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PCMI Exam 2 > Upper Respiratory Exam > Flashcards

Upper Respiratory Exam Flashcards

1
Q
  • What are two possible diagoses in pt with a sore throat?
A
  • Strep
  • Viral/allergic etiology
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2
Q
  • What are two possible diagnoses for pt with an ear infection?
A
  • AOM (acute otitis media)
  • AOE (acute otitis externa)
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3
Q
  • What is the medical term for the common cold?
A
  • Acute rhinosinusitis
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4
Q
  • What are two common diagnoses in acute childhood upper respiratory illnesses?
A
  • Croup
  • Epiglottitis
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5
Q
  • What can cause dizziness?
A
  • Benign postional vertigo
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6
Q
  • Identify the labeled structures
A
  1. Sphenoid sinus
  2. Frontal sinus
  3. Ethmoid sinus
  4. Maxillary sinus
  5. Frontal sinus does not develop until age 8-10
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7
Q
  • What etiology is shown in the image below?
A
  • Tonsillar swelling
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8
Q
  • What etiology is shown in the image below?
A
  • Tonsillar swelling, erythema and exudate
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9
Q
  • What etiology is shown in the image below?
  • What is the common cause?
A
  • Cobblestoning of the posterior pharynx
  • Indicative of post nasal drainage (usually caused by allergic rhinitis) irritating the posterior pharynx
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10
Q
  • Identify the following anatomical landmarks in the mouth
A
  1. Gingiva
  2. Mucosa
  3. Posterior gingiva
  4. Buccal mucosa
  5. Vestibule
  6. Anterior Gingiva
  7. Mucosa
  8. Hard Palate
  9. Soft Palate
  10. Tonsillar Area
  11. Floor of mouth
  12. Ventral surface of tongue
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11
Q
  • Identify the anatomical components of the external ear
A
  • Top to bottom (Left)
    • Helix
    • Antihelix
    • Entrance to ear canal
  • Right side (Top to bottom)
    • Tragus
    • Lobule
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12
Q
  • When examining the external ear, check for _,_, and tenderness of the _
A

drainage, redness, tragus

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13
Q
  • How will otitis media present in ear exam?
A
  • Bulging TM with varyimg degree of erythema
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14
Q
  • Which lymph nodes should be assessed?
  • What is considered a “normal” lymph node?
A
  • **
  • Soft, round, mobile, non-tender
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15
Q

Pharyngitis

A
  • Inflammation of pharynx resulting in sore throat
  • Most likely cause:
    • Viral (Adenovirus, rhinovirus, coronaviruses, enteroviruses, influenza A and B, parainfluenze viruses, respiratory syncytial virus)
    • Bacterial (GABHS, Chlamydia, mycoplasma pneumoniae)
    • Common sx:
      • Coryza (inflamed mucus membrane)
      • Conjunctivitis
      • Malaise or fatigue
      • Hoarseness
      • Low grade fever
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16
Q
  • What are some differential diagnoses secondary to pharyngitis?
A
  • GERD
  • Postnasal drip secondary to rhinitis
  • Persistent cough
  • Thyroiditis
  • Allergies
  • Foreign body
  • Smoking
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17
Q
  • Streptococcal Pharyngitis
A
  • Group A beta-hemolytic strep (pyogenes)
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18
Q
  • Why will patient’s with sore throat sometimes report with nausea?
A
  • Pharynx right next to intrabdominal organs on homonculus
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19
Q
  • Highest likelihood of GABHS if…
A
  • 5-15 years old
  • Winter and early spring seasons
  • absence of cough
  • anterior cervical lymphadenopathy
  • tonsillar exudate
  • fever
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20
Q
  • Which scoring system do you use for managing treatment of sore throat?
A
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21
Q
  • What lab tests could you perform in pt with sore throat?
A
  • Rapid antigen detection test/rapid streptococcal antigen test
    • Detects presence of group A strep
  • Throat culture
    • Throat swab of posterior tonsillopharyngeal area and inoculated onto agar plate
  • Monospot test
    • Rapid slide test for mono
22
Q
  • What type of antibiotics could you give?
A
  • Antibiotics (Penicillin Class)
23
Q
  • What type of conservative management can be performed?
A

Conservative management

NSAIDs

Cough Drips

Chloraseptic sprays

24
Q

Acute otitis media

A

Symptomatic inflammation of the middle ear caused by bacteria or viruses

25
Q

Acute suppurative OM

A

Acute OM with purulent material in the middle ear

26
Q

OM w/ effusion (serous OM)

A

Inflammation and fluid buildup (effusion) in middle ear without infection

Can be d/t fluid buildup persisting after ear infection

May also occur b/c of dysfunction or noninfectious blockage of eustachain tubes

27
Q
  • Chronic OM with effusion
A
  • Fluid remains in middle ear and continues to return without infection
  • Makes children susceptible to new infections
  • May alter hearing
28
Q
  • Chronic suppurative otitis media
A
  • Persistent ear infection that results in perforation or tearing of the eardrum
29
Q
  • Otitis media can be caused by _
A
  • Bacteria entering small break in the skin
  • Small break in skin of the ear canal
30
Q
  • Ostosclerosis
A
  • Abnormal bone growth around stapes
  • Progessive hearing loss (10-30): 2 Types
    • 1) Conductive loss
      • Ossicle sclerosis
    • 2) Sensory loss
      • Otic capsule closes
31
Q
  • Where do you place the tuning fork in the weber test?
A

Midline

Weber’s test tests for lateralization

32
Q
  • With conductive loss, where does the hearing localize
  • With sensorineural loss, where does the hearing localize
A
  • Conductive=affected side
  • Sensorineural loss=side opposite affected ear
33
Q
  • Normal Rinne test _ conduction is greater than _ conduction
  • With conductive loss _ conduction is greater than _ conduction
A
  • Normal: Air > Bone
  • Conductive Loss: Bone > Air

Rinne test tests for air and bone conduction

34
Q
  • What are some causes of conductive hearing loss?
A
  • Cerumen impaction
  • Middle ear fluid
  • Lack of movement of the ossicles
  • Trauma
  • Tumor
35
Q
  • Causes of sensorineural hearing loss
A
  • Hereditary
  • Meniere Disease
  • MS
  • Trauma
  • Ototoxic Drugs
  • Barotrauma
36
Q
  • Rhinosinusitis/Sinusisis
A

Mucosal lining in paranasal sinuses and nasal cavity become inflamed

  • Causes
    • Viral:
      • Rhinovirus
      • Adenovirus
      • Influenza Virus
      • Parainfluenza Virus
    • Bacterial
      • Strep pneumoniae
      • Haemophilus influenzar
      • Moraxella catarrhalis
    • Dental infections
    • Iatrogenic causes
    • ID
    • Impaired ciliary motility
    • Mechanical obstruction
  • Sx:
    • Nasal discharge
    • Cough
    • Sneezing
    • Nasal COngestion
    • Fever
    • Headache
    • Pain
    • Facial pressure
  • No imaging or labs needed
37
Q
  • Bacterial sinusitis
A
  • Double sickening
  • Purulent rhinorrhea
  • Elevated ESR?
  • Indicated if sx of acute rhinosinusitis have not improved after ten days of onset of UR symptoms
  • TX
    • First line antibiotic
      • Amoxicillin
      • Augmentin
    • Second line antibiotic
      • Doxycycline
      • Levaquin
      • Clindamycin
      • Cefixime
38
Q
  • Croup/Laryngotracheitis
A
  • Swelling of larynx, trachea, bronchi causing inspiratory stridor and barking cough in children 6 mo to 3 yr of age
  • Causes
    • ​Parainfluenza virus
    • Respiratory syncytial virus
  • Presentation
    • ​Fever
    • Nasal Flaring
    • Respiratory Restrictractions
    • Stridor
  • Tx
    • ​O2
    • Dexmethasone
    • Nebulized Epi
39
Q
  • Epiglottitis
A
  • Inflammation of epiglottis and adjacent structures
  • Px:
    • high grade fever
    • toxic appearance
    • child sitting or leaning forward
  • Causes:
    • Hemophilus Type B Influenza
    • Group A Beta Hemolytic Strep
  • Hx:
    • Rapid onset of sx
    • Sore throat
    • Muffled Voice
    • Drooling
  • Workup : Lateral neck XR, WBC
  • Tx: Protect airway (intubate if needed) broad spectrum antibiotics
40
Q
  • Differential for ENT Causes of Vertigo
A
  • Eustachian Tube Dysfunction
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Vestibular Neuritis (Inflammation of the nerve)
  • Labrynthitis (Inflammation of the labyrinth)
  • Meniere’s Disease
41
Q
  • How do you dx BPPV?
  • How do you treat?
A
  • Dix-Hallpike Maneuver
  • Epley Maneuver
42
Q
  • What are aphthous ulcers?
A
  • Canker sores
43
Q
  • What is cheilitis
A
  • Red cracks at corners of mouth (usually d/t B12 or iron deficiency)
44
Q
  • What is gingivitis?
A
  • Swelling or ulcerations on the gums
45
Q
  • What is torus palantinus?
A
  • BENIGN LUMP ON HARD PALATE
46
Q
  • The _ connects lip with the gingiva
A
  • Labial frenulum
47
Q
  • The _ connects the tongue with the floor of the mouth
A
  • Lingual frenulum
48
Q

_ is the opening of the sublingual ducts on either side of the lingual frenulum

A
  • Sublingual caruncle
49
Q
  • What nerves control the soft palate?
  • What occurs with paralysis ?
A
  • CN IX and X
  • Uvula deviates to opposite side and soft palate does not rise with saying ah
50
Q
  • Identify the following structures of the outer ear
A
  1. Helix
  2. Triangular fossa
  3. Antihelix
  4. Concha
  5. Antitragus
  6. External auditory meatus
  7. Tragus
  8. Lobule
51
Q
  • Which lymph nodes should you palpate on a URE?
    *

PCMI Exam 2 (11 decks)

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