Nose Mouth and Throat disorders Flashcards
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
B) Less than 4 weeks
Which of the following is a common cause of sinusitis?
A) Fungal
B) Bacterial
C) Viral
D) All of the above
D) All of the above
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
C) Prolonged inflammation with repeated or inadequately treated acute infection lasting more than 12 weeks
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) URI for at least 7 days with two or more symptoms
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
C) Drinking alcohol
What is the first-line antibiotic treatment for acute bacterial sinusitis?
A) Azithromycin
B) Amoxicillin
C) Ciprofloxacin
D) Erythromycin
B) Amoxicillin
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
B) For allergic sinusitis
Which of the following is a symptom of sinusitis?
A) Abdominal pain
B) Headache when bending down
C) Swollen feet
D) Chest pain
B) Headache when bending down
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
B) Sinus irrigation with saline
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
D) Sinus aspiration and culture
What is a common complication of untreated sinusitis?
A) Diabetes
B) Cavernous sinus thrombosis
C) Hypertension
D) Liver disease
B) Cavernous sinus thrombosis
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
B) ABRS involves purulent nasal discharge and poor response to decongestants
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
B) 3-6 weeks
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
D) All of the above
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) Smoking
Which of the following is a common cause of allergic rhinitis?
A) Seasonal allergens
B) Bacterial infection
C) Hormonal changes
D) Environmental irritant
A) Seasonal allergens
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
Answer: C) Itching of the nose, eyes, or throat
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
Answer: B) Clear or purulent nasal discharge
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
Answer: B) Stopping the offending medication
What is the primary cause of rhinitis medicamentosa?
A) Seasonal allergens
B) Overuse of topical nasal decongestants
C) Hormonal changes
D) Viral infection
: B) Overuse of topical nasal decongestants
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
Answer: D) Mupirocin ointment
What is the best management strategy for vasomotor rhinitis?
A) Hydration
B) Trigger avoidance and symptom management
C) Antibiotics
D) Mupirocin ointment
Answer:
B) Trigger avoidance and symptom management
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
Answer: B) Clear nasal discharge
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
Answer: B) Dry, crusty nasal mucosa with foul odor
What is the treatment for hormonal rhinitis?
A) Supportive care and medication adjustment
B) Intranasal steroids
C) Mupirocin ointment
D) Leukotriene receptor antagonists
Answer: A) Supportive care and medication adjustment
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
Answer: B) Stop the offending medication, intranasal or systemic steroids
Which of the following is a cause of vasomotor rhinitis?
A) Seasonal allergens
B) Hormonal changes
C) Environmental irritants
D) Chronic nasal inflammation
Answer: C) Environmental irritants
What is the primary treatment for viral rhinitis?
A) Intranasal steroids
B) Supportive care
C) Leukotriene receptor antagonists
D) Antibiotics
Answer: B) Supportive care
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
Answer: B) Pale, boggy nasal mucosa
Which of the following treatments is recommended for allergic rhinitis?
A) Antibiotics
B) Trigger avoidance
C) Mupirocin ointment
D) Hydration
B) Trigger avoidance
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
Answer: C) Sneezing or blowing the nose
What is a potential complication of posterior nasal packing?
A) Headache
B) Infection
C) Increased nasal congestion
D) Dry nasal mucosa
Answer: B) Infection
Which medication should be reconsidered in patients with frequent epistaxis?
A) Acetaminophen
B) Anticoagulants
C) Antibiotics
D) Antihistamines
Answer: B) Anticoagulants
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) Use of vasoconstrictor agents like Afrin
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
Answer: B) The next day
What is a common symptom of posterior nosebleeds?
A) Lightheadedness
B) Blood extending into the pharynx
C) Rapid heartbeat
D) Dried blood in nares
Answer: B) Blood extending into the pharynx
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
Answer: A) Avoiding nasal trauma
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
Answer: B) Anterior nasal packing
What is a common symptom of an anterior nosebleed?
A) Hemoptysis
B) Blood in the pharynx
C) Dried blood in the nares
D) Hematemesis
Answer: C) Dried blood in the nares
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
Answer: B) Firm, continuous pressure on the nose
What is the primary cause of epistaxis?
A) Bacterial infection
B) Trauma to the nasal mucosa
C) Fungal infection
D) Viral infection
Answer: B) Trauma to the nasal mucosa
What is the primary treatment for nicotinic stomatitis?
A) Antifungals
B) Antibiotics
C) Smoking cessation
D) Antivirals
Answer: C) Smoking cessation
Which type of stomatitis is often associated with ill-fitting dentures?
A) Vincent stomatitis
B) Denture-related stomatitis
C) Pseudomembranous stomatitis
D) Allergic stomatitis
Answer: B) Denture-related stomatitis
What is another name for Vincent stomatitis?
A) Black hairy tongue
B) Smoker’s palate
C) Angular cheilitis
D) Trench mouth
Answer: D) Trench mouth
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
Answer: C) Allergic stomatitis
What is a common risk factor for pseudomembranous stomatitis?
A) Excessive alcohol consumption
B) Smoking
C) Frequent use of antibiotics
D) Allergic reactions
Answer: B) Smoking
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
Answer: A) Herpes simplex
What is the main risk factor for angular stomatitis?
A) Poor oral hygiene
B) Nutritional deficiencies
C) Secondary infection
D) Allergies
Answer: C) Secondary infection
What is a general treatment recommendation for all types of stomatitis?
A) Antibiotics
B) Liquid diet
C) Antivirals
D) Antifungals
Answer: B) Liquid diet
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
Answer: B) Oral candidiasis
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
Answer: B) Painful, shallow gray lesions
What is the common cause of Vincent stomatitis (trench mouth)?
A) Viral infection
B) Fuso-spirochetal infection
C) Allergic reaction
D) Nutritional deficiency
Answer: B) Fuso-spirochetal infection
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
Answer: C) Removal of risk factors and good oral hygiene
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
Answer: B) Vincent stomatitis
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
Answer: C) Nicotinic stomatitis
What can cause pseudomembranous stomatitis (black hairy tongue)?
A) Viral infections
B) Use of bismuth-containing medications
C) Smoking
D) All of the above
Answer: D) All of the above
What is a common cause of aphthous ulcers (canker sores)?
A) Smoking
B) Nutritional deficiencies
C) Antibiotic use
D) Fuso-spirochetal infection
Answer: B) Nutritional deficiencies
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
Answer: A) Oral candidiasis
What is the primary cause of aphthous ulcers?
A) Bacterial infection
B) Nutritional deficiencies
C) Viral infection
D) Fungal infection
Answer: B) Nutritional deficiencies
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
Answer: C) Group A beta-hemolytic streptococcus (GABHS)
Which of the following viruses is a common cause of pharyngitis?
A) Epstein-Barr virus
B) Streptococcus pyogenes
C) Neisseria gonorrhea
D) Haemophilus influenza
Answer: A) Epstein-Barr virus
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
Answer: C) Neisseria gonorrhea
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
Answer: B) 3
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
Answer: A) 0
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
Answer: A) Do not test or treat
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
Answer: B) Check rapid strep test; send culture if negative
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
Answer: B) Send culture and treat empirically
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
Answer: C) Penicillin V potassium (PenVK)
Which of the following is NOT typically a cause of viral pharyngitis?
A) Rhinovirus
B) Influenza virus
C) Streptococcus pyogenes
D) Adenovirus
Answer: C) Streptococcus pyogenes
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
Answer: C) 10 days
Which supportive care measure is recommended for patients with pharyngitis?
A) Warm saltwater gargles
B) Cold compresses
C) Avoiding fluids
D) Taking diuretics
Answer: A) Warm saltwater gargles
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
Answer: A) Sneezing and blowing the nose
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
Answer: D) All of the above
What infection is caused by Chlamydia pneumoniae?
A) Viral pharyngitis
B) Bacterial pharyngitis
C) Fungal pharyngitis
D) Parasitic pharyngitis
Answer: B) Bacterial pharyngitis
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
Answer: B) When the sore throat begins and when antibiotics are completed
What is the primary cause of mononucleosis in 90% of cases?
A) Cytomegalovirus (CMV)
B) Epstein-Barr virus (EBV)
C) Rhinovirus
D) Influenza virus
B) Epstein-Barr virus (EBV)
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
Answer: A) Acute post-streptococcal glomerulonephritis
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
Answer: B) Warm compresses to enlarged, tender cervical nodes
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
Answer: B) After 2-3 days
Which other virus, apart from Epstein-Barr virus, can cause mononucleosis?
A) Adenovirus
B) Cytomegalovirus (CMV)
C) Herpes simplex virus
D) Varicella-zoster virus
Answer: B) Cytomegalovirus (CMV)
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
Answer: B) Immediate referral to the emergency department
Which diagnostic test is used in-office to diagnose mononucleosis?
A) Rapid strep test
B) Monospot test
C) Throat culture
D) CT scan
Answer: B) Monospot test
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
Answer: B) Tender adenopathy
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
Answer: B) It can irritate the liver
Which of the following is a common physical finding in mononucleosis patients?
A) Jaundice
B) Hepatomegaly
C) Bradycardia
D) Hypertension
Answer: B) Hepatomegaly
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
Answer: C) Guillain-Barré syndrome, myocarditis, or glomerulonephritis
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
Answer: B) Recovery may take 1-3 months to reach baseline activity level
How long should a patient with mononucleosis avoid contact sports?
A) 1 week
B) 2 weeks
C) 3 weeks
D) 4 weeks
Answer: D) 4 weeks
Which medication can be used for severe oral swelling in mononucleosis?
A) NSAIDs
B) Antibiotics
C) Steroids (e.g., prednisone)
D) Antivirals
Answer: C) Steroids (e.g., prednisone)
What is the mainstay of treatment for infectious mononucleosis?
A) Antivirals
B) Antibiotics
C) Symptom control and rest
D) Surgery
Answer: C) Symptom control and rest
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
Answer: B) CMV IgG
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
Answer: B) Increased lymphocytes with 10% atypical lymphocytes
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
Answer: B) Perform a monospot test
Which symptom is NOT commonly associated with mononucleosis?
A) Sore throat
B) Fever
C) Rash
D) Chest pain
Answer: D) Chest pain
