Head/Neck bugs

Question 1

What are the common causes of the common cold?

Answer 1

rhinovirus, coronavirus, parainfluenza virus, rsv, influenza virus, adenovirus, and human metapneumovirus

Question 2

What is the most common bacterial cause of pharyngitis?

Answer 2

Group A strep (strep pyogenes)

Question 3

What symptoms, if present with pharyngitis, suggest a viral etiology?

Answer 3

Cough and rhinorrhea

Question 4

What are the risks associated with untreated bacterial pharyngitis caused by GAS?

Answer 4

Peritonsillar abscesses, retropharyngeal abscesses, post-strep glomerulonephritis, acute rheumatic fever

Question 5

What are the symptoms of acute EBV infection?

Answer 5

Infectious mononucleosis: fever, lymphadenopathy, tonsillar pharyngitis

Question 6

What is the likely etiology of a generalized maculopapular rash after ampicillin or amoxicillin treatment?

Answer 6

EBV incorrectly treated with antibiotics leading to a reaction to the antibiotics

Question 7

What is the only fungal cause of pharyngitis?

Answer 7

Candidia

Question 8

What is the presentation of primary HSV-1 infection?

Answer 8

Gingivostomatitis, fever, malaise, headache, vesicles (that progress to ulcers), submandibular lymphadenopathy

Question 9

What disease presents with ulcers isolated to the soft palate and anterior pillars?

Answer 9

Hand, foot, and mouth disease (coxsackie A virus)

Question 10

What are the typical causes of epiglottitis?

Answer 10

Formerly haemophilus influenzae type B, now more often strep pneumo, strep pyogenes, and staph aureus

Question 11

What is lemierre syndrome?

Answer 11

A complication of bacterial pharyngitis/tonsillitis that involves extension of infection to the lateral pharyngeal spaces and internal jugular vein. Can lead to sepsis and death.

Question 12

What bacteria is most often the cause of lemierre syndrome?

Answer 12

Fusobacterium necrophorum

Question 13

What is the treatment of lemierre disease?

Answer 13

Beta-lactamase resistant beta-lactam antibiotic

Question 14

What is ludwig angina?

Answer 14

Life-threatening cellulitis of the soft tissue involving the floor of the mouth and neck.

Question 15

What is the likely etiology of ludwig angina?

Answer 15

Usually polymicrobial involving oral flora

Question 16

What are the common symptoms of ludwig angina?

Answer 16

Neck pain, swelling, dysphagia, “bull neck”

Question 17

What is cervicofacial actinomycosis?

Answer 17

A chronic odontogenic infection caused by actinomyces spp. that complicates tooth infection or gingivitis

Question 18

What is the most common viral cause of otitis media?

Answer 18

RSV, coronaviruses, influenza, adenovirus, human metapneumovirus, picornaviruses

Question 19

What are the most common bacterial causes of otitis media?

Answer 19

Strep pneumo, haemophilus influenzae, moraxella catarrhalis

Question 20

What is the mechanism of acute otitis media?

Answer 20

Edema obstructs the eustacian tube and leads to an increase in negative pressure of the middle ear and build up of mucosal secretions that feed bacterial growth

Question 21

What are common causes of otitis externa?

Answer 21

Pseudomonas aeruginosa, staph aureus

Question 22

What are common causes of acute sinusitis?

Answer 22

Viruses, strep pneumo, haemophilus influenzae

Question 23

What are common causes of chronic sinusitis?

Answer 23

Staph aureus, strep pneumo

Question 24

What are the most common causes of periorbital cellulitis?

Answer 24

Staph aureus, strep pneumo, strep pyogenes

Question 25

What is the presentation of periorbital cellulitis?

Answer 25

Erythema, edema, eyelid swelling, usually unilateral. Normally has motility and regular vision.

Question 26

What is the difference between periorbital and orbital cellulitis?

Answer 26

Orbital cellulitis is more serious and involves the muscle or fat within the orbit, not just the skin/soft tissue around the orbit

Question 27

What are the most common causes of orbital cellulitis?

Answer 27

Staph aureus, strep spp.

Question 28

What condition is rhino-orbital-cerebral mucormycosis associated with?

Answer 28

Diabetic ketoacidosis

Question 29

What are the JONES criteria?

Answer 29

Criteria for rheumatic fever. Joints (migratory polyarthritis), (<3) carditis, Nodules, Erythema marginatum, Syndenham’s chorea

Question 30

What species is group B streptococcus?

a) streptococcus gallolyticus
b) streptococcus dysgalactiae
c) streptococcus agalactiae
d) streptococcus milleri
e) streptococcus mutans

Answer 30

c) streptococcus agalactiae

Question 31

What cell is latently infected by EBV?

a) B-lymphocyte
b) T-lymphocyte
c) NK cell
d) endothelial cell

Answer 31

a) B-lymphocyte

Question 32

A 23 year-old woman presents with one week of fever, chills, and sore throat progressing to right-sided neck pain and then pleuritic chest pain and SOB. On exam she has right neck swelling and tenderness. Chest x-ray shows multiple nodular opacities. What bacteria is the likely cause of infection?

a) streptococcus pneumoniae
b) streptococcus pyogenes
c) haemophilus influenzae
d) fusobacterium necrophorum

Answer 32

d) fusobacterium necrophorum

Question 33

A 67 year-old male presents with jaw swelling for 2 days. He has been taking oral penicillin for a few days for an infected tooth. Now he can’t fully open his mouth and notices wheezing when he exhales. On exam he has audible stridor and sublingual and submandibular swelling. What is the likely cause of this infection?

a) clostridium tetani
b) mixed oropharyngeal flora
c) haemophilus influenzae
d) streptococcus pyogenes

Answer 33

b) mixed oropharyngeal flora