use of appropriate eye protection for primary prevention of eye trauma
B. immediately removing any protruding foreign body from the eye
C. using fluorescein staining to detect small objects in the eye
D. prompt referral to an eye care specialist

A

B. immediately removing any protruding foreign body from the eye

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8
Q 
Which of the following is a common vision problem in the person with untreated primary open angle glaucoma
A. peripheral vision loss
B. blurring of near vision
C. difficulty with distant vision
D. need for increased illumination
A

A. peripheral vision loss

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9
Q

primary open angle glaucoma is primarily caused by:
A. hardening of the lens
B. elevated intraocular pressure
C. degeneration of the optic nerve
D. hypotension in the anterior maxillary artery

A

B. elevated intraocular pressure

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10
Q 
Which of the following is most likely to be found on the fundoscopic examination in a patient with untreated primary open angle glaucoma
A. excessive cupping of the optic disc
B. arteriovenous nicking
C. papilledema
D. flame-shaped hemorrhages
A

A. excessive cupping of the optic disc

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11
Q 
Risk factors for primary open angle glaucoma include all of the following except:
A. African ancestry
B. Type 2 DM
C. advanced age
D. blue eye color
A

D. blue eye color

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12
Q

Key diagnostic findings in POAG include which of the following?
A. intraocular pressure greater than 25mm Hg
B. papilledema
C. cup to disk ratio greater than 0.4
D. sluggish pupillary response

A

A. intraocular pressure greater than 25mm Hg

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13
Q 
Treatment options for POAG include all of the following topical ocular agents except:
A. beta adrenergic antagonists
B. alpha agonists
C. prostaglandin analogues
D. mast cell stabilizers
A

D. mast cell stabilizers

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14
Q 
A22 year old woman presents with a "pimple" on her right eye lid.  Examination reveals a 2mm pustule on the lateral border of the right eyelid margin.  This is most consistent with:
A. a chalazion
B. a hordeolum
C. blepharitis
D. cellulitis
A

B Hordeolum

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15
Q 
a 22 year old woman presents with a bump on her right eyelid.  Examination reveals a 2mm, hard, non tender swelling on the lateral border of the right eyelid margin.  This is most consistent with:
A. chalazion
B. hordeolum
C. blepharitis
D. cellulitis
A

A. chalazion

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16
Q 
First line treatment of uncomplicated hordeolum is:
A. topical corticosteroid
B. warm compresses to the affected area
C. incision and drainage
D. oral anti microbial therapy
A

B warm compresses to the affected area

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17
Q 
A potential complication of hordeolum is:
A. conjunctivitis
B. cellulitis of the eyelid
C. corneal ulceration
D. sinusitis
A

B. cellulitis of the eyelid

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18
Q 
Initial treatment for a chalazion is
A. topical fluoroquinolone
B. topical corticosteroid
C. warm compresses of the affected area
D. surgical excision
A

C. warm compresses of the affected area.

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19
Q 
A 19 year old presents with a chief c/o a red, irritated eye for the past 48 hours with eyelids that were "stuck together" this morning when he awoke.  Examination reveals injected palpebral and bulbar conjunctiva and reactive pupils; vision screen with the Snellen chart evaluation reveals 20/30 in the right eye (OD), left eye (OS) and both eyes (OU).  and purulent eye discharge on the right.  This presentation is most consistent with:
A. suppurative conjunctivitis
B. viral conjunctivitis
C. allergic conjunctivitis
D. mechanical injury
A

A. suppurative conjunctivitis

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20
Q 
A 19 year old woman presents with a c/o bilateral, itchy red eyes with tearing that occurs intermittently throughout the year and is often accompanied by a rope like eye discharge and clear nasal discharge.  This is most consistent with conjunctival inflammation caused by an
A. bacterium
B. virus
C. allergen
D. injury
A

C. allergen

21
Q

You inspect the oral cavity of a 69 year old man who has a 100 pack per year cigarette smoking history. You find a lesion suspicious for malignancy and describe it as:
A. raised, red and painful
B. a denuded patch with a removal white coating
C. an ulcerated lesion with indurated margins
D. a vesicular form lesion with macerated margins

A

C. an ulcerated lesion with indurated margins

22
Q 
A firm, painless relatively fixed submandibular node would most likely be seen in the diagnosis of
A. herpes simplex
B. acute otitis media
C. bacterial pharyngitis
D. oral cancer
A

D. oral cancer

23
Q 
An independent risk fact of oral cancer is infection with
A. human herpes virus type 1
B. human papillomavirus type 16
C. adenovirus type 16
D. Epstein barr virus
A

B. HPV type 16

24
Q 
A 45 year old man presents with otitis externa.  Likely causative pathogens include all of the following except:
A. enterobacteriaceae
B. P. aeruginosa
C. Proteus spp.
D. M. catarrhalis
A

D

25
Q 
Risk factors for otitis externa include all of the following except:
A. frequent air travel
B. vigorous use of a cotton swab
C. frequent swimming
D. cerumen impaction
A

A. frequent air travel

26
Q

Physical exam findings in otitis externa include
A. TM immobility
B. increased ear pain with tragus palpation
C. TM erythema
C. TM bullae

A

B. increased ear pain with tragus palpation

27
Q 
Risk factors for AOM include all of the following except:
A. upper URI
B. untreated allergic rhinitis
C. tobacco use
D. aggressive ear canal hygiene
A

D. aggressive ear canal hygiene

28
Q 
Expected findings in AOM include
A. prominent bony landmarks
B. TM immobility
C. itchiness and crackling in the affected ear
D. submental lymphadenopathy
A

B. TM immobility

29
Q 
A 25 year old woman has a 3 day history of left ear pain that began after 1 week of URI symptoms.  On PE you find she has AOM.  She is allergic to PCN (anaphylactic rxn).  She took an antimicrobial for the treatment of a UTI 2 weeks ago.  The most appropriate oral antimicrobial option for this patient is:
A. clarithromycin
B. levofloxacin
C. amoxicillin
D. cefadroxil
A

B. levofloxacin

30
Q 
Which of the following is absent in otitis media with effusion?
A. fluid in the middle ear
B. otalgia
C. fever
D. itch
A

C. fever

31
Q 
treatment of otitis media with effusion usually includes
A. symptomatic treatment
B. antimicrobial therapy
C. an antihistamine
D. a mucolytic
A

A. symptomatic treatment

32
Q 
an 18 year old woman has a chief c/o a "sore throat and swollen glands" for the past 3 days.  Her PE includes a temperature of 101, exudative pharyngitis, and tender anterior cervical lymphadenopathy.  Right and left upper quadrant abdominal tenderness is present.  The most likely diagnosis is:
A. Strep pyogenes pharyngitis (GABHS)
B. infectious mononucleosis
C. viral pharyngitis
C. Vincent angina
A

A. GABHS

33
Q 
Treatment options for strept throat for a patient with a pencillin allergy include all of the following except;
a. azithromycin
B. Bactrim
C. clarithromycin
D. clindamycin
A

B. Bactrim

34
Q 
A 26 year old man presents with a progressively worsening sore throat with dysphagia, trismus and unilateral otalgia.  His voice is muffled and exam reveals an erythematous, swollen tonsils with contralateral uvular deviation.  The most likely diagnosis is
A. infectious mono
B. viral pharyngitis
C. peritonsillar abscess
D. early stage scarlet fever
A

C. peritonsillar abscess

35
Q 
The symptoms of rheumatic fever include:
A. severe, intermittent headaches
B. carditis and arthritis
C. hepatic dysfunction
D. generalized rash
A

B. carditis and arthritis

36
Q 
The rash associated with scarlet fever typically occurs how long after the start of symptomatic infection?
A. 2 days
B. 4 days
C. 7-10 days
D. 2-3 weeks
A

A. 2 days

37
Q

Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis?
A. upper respiratory tract infection symptoms persisting beyond 7-10 days
B. mild mid facial fullness and tenderness
C. preauricular lymphadenopathy
D. marked eyelid edema

A

A. URI symptoms persisting beyond 7-10 days

38
Q 
The most common causative bacterial pathogen in ABRS in a 40 year old adult is;
A. M pneumonia
B. S pneumonia
C. M. catarrhalis
D. E. coli
A

B. S. pneumoniae

39
Q 
Which of the following is the first line therapy for the treatment of ABRS in an adult with no recent antimicrobial use?
A. amoxicillin-clavulanate
B. Bactrim
C. clarithromycin
D. moxifloxacin
A

A. Augmentin

40
Q

A 45 year old with severe ABRS has shown no clinical improvement after a total of 10 days of antimicrobial therapy. Initially treated with doxycycline for 5 days, then switched to levofloxacin for past 5 days. This is his 3rd episode of ABRS in the past 6 months. You consider;
A. initiating a course of oral corticosteroid
B. switching treatment to moxifloxacin
C. prompt referral for sinus imaging with CT scan
D. discontinuing antimicrobial therapy, performing a nasal swab for culture and sensitivity, and treatment dependent on the results

A

C. prompt referral for CT scan

41
Q 
According to the latest evidence, all of the following have demonstrated efficacy in relieving symptoms of ABRS except:
A. saline nasal spray
b. nasal corticosteroid
C. oral decongestant
D. acetaminophen
A

C. oral decongestant.

42
Q

Double sickening is define as (choose all that apply)
A. nasal discharge progressing from clear to purulent to clear without antibiotic use
B. acute worsening of respiratory symptoms
C. new fever occurring 6-7 days after signs of URI
D. persistent cough

A

B and C

43
Q 
Which of the following is the most prudent first line treatment choice for an otherwise well toddler with AOM who requires antibiotics
A. ceftibuten
B. amoxicillin
C. cefuroxime
D. azithromycin
A

B. amoxicillin

44
Q

Which of the following does no represent a risk factor for recurrent AOM in younger children?
A. pacifier use after age 10 months
B. history of first episode of AOM before age 3 months
C. exposure to second hand smoke
D. beta lactam allergy

A

D. beta lactam allergy

45
Q 
The main risk factor for AOM in infants is
A. undiagnosed dairy allergy
B. Eustachian tube dysfunction
C. cigarette smoke exposure
D. use of soy based infant formula
A

B. Eustachian tube dysfunction

46
Q

A 3 year old boy with AOM continues to have otalgia and fever >102 after 3 days of Augmentin therapy Which of the following is recommended
A. watch and wait while using analgesics
B. start antibiotics with oral azithromycin
C. initiate therapy with oral clindamycin
D. administer IM ceftriaxone

A

D. administer IM ceftriaxone

47
Q 
Which of the following must be present for the diagnosis of AOM? More than one can apply
A. bulging of the TM
B. TM retraction
C. otalgia
D. anterior cervical lymphadenopathy
A

A and C

48
Q

The following criteria should be met for a child to be treated for AOM with observation and analgesia but no antibiotics (choose all that apply)
A. age greater than 6 months
B. bilateral infection
C. moderate illness
D. presumptively caused by bacterial infection

A

A and C

NURP 503 Exam 2' (23 decks)

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