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PCM Midterm > Upper Respiratory Exam + Competency > Flashcards

Upper Respiratory Exam + Competency Flashcards

1
Q

What might you see in the pharynx that indicates drainage down the back of the throat which has irritated the mucosa?

A

Cobblestoning

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2
Q

What causes streptococcal pharyngitis

A

Group A beta-hemolytic streptococcus (strep pyogenes)

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3
Q

The highest likelihood of group A beta hemolytic streptococcus is indicated by the AFACT mnemonic, what does it stand for?

A 
Age (children 5-15)
Fever
Absence of cough
Cervical lymphad. (Tender anterior)
Tonsillar exudate

Also more common in winter and early spring

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4
Q

What might you see in the pharynx of someone with strep?

A

Beefy red soft palate and uvula

Enlarged red tonsils

White or yellow patches on tonsils

Tiny red hemorrhages on soft palate

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5
Q

What scoring system is used as a CDM tool to determine course of action for patients with CC of sore throat?

A

Modified Centor Criteria

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6
Q

What is the Centor scoring system?

A

Age: 1 point for 3-14, 0 pts for 15-44, -1 for >45

Fever: temp over 100.4

Absence of cough = +1

Cervical adenopathy = +1

Tonsilar exudate = +1

0,1 = no additional testing or treatment

2,3 = perform throat culture or RADT (rapid antigen detection testing)

4,5 = consider empiric tx with abx

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7
Q

What might patients report with GABH?

A 
Sore throat
Headache
Fatigue
Fever
Body aches
Nausea
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8
Q

Why might a patient with pharyngitis complain of nausea?

A

Pharynx is right next to intra-abdominal organs on the somatosensory homunculus

[could also be from swallowing nasal secretions]

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9
Q

______ = caused by mucus and food that get trapped in the crypts of the tonsils; cause bad breath

A

Tonsiloliths (tonsil stones)

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10
Q

What would you call a middle ear infection

A

Acute otitis media

Otitis media with effusion

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11
Q

What would you call an inner ear infection

A

Labyrinthitis

Vestibular neuritis

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12
Q

what type of ear infection involves erythematous, bulging TM which has reduced mobility when pneumatic otoscope is used?

A

Acute otitis media

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13
Q

_______ is symptomatic inflammation of the middle ear that can be caused by bacteria OR viruses

A

Acute OM

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14
Q

_____________is acute OM with purulent material in the middle ear

A

Acute suppurative OM

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15
Q

______________ is inflammation and fluid buildup in the middle ear WITHOUT bacterial or viral infection

May occur because the fluid buildup persists after an ear infection has resolved. May also occur because of some dysfunction or noninfectious blockage of eustachian tubes

A

OM with effusion (serous OM)

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16
Q

__________ occurs when fluid remains in the middle ear and continues to return without bacterial or viral infection

This makes children susceptible to new ear infections and may affect hearing

A

Chronic OM with effusion

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17
Q

__________ is a persistent ear infection that often results in tearing or perforation of the eardrum

A

Chronic suppurative OM

18
Q

What is considered “chronic” for OM?

A

Lasting more than 6 weeks

19
Q

Would you prescribe abx for OM with effusion?

A

No, no bacteria or viruses present

20
Q

___________ is abnormal bone growth around the stapes bone; associated with progressive hearing loss beginning between ages 10-30. Marked hearing loss during middle age

A

Otosclerosis

21
Q

What are the 2 types of otosclerosis?

A

Conductive loss - ossicle sclerosis into a single immovable mass; middle ear

Sensory loss - otic capsule sclerosis; inner ear

[affects about 10%of caucasians, females more than males]

22
Q

What is the results of the weber test for someone with conductive hearing loss vs sensorineural

A

Conductive: Sound lateralizes to the affected side

Sensorineural: lateralizes to side opposite the affected side

23
Q

Normal vs. conductive loss result of rinne test

A

Normal: air conduction > bone conduction

Conductive loss: bone conduction > air conduction

24
Q

What are some osteopathic considerations for otitis media?what is important to do FIRST?

A

Open thoracic inlet FIRST

Viscerosomatic reflex (sympathetic T1-4, parasymp: vagus)

Sinus milking
Galbreath technique
Temporal rocking
V-spread

25
Q

What is the technical term for bacterial sinus infection

A

Acute rhinosinusitis (bacterial)

26
Q

Signs/symptoms of acute rhinosinusitis

A

Persistent and not improving x7-10 days
Severe for 3-4 days
Maybe fever

Worsening or double-sickening 3-4 days into illness

Purulent mucus from nose

ESR > 10 mm/hr

Maxillary tooth pain

27
Q

Most common causes of bacterial sinusitis

A

Strep pneumoniae, H. Influenzae, moraxella catarrhalis

28
Q

Tx for bacterial sinusitis - what is first choice, and what is given if patient has drug allergy to first choice?

A

First choice = amoxicillin with or w/o clavulanate

If allergy: doxycycline or respiratory fluroquinalone

29
Q

When would you switch someone’s abx for bacterial sinusitis

A

If they worsen within 7 days while on abx

30
Q

T/F: long-course abx tend to be more effective at treating bacterial sinusitis

A

False, no statistically significant diff between the two

31
Q

What is the most common cause of acute viral rhinosinusitis

A

Viral URI

32
Q

Pt presenting during first 3-4 days of illness - can’t tell if viral or bacterial rhinosinusitis. How can you conclude that it is likely bacterial?

A

Presence of double sickening at day 5-10

33
Q

How would you treat viral acute rhinosinusitis

A

Watchful waiting
Symptomatic tx: saline rinse, analgesics, intranasal steroids

Consider abx after 7-10 days - SNAP = safety net antibiotic prescription may be given with instructions

34
Q

Most common cause of eustachian tube dysfunction

A

ET gets inflamed and mucus or fluid builds up; caused by cold, flu, sinusitis, allergies

35
Q

_____ == sudden sesnation that youre spinning or that inside of your head is spinning; causes brief episodes of mild to intense dizziness; usually triggered by changes in head position

A

BPPV

36
Q

________ = affects branch associated with balance, resulting in dizziiness or vertigo but NO CHANGE IN HEARING.

A

Vestibular neuritis (may also be called neuronitis)

37
Q

______ = occurs when infection affects both branches of vestibulocochlear n., resulting in HEARING CHANGES

A

Labyrinthitis

38
Q

_______ = disorder of inner ear causing episodes of vertigo and fluctuating hearing loss with progresive, ultimately permanent hearing loss, tinnitus, feeling of ear fullness

Often affects only 1 ear

Can occur at any age, starts at ages20-50

A

Meniere’s diseae

39
Q

Most common cause of BPPV

A

Canalithiasis (debris floating in canal portion of SCC)

40
Q

Cause of BPPV other than canalithiasis

A

Cupulolithiasis (debris adhered to cupula of crista ampulars)

41
Q

Diagnosis technique for BPPV

A

Dix-Hallpike maneuver

42
Q

Dx and tx of epley maneuver

A

Epley maneuver

PCM Midterm (7 decks)

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