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Nose Mouth and Throat disorders Flashcards

1
Q

What is the duration of acute sinusitis?

A) Less than 2 weeks
B) Less than 4 weeks
C) 4 to 12 weeks
D) More than 12 weeks

A

B) Less than 4 weeks

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2
Q

Which of the following is a common cause of sinusitis?

A) Fungal
B) Bacterial
C) Viral
D) All of the above

A

D) All of the above

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2
Q

What are the symptoms of chronic sinusitis?

A) Abrupt onset, lasting less than 4 weeks
B) Persistent nasal discharge lasting 4 to 12 weeks
C) Prolonged inflammation with repeated or inadequately treated acute infection lasting more than 12 weeks
D) None of the above

A

C) Prolonged inflammation with repeated or inadequately treated acute infection lasting more than 12 weeks

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3
Q

What are the diagnostic criteria for sinusitis?

A) URI for at least 7 days with two or more symptoms
B) Fever for at least 7 days with one symptom
C) URI for 3 days with one symptom
D) Fever for 3 days with two symptoms

A

A) URI for at least 7 days with two or more symptoms

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4
Q

Which of the following is not a risk factor for sinusitis?

A) Viral URI
B) Smoking
C) Drinking alcohol
D) Exposure to cold/damp weather

A

C) Drinking alcohol

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5
Q

What is the first-line antibiotic treatment for acute bacterial sinusitis?

A) Azithromycin
B) Amoxicillin
C) Ciprofloxacin
D) Erythromycin

A

B) Amoxicillin

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6
Q

When should you refer a patient with sinusitis to an allergist?

A) For acute sinusitis
B) For allergic sinusitis
C) For bacterial sinusitis
D) For fungal sinusitis

A

B) For allergic sinusitis

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7
Q

Which of the following is a symptom of sinusitis?

A) Abdominal pain
B) Headache when bending down
C) Swollen feet
D) Chest pain

A

B) Headache when bending down

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8
Q

Which non-pharmacologic treatment can help with sinusitis symptoms?

A) Cold packs
B) Sinus irrigation with saline
C) Taking hot showers
D) All of the above

A

B) Sinus irrigation with saline

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9
Q

Which diagnostic test is rarely needed for sinusitis but can be considered for severe cases?

A) MRI
B) X-ray
C) CT scan
D) Sinus aspiration and culture

A

D) Sinus aspiration and culture

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9
Q

What is a common complication of untreated sinusitis?

A) Diabetes
B) Cavernous sinus thrombosis
C) Hypertension
D) Liver disease

A

B) Cavernous sinus thrombosis

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10
Q

What is a key difference between acute viral rhinosinusitis (AVRS) and acute bacterial rhinosinusitis (ABRS)?

A) AVRS lasts more than 12 weeks
B) ABRS involves purulent nasal discharge and poor response to decongestants
C) AVRS always requires antibiotics
D) ABRS does not involve sinus pain

A

B) ABRS involves purulent nasal discharge and poor response to decongestants

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11
Q

For subacute sinusitis, what is the recommended duration for antibiotic treatment?

A) 5-7 days
B) 3-6 weeks
C) 10-14 days
D) 1-2 weeks

A

B) 3-6 weeks

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12
Q

What should be included in patient education for managing sinusitis at home?

A) Avoid contact with contributing factors
B) Use a cool-mist humidifier
C) Drink plenty of fluids
D) All of the above

A

D) All of the above

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13
Q

Which of the following should be avoided to prevent sinusitis?

A) Smoking
B) Using a humidifier
C) Drinking plenty of fluids
D) Using nasal saline spray

A

A) Smoking

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14
Q

Which of the following is a common cause of allergic rhinitis?

A) Seasonal allergens
B) Bacterial infection
C) Hormonal changes
D) Environmental irritant

A

A) Seasonal allergens

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15
Q

What symptom distinguishes allergic rhinitis from other types of rhinitis?

A) Nasal congestion
B) Clear nasal discharge
C) Itching of the nose, eyes, or throat
D) Headache

A

Answer: C) Itching of the nose, eyes, or throat

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16
Q

What is a common symptom of viral rhinitis?

A) Foul odor
B) Clear or purulent nasal discharge
C) Itching of the nose
D) Dry, crusty nasal mucosa

A

Answer: B) Clear or purulent nasal discharge

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17
Q

What is the first step in managing rhinitis medicamentosa?

A) Use of intranasal steroids
B) Stopping the offending medication
C) Starting antibiotics
D) Trigger avoidance

A

Answer: B) Stopping the offending medication

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18
Q

What is the primary cause of rhinitis medicamentosa?

A) Seasonal allergens
B) Overuse of topical nasal decongestants
C) Hormonal changes
D) Viral infection

A

: B) Overuse of topical nasal decongestants

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19
Q

Which medication is not recommended for the treatment of allergic rhinitis?

A) Intranasal steroids
B) New generation oral antihistamines
C) Leukotriene receptor antagonists
D) Mupirocin ointment

A

Answer: D) Mupirocin ointment

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20
Q

What is the best management strategy for vasomotor rhinitis?

A) Hydration
B) Trigger avoidance and symptom management
C) Antibiotics
D) Mupirocin ointment
Answer:

A

B) Trigger avoidance and symptom management

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21
Q

Which of the following is a symptom of non-allergic vasomotor rhinitis?

A) Itching of the nose, eyes, or throat
B) Clear nasal discharge
C) Purulent nasal discharge
D) Foul odor

A

Answer: B) Clear nasal discharge

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22
Q

What is a common finding in atrophic rhinitis?

A) Pale, boggy nasal mucosa
B) Dry, crusty nasal mucosa with foul odor
C) Red, swollen nasal mucosa

A

Answer: B) Dry, crusty nasal mucosa with foul odor

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23
Q

What is the treatment for hormonal rhinitis?

A) Supportive care and medication adjustment
B) Intranasal steroids
C) Mupirocin ointment
D) Leukotriene receptor antagonists

A

Answer: A) Supportive care and medication adjustment

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24
Q

What is the recommended treatment for rhinitis medicamentosa?

A) Continue the offending medication
B) Stop the offending medication, intranasal or systemic steroids
C) Mupirocin ointment intranasal
D) Oral antihistamines

A

Answer: B) Stop the offending medication, intranasal or systemic steroids

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24
Q

Which of the following is a cause of vasomotor rhinitis?

A) Seasonal allergens
B) Hormonal changes
C) Environmental irritants
D) Chronic nasal inflammation

A

Answer: C) Environmental irritants

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25
Q

What is the primary treatment for viral rhinitis?

A) Intranasal steroids
B) Supportive care
C) Leukotriene receptor antagonists
D) Antibiotics

A

Answer: B) Supportive care

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26
Q

What is a typical exam finding for allergic rhinitis?

A) Red, swollen nasal mucosa
B) Pale, boggy nasal mucosa
C) Dry, crusty nasal mucosa
D) Nasal congestion without discharge

A

Answer: B) Pale, boggy nasal mucosa

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27
Q

Which of the following treatments is recommended for allergic rhinitis?

A) Antibiotics
B) Trigger avoidance
C) Mupirocin ointment
D) Hydration

A

B) Trigger avoidance

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28
Q

Which activity should be avoided for 12 hours after an epistaxis episode?

A) Eating
B) Drinking water
C) Sneezing or blowing the nose
D) Walking

A

Answer: C) Sneezing or blowing the nose

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29
Q

What is a potential complication of posterior nasal packing?

A) Headache
B) Infection
C) Increased nasal congestion
D) Dry nasal mucosa

A

Answer: B) Infection

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30
Q

Which medication should be reconsidered in patients with frequent epistaxis?

A) Acetaminophen
B) Anticoagulants
C) Antibiotics
D) Antihistamines

A

Answer: B) Anticoagulants

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30
Q

What should be done for recurrent minor anterior nosebleeds?

A) Use of vasoconstrictor agents like Afrin
B) Ice pack application
C) Posterior nasal packing
D) Immediate referral to ENT

A

A) Use of vasoconstrictor agents like Afrin

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31
Q

When should a patient with nasal packing follow up?

A) After one week
B) The next day
C) After two weeks
D) Only if symptoms worsen

A

Answer: B) The next day

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32
Q

What is a common symptom of posterior nosebleeds?

A) Lightheadedness
B) Blood extending into the pharynx
C) Rapid heartbeat
D) Dried blood in nares

A

Answer: B) Blood extending into the pharynx

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33
Q

Which of the following is a recommended prevention method for epistaxis?

A) Avoiding nasal trauma
B) Frequent nasal irrigation
C) Using antibiotics
D) Regular use of nasal decongestants

A

Answer: A) Avoiding nasal trauma

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34
Q

Which treatment is recommended for severe anterior nosebleeds?

A) Application of ice pack
B) Anterior nasal packing
C) Vasoconstrictor agents only
D) Sitting upright with head tilted forward

A

Answer: B) Anterior nasal packing

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35
Q

What is a common symptom of an anterior nosebleed?

A) Hemoptysis
B) Blood in the pharynx
C) Dried blood in the nares
D) Hematemesis

A

Answer: C) Dried blood in the nares

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36
Q

What is the first step in managing an acute minor anterior nosebleed?

A) Use of vasoconstrictor agents
B) Firm, continuous pressure on the nose
C) Chemical cauterization
D) Nasal packing

A

Answer: B) Firm, continuous pressure on the nose

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37
Q

What is the primary cause of epistaxis?

A) Bacterial infection
B) Trauma to the nasal mucosa
C) Fungal infection
D) Viral infection

A

Answer: B) Trauma to the nasal mucosa

38
Q

What is the primary treatment for nicotinic stomatitis?

A) Antifungals
B) Antibiotics
C) Smoking cessation
D) Antivirals

A

Answer: C) Smoking cessation

39
Q

Which type of stomatitis is often associated with ill-fitting dentures?

A) Vincent stomatitis
B) Denture-related stomatitis
C) Pseudomembranous stomatitis
D) Allergic stomatitis

A

Answer: B) Denture-related stomatitis

40
Q

What is another name for Vincent stomatitis?

A) Black hairy tongue
B) Smoker’s palate
C) Angular cheilitis
D) Trench mouth

A

Answer: D) Trench mouth

41
Q

Which stomatitis condition can be caused by the use of retainers or mouth guards?

A) Aphthous ulcers
B) Oral candidiasis
C) Allergic stomatitis
D) Vincent stomatitis

A

Answer: C) Allergic stomatitis

42
Q

What is a common risk factor for pseudomembranous stomatitis?

A) Excessive alcohol consumption
B) Smoking
C) Frequent use of antibiotics
D) Allergic reactions

A

Answer: B) Smoking

43
Q

Which condition is characterized by groups of vesicles that become painful and crust over?

A) Herpes simplex
B) Aphthous ulcers
C) Vincent stomatitis
D) Nicotinic stomatitis

A

Answer: A) Herpes simplex

44
Q

What is the main risk factor for angular stomatitis?

A) Poor oral hygiene
B) Nutritional deficiencies
C) Secondary infection
D) Allergies

A

Answer: C) Secondary infection

45
Q

What is a general treatment recommendation for all types of stomatitis?

A) Antibiotics
B) Liquid diet
C) Antivirals
D) Antifungals

A

Answer: B) Liquid diet

46
Q

Which type of stomatitis is often linked to antibiotic use and elevated blood sugars?

A) Aphthous ulcers
B) Oral candidiasis
C) Nicotinic stomatitis
D) Angular stomatitis

A

Answer: B) Oral candidiasis

47
Q

What is the primary symptom of aphthous ulcers?

A) Itching
B) Painful, shallow gray lesions
C) White plaque on the mucosa
D) Red and swollen gums

A

Answer: B) Painful, shallow gray lesions

48
Q

What is the common cause of Vincent stomatitis (trench mouth)?

A) Viral infection
B) Fuso-spirochetal infection
C) Allergic reaction
D) Nutritional deficiency

A

Answer: B) Fuso-spirochetal infection

49
Q

What is the best initial management for pseudomembranous stomatitis (black hairy tongue)?

A) Systemic antibiotics
B) Antiviral medication
C) Removal of risk factors and good oral hygiene
D) Application of antifungal ointment

A

Answer: C) Removal of risk factors and good oral hygiene

50
Q

Which type of stomatitis is commonly caused by secondary bacterial infections due to poor oral hygiene?

A) Aphthous ulcers
B) Vincent stomatitis
C) Angular stomatitis
D) Oral candidiasis

A

Answer: B) Vincent stomatitis

51
Q

What condition is often caused by smoking and presents with a speckled white and red appearance on the palate?

A) Angular stomatitis
B) Vincent stomatitis
C) Nicotinic stomatitis
D) Aphthous ulcers

A

Answer: C) Nicotinic stomatitis

52
Q

What can cause pseudomembranous stomatitis (black hairy tongue)?

A) Viral infections
B) Use of bismuth-containing medications
C) Smoking
D) All of the above

A

Answer: D) All of the above

53
Q

What is a common cause of aphthous ulcers (canker sores)?

A) Smoking
B) Nutritional deficiencies
C) Antibiotic use
D) Fuso-spirochetal infection

A

Answer: B) Nutritional deficiencies

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60
Q

Which condition is characterized by white plaque that can be scraped off, revealing erythematous mucosa?

A) Oral candidiasis
B) Herpes simplex
C) Angular stomatitis
D) Vincent stomatitis

A

Answer: A) Oral candidiasis

61
Q

What is the primary cause of aphthous ulcers?

A) Bacterial infection
B) Nutritional deficiencies
C) Viral infection
D) Fungal infection

A

Answer: B) Nutritional deficiencies

62
Q

What is the most common bacterial cause of pharyngitis?

A) Haemophilus influenza
B) Mycoplasma pneumonia
C) Group A beta-hemolytic streptococcus (GABHS)
D) Neisseria gonorrhea

A

Answer: C) Group A beta-hemolytic streptococcus (GABHS)

63
Q

Which of the following viruses is a common cause of pharyngitis?

A) Epstein-Barr virus
B) Streptococcus pyogenes
C) Neisseria gonorrhea
D) Haemophilus influenza

A

Answer: A) Epstein-Barr virus

64
Q

Which of the following is a sexually transmitted infection that can cause pharyngitis?

A) Epstein-Barr virus
B) Rhinovirus
C) Neisseria gonorrhea
D) Mycoplasma pneumonia

A

Answer: C) Neisseria gonorrhea

65
Q

What is the score for a 16-year-old patient with fever > 100.5°F, tonsillar exudate, and absence of cough?

A) 2
B) 3
C) 4
D) 5

A

Answer: B) 3

66
Q

A patient over 45 years old has tender anterior cervical lymphadenopathy and absence of cough. What is their score according to the diagnosis criteria?

A) 0
B) 1
C) 2
D) 3

A

Answer: A) 0

67
Q

Which of the following actions is appropriate for a patient with a diagnosis score of 1?

A) Do not test or treat
B) Check rapid strep test and send culture if negative
C) Treat empirically with antibiotics
D) Immediate referral to ENT

A

Answer: A) Do not test or treat

68
Q

What is the appropriate action for a patient with a score of 2-3 according to the diagnosis criteria for pharyngitis?

A) Do not test or treat
B) Check rapid strep test; send culture if negative
C) Treat empirically with antibiotics
D) Immediate referral to ENT

A

Answer: B) Check rapid strep test; send culture if negative

69
Q

For a patient with a score of 3+ who tests negative on a rapid strep test, what is the next step?

A) Do not treat
B) Send culture and treat empirically
C) Immediate referral to ENT

A

Answer: B) Send culture and treat empirically

70
Q

Treatment of Pharyngitis/Tonsillitis
What is the first-line antibiotic treatment for Group A strep pharyngitis?

A) Azithromycin
B) Amoxicillin
C) Penicillin V potassium (PenVK)
D) Ciprofloxacin

A

Answer: C) Penicillin V potassium (PenVK)

71
Q

Which of the following is NOT typically a cause of viral pharyngitis?

A) Rhinovirus
B) Influenza virus
C) Streptococcus pyogenes
D) Adenovirus

A

Answer: C) Streptococcus pyogenes

72
Q

How long is the typical course of Penicillin V potassium (PenVK) for treating Group A strep pharyngitis?

A) 5 days
B) 7 days
C) 10 days
D) 14 days

A

Answer: C) 10 days

73
Q

Which supportive care measure is recommended for patients with pharyngitis?

A) Warm saltwater gargles
B) Cold compresses
C) Avoiding fluids
D) Taking diuretics

A

Answer: A) Warm saltwater gargles

74
Q

What should be avoided for 12 hours after managing a nosebleed to prevent further irritation?

A) Sneezing and blowing the nose
B) Drinking fluids
C) Using nasal decongestants
D) Eating solid foods

A

Answer: A) Sneezing and blowing the nose

75
Q

In what situation is referral to ENT indicated for a patient with pharyngitis?

A) Severe anterior bleeds
B) Posterior bleeds
C) Recurrent bleeds
D) All of the above

A

Answer: D) All of the above

75
Q

What infection is caused by Chlamydia pneumoniae?

A) Viral pharyngitis
B) Bacterial pharyngitis
C) Fungal pharyngitis
D) Parasitic pharyngitis

A

Answer: B) Bacterial pharyngitis

76
Q

How long should patients with pharyngitis wait before replacing their toothbrush?

A) After 1 day of antibiotics
B) When the sore throat begins and when antibiotics are completed
C) When the sore throat begins
D) When antibiotics are completed

A

Answer: B) When the sore throat begins and when antibiotics are completed

77
Q

What is the primary cause of mononucleosis in 90% of cases?

A) Cytomegalovirus (CMV)
B) Epstein-Barr virus (EBV)
C) Rhinovirus
D) Influenza virus

A

B) Epstein-Barr virus (EBV)

78
Q

Which complication should patients with pharyngitis be educated about that might present with reddish, tea-colored urine 2-3 weeks post-infection?

A) Acute post-streptococcal glomerulonephritis
B) Rheumatic fever
C) Peritonsillar abscess
D) Epiglottitis

A

Answer: A) Acute post-streptococcal glomerulonephritis

78
Q

What patient education should be provided to someone with pharyngitis to manage their condition effectively?

A) Avoid drinking fluids
B) Warm compresses to enlarged, tender cervical nodes
C) Avoid taking antibiotics
D) Use diuretics regularly

A

Answer: B) Warm compresses to enlarged, tender cervical nodes

79
Q

For a patient with pharyngitis, when should they call their healthcare provider if symptoms do not improve?

A) After 1 day
B) After 2-3 days
C) After 5 days
D) After 1 week

A

Answer: B) After 2-3 days

80
Q

Which other virus, apart from Epstein-Barr virus, can cause mononucleosis?

A) Adenovirus
B) Cytomegalovirus (CMV)
C) Herpes simplex virus
D) Varicella-zoster virus

A

Answer: B) Cytomegalovirus (CMV)

81
Q

Which follow-up measure is recommended for a patient with severe pharyngitis and concern for airway obstruction?

A) Call the healthcare provider after 2-3 days
B) Immediate referral to the emergency department
C) Regular check-up in 2 weeks
D) Take over-the-counter pain medication

A

Answer: B) Immediate referral to the emergency department

82
Q

Which diagnostic test is used in-office to diagnose mononucleosis?

A) Rapid strep test
B) Monospot test
C) Throat culture
D) CT scan

A

Answer: B) Monospot test

83
Q

What is a typical finding in the posterior cervical region during a physical exam of a patient with mononucleosis?

A) Petechiae
B) Tender adenopathy
C) Erythema
D) Lesions

A

Answer: B) Tender adenopathy

84
Q

Why should patients with mononucleosis avoid alcohol?

A) It can interact with medications
B) It can irritate the liver
C) It can cause dehydration
D) It can worsen fever

A

Answer: B) It can irritate the liver

85
Q

Which of the following is a common physical finding in mononucleosis patients?

A) Jaundice
B) Hepatomegaly
C) Bradycardia
D) Hypertension

A

Answer: B) Hepatomegaly

86
Q

Which complications should prompt a follow-up referral to a specialist?

A) Severe headache
B) Persistent cough
C) Guillain-Barré syndrome, myocarditis, or glomerulonephritis
D) Mild fatigue

A

Answer: C) Guillain-Barré syndrome, myocarditis, or glomerulonephritis

87
Q

When educating a patient about mononucleosis, which of the following should be emphasized regarding recovery time?

A) Recovery usually takes 1-2 weeks
B) Recovery may take 1-3 months to reach baseline activity level
C) Recovery is immediate after fever subsides
D) Recovery requires hospitalization

A

Answer: B) Recovery may take 1-3 months to reach baseline activity level

88
Q

How long should a patient with mononucleosis avoid contact sports?

A) 1 week
B) 2 weeks
C) 3 weeks
D) 4 weeks

A

Answer: D) 4 weeks

89
Q

Which medication can be used for severe oral swelling in mononucleosis?

A) NSAIDs
B) Antibiotics
C) Steroids (e.g., prednisone)
D) Antivirals

A

Answer: C) Steroids (e.g., prednisone)

90
Q

What is the mainstay of treatment for infectious mononucleosis?

A) Antivirals
B) Antibiotics
C) Symptom control and rest
D) Surgery

A

Answer: C) Symptom control and rest

91
Q

What additional diagnostic test would show a past CMV infection in a patient with mononucleosis-like symptoms?

A) EBV IgM
B) CMV IgG
C) Monospot test
D) Throat culture

A

Answer: B) CMV IgG

92
Q

Which lab finding is indicative of mononucleosis on a CBC with differential?

A) Elevated neutrophils
B) Increased lymphocytes with 10% atypical lymphocytes
C) Decreased red blood cells
D) Elevated eosinophils

A

Answer: B) Increased lymphocytes with 10% atypical lymphocytes

93
Q

What is the best initial step when a patient presents with suspected mononucleosis?

A) Start antibiotics immediately
B) Perform a monospot test
C) Order a CT scan
D) Recommend bed rest

A

Answer: B) Perform a monospot test

93
Q

Which symptom is NOT commonly associated with mononucleosis?

A) Sore throat
B) Fever
C) Rash
D) Chest pain

A

Answer: D) Chest pain

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