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EENT Flashcards

1
Q

Hordeolum (Stye) (-1-)
Def: a -2- abscess on the upper or lower eyelid, which is -3-
Causes/Incidence
> -2- -4-

A
  1. HOT (red, abrupt)
  2. staphylococcal/-us
  3. extremely common
  4. aureus
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2
Q 
Hordeolum (Stye) - DDx
> -1-
> -2-
> -3-
> -4-
A
  1. conjunctivitis
  2. chalazion
  3. blepharitis
  4. dacryocystitis
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3
Q

Hordeolum (Stye) - S/S
> -1-
> -2- (acutely -3-) and edema
> -4- to the -5-

A
  1. Abrupt onset
  2. localized pain
  3. tender
  4. pain proportionate
  5. degree of edema
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4
Q

Hordeolum (Stye) - Mgmt
-1- several times a day
Often -2-
Topical bacitracin or -3- may be considered
Refer to -4- if there is -5- w/in approximately 48 hours

A
  1. warm compresses
  2. bursts/resolves spontaneously
  3. erythromycin ophthalmic ointment
  4. ophthalmologist for I&D
  5. no resolution
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5
Q

Chalazion (-1-)
Def: a granulomatous (beady nodule) on the eyelid; infection or -2- of the meibomian gland
Note: a chalazion is a hard, -3- cyst; it differs from styes in that chalazia are usually -4-

A
  1. Cold (not painful)
  2. retention cyst
  3. non-tender
  4. painless
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6
Q

Chalazion - S/S
> -1-
> -2-
> -3- if the cyst is -4- to impress the -5-; may cause astigmatism due to pressure on the -5-

A
  1. Red conjunctiva
  2. itching
  3. visual distortion
  4. large enough
  5. cornea
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7
Q

Chalazion - S/S
> -1- sensitivity
> Increased -2-

A
  1. Light

2. tearing

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8
Q

Chalazion - Mgmt
> -1-
> Referral -2- (-3-)

A
  1. warm compresses
  2. for surgical removal
  3. usually the course
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9
Q

Conjunctivitis
Def: the -1- eye disorder; a(n) inflammation/infection of the -2- that covers the front of the eye and lines the inside of the eyelids resulting from a(n) -3-

A
  1. most common
  2. mucous membrane
  3. variety of causes (allergies, chemical irritation, bacteria, viruses, gonococcus/chlamydia)
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10
Q

Conjunctivitis - S/S
> -1-, irritation
> -2-
> Eyelids may be -3- with -4-

A
  1. inflammation, redness
  2. increased tears
  3. crusty and sticky
  4. mucopurulent discharge
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11
Q

Conjunctivitis - Labs/Dx

-1- when indicated (e.g., if -2- is suspected)

A
  1. gram stain & culture

2. gonorrhea

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12
Q

Conjunctivitis - Mgmt
Type: -1-
Discharge: none
Tx considerations: -2-; flushing with -3-

A
  1. Chemical
  2. self-limiting
  3. normal saline
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13
Q

Conjunctivitis
Type: -1-
Discharge: -2-
Tx considerations: -3- ointment; -4- ophthalmic -5-

A
  1. bacterial
  2. purulent, thick
  3. erythromycin 0.5% ophthalmic (as young as newborn)
  4. Polytrim
  5. solution or ointment
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14
Q

Conjunctivitis
Type: -1-
Discharge: -2-, regardless of -3-
Tx considerations: -4- or -5-

A
  1. Gonococcal - EMERGENCY
  2. copious, green, purulent
  3. activity/sleep
  4. Emergent ceftriaxone
  5. cefotaxime IM
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15
Q

Conjunctivitis - Mgmt
Type: -1-
Discharge: none
Tx considerations: -2- opthalmic -3-; -4- ophtalmic -3-; -5-

A
  1. chlamydial
  2. erythormycin
  3. ointment
  4. tetracycline
  5. oral azithromycin
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16
Q

Conjunctivitis
Type: allergic
S/S - Discharge: -2-, -3-, -4-
Tx considerations: -5-; prescription antihistamine -6-

A
  1. stringy (clear)
  2. increased tearing
  3. bilateral
  4. oral antihistamines
  5. eye drops (olopatadine)
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17
Q 
Conjunctivitis - Mgmt
Type: -1-
Discharge: -2-
Tx considerations:
> -3- care
>> mild: -4- drops
>> moderate: decongestants/antihistamines, NSAIDs
> Sulfacetamide 10% ophthalmic solution for -7-
A
  1. Viral
  2. watery
  3. symptomatic
  4. saline (artificial tears, refrigerated is best)
  5. bacterial (secondary) prophylaxis
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18
Q

Conjunctivitis - Mgmt
Type: -1-; emergency
Discharge: -2- and -3-
Tx considerations: -4- to the -5-

A
  1. Herpetic
  2. bright red
  3. irritated
  4. emergency referral
  5. ED/ophthalmologist (esp. re: lesions on face near/approaching eye)
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19
Q

Cataracts
Def: an abnormal, uniform, -1- of the eye seen in children with co-morbid syndromes (e.g. -2-, -3-, -4-, atopic dermatitis)

A
  1. progressive opacity
  2. Down
  3. Marfan
  4. DM
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20
Q 
Cataracts - Causes/Incidence
> -1-
> Prolonged -2-
> -3-
> -4-
> -5-
A
  1. congenital
  2. steroid use
  3. infection
  4. injury
  5. radiation (onc)
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21
Q 
Cataracts - S/S
> -1- vision
> -2-
> Poor -3-
> -4-
A
  1. clouded, blurred, dim
  2. white fundus reflex (absent red reflex)
  3. visual fixation
  4. photophobia
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22
Q 
Cataracts
> Lab/Dx
>> -1-
> Mgmt
>> -2- removal
A
  1. none indicated

2. refer for surgical

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23
Q

Strabismus
Def: strabismus is a(n) -1- as a result of -2-. If acquired -3- of age, strabismus is usally related to an underlying problem

A
  1. ocular misalignment
  2. uncoordinated ocular muscles
  3. after 6 mo
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24
Q

Strabismus - S/S
> -1-: eyes deviate -2-
> -3-: eyes deviate -4-

A
  1. Esotropia
  2. inward
  3. exotropia
  4. outward
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25
Q

Strabismus - S/S
> -1-: eyes deviate -2-
> -3-: eyes deviate -4-
> Hirschberg: -5-

A
  1. hypertorpia
  2. up
  3. hypotropia
  4. down
  5. light reflex: asymmetric
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26
Q

Strabismus - Mgmt
-1-
> if fixed or -2- of age or more
> -3- for -4- (-5-)

A
  1. Refer to ophthalmology
  2. continuous at 6 months
  3. Immediately
  4. hyper-/hypotropia
  5. indicative of CNS lesion (also refer to neuro)
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27
Q 
Otitis Externa (Swimmer's Ear)
Def: inflammation of the -1-
> Causes/Incidence
>> Infection
>>> -2-
>>> -3-
>> Recent history of -4-
A
  1. external auditory meatus
  2. bacterial (usually gram-neg)
  3. fungal
  4. water exposure
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28
Q

OE - S/S
> -1- (-2-)
> Purulent and sometimes, -3-

A
  1. otalgia
  2. esp. when pulling pinna/auricle
  3. malodorous discharge (pseudomonas)
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29
Q

OE - PE Findings
> -1- of the -2-
> -3- of the -2-
> -4- (sometimes with odor)

A
  1. erythema
  2. ear canal
  3. edema
  4. purulent exudate
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30
Q

OE - PE Findings
> -1- of -2- or when the -3-
> -4-

A
  1. pain upon manipulation
  2. auricle
  3. tragus is compressed
  4. TM: clear, flat
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31
Q

OE - lab/dx

Pneumatic -1- should -2-

A
  1. otoscopy (if possible r/t edema)

2. demonstrate mobility

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32
Q 
OE - mgmt
> -1-
> -2- or injury
> Topical ear mediations
>> Bacterial
>>> -3- and -4-
A
  1. remove purulent debris
  2. protect from moisture
  3. ciprofloxacin
  4. dexamethasone otic drops
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33
Q 
OE - mgmt
> Topical ear mediations
>> Fungal
>>> -1- (e.g., -2-)
> Pain mgmt (-3-)
> prevention; -4- afer bathing and/or swimming
A
  1. antifungal drops
  2. clotrimazole 1% solution
  3. acetaminophen or ibuprofen
  4. dry external ear
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34
Q

AOM
Def: a bacterial infection of the mucosally lined air-containing spaces of the temporal bone that can interfere with air conduction. -1- is repsonsible for anout 30-50% and -2- for about 20% of AOM cases

A
  1. S. pneumoniae

2. H. influenzae

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35
Q 
AOM - S/S
> Decreased -1-
> -2-
> -3-
> -4-/-5-
A
  1. hearing
  2. fever
  3. otalgia
  4. nausea
  5. vomiting
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36
Q 
AOM - PE Findigns
> -1-
>> -2-
>> -3-
> -4- exudate
> -1- often -5-
A
  1. TM
  2. erythema
  3. edema
  4. purulent
  5. bulges (“hot ear”)
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37
Q

AOM - Lab/Dx

-1- of TM with -2-

A
  1. Impaired mobility

2. pneumatic otoscopy

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38
Q

AOM - MGMT
> -1- mgmt: -2-
> Observation period for healthy children: -3-

A
  1. pain
  2. acetaminophen
  3. 48-72 hours
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39
Q

AOM - MGMT
Meds
> -1- PO for -2-
> -3- recommended for -4-

A
  1. amoxicillin 80-90 (HIGH DOSE) mg/kg/day BID
  2. 10 days
  3. amox-clavu
  4. resistant strains
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40
Q

AOM - MGMT
Prevention
> -1-: -2-, -3-, annual -4-
> Avoid -5-

A
  1. vax
  2. Hib
  3. PCV13
  4. flu
  5. second hand smoke
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41
Q

Serous Otitis Media/Otitis Media w/ Effusion (OME)
Def: the presence of -1- in the -2- w/o s/s of AOM; also known as chronic OME.
S/S
> -3-
> -4- when pressure altered
> -5- ear

A
  1. fluid (clear)
  2. middle ear(s)
  3. hearing loss
  4. popping sensation
  5. fullness in the
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42
Q

OME - PE Findings
> -1- behind the -2-
> Decreased -3-
> -4- tests suggestive of -5-

A
  1. air bubbles
  2. TM
  3. membrane mobility
  4. Weber & Rinne
  5. conductive hearing loss
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43
Q

OME - Labs/Dx

-1- via -2-

A
  1. decreased hearing

2. audiometry

44
Q 
OME - Mgmt
> watchful monitoring: -1-
> abx therapy: -2-
> -3-: -4-
> -5- months
A
  1. 3 months
  2. no long-term efficacy
  3. antihistamines/decongestants
  4. ineffective
  5. re-evaluate in 3-6
45
Q

Hearing Loss

def: any degree of -1- ability to -2-; may be -3-.

A
  1. impairment in the
  2. aprehend sound
  3. conductive, sensorineural, or mixed
46
Q 
Hearing Loss
Conduction Causes
> -1- impaction/foreign body (-2-)
> -3-
> -4-
> -5-
A
  1. Cerumen
  2. most treatable
  3. hematoma
  4. OM
  5. perforated TM
47
Q 
Hearing Loss
> Sensorineural Loss
>> Impaired transmission of sound through the -1-
>> Causes
>>> -2-
>>> -3-
>>> -4- disease
>>> -5-
A
  1. nervous system
  2. acoustic neuroma
  3. syphillis
  4. CNS
  5. medication toxicity
48
Q

Understanding -1- & -2- tests
> Expected findings
» -1- test: Sound -3- and not lateralize
» -2- test: -4- > -5-

A
  1. Weber (weber-head)
  2. Rinne (like the wind!)
  3. should be heard equally in both ears
  4. air conduction
  5. bone conduction
49
Q 
Hearing Loss
S/S
Findings w/ Hearing Loss
> Conductive hearing loss
>> Weber: sound -1- to the -2-
>> Rinne: -3- in affected ear (i.e. -4-)
A
  1. lateralizes
  2. affected ear
  3. abnormal
  4. AC < BC
50
Q 
Hearing Loss
S/S
Findings w/ Hearing Loss
> -1-
>> Weber: sound -2- to the -3-
>> Rinne: -4- in the -5-
A
  1. Sensorineural hearing loss
  2. lateralizes
  3. unaffected ear
  4. AC > BC
  5. affected ear
51
Q 
Hearing Loss
Lab/Dx
> Otoscopic ex: -1- and TM
> General -2-
> -3-
> -4- a neuro condition is suspected
A
  1. inspect canal
  2. neuro exam
  3. audiometric testing
  4. CT scan if
52
Q 
Hearing Loss
Mgmt
> remove -1-
> -2-
> Refer for -3-
A
  1. foreign body/cerumen
  2. refer for audiogram
  3. further evaluation/hearing aid
53
Q

Allergic Rhinitis

Def: -1- to -2-

A
  1. immune-mediated response

2. allergens

54
Q 
Allergic Rhinitis
S/S
> -1- discharge
> -2-
> -3- eyes
> -4- (from -5-)
A
  1. postnasal (clear/white)
  2. sneezing
  3. itchy
  4. HA
  5. nose blowing, even
55
Q 
Allergic Rhinitis
Mgmt
> -1- (often requires skin-prick test or other ID measure; not possible for all allgerns)
> -2- antihistamines (e.g., -3-)
> -4- (e.g., -5-)
A
  1. avoid allergens
  2. second-generation
  3. loratidine, cetirizine, fexofenadine
  4. Intranasal corticosteroids
  5. budesonide, fluticasone
56
Q 
Common Cold
Def: -1-, a -2- URI
S/S
> -3-
> -4-
A
  1. viral rhinitis
  2. self-limiting
  3. sore throat
  4. Malaise
57
Q 
Common Cold
Mgmt
> -1- and -2-
> No -3-; avoid antitussives for children -4-
> (-5-)
A
  1. rest
  2. hydration
  3. OTC cold preps (decongestants, antihistamines, antitussives, expectorants)
  4. < 6 years of age
  5. should be resolved by day 12 (consider DDx for longer)
58
Q

Common Cold
Mgmt
> No -1-
> -2- mgmt w/ -3-

A
  1. abx
  2. pain/fever
  3. acetaminophen or ibuprofen
59
Q

(Rhino-)Sinusitis
Def: Occurs when an undrained collection of pus accumulates in one or more of the paranasal sinuses in -1-. The -2- and -3- are the -4-.

A
  1. children age 4+
  2. maxillary
  3. ethmoid sinuses
  4. most commonly affected
60
Q

(Rhino-)Sinusitis

Def: Typical pathogens are the same as those of -1- (-2-): -3-, -4-, -5-

A
  1. AOM
  2. all connected: sinuses, nasal, optical, and otic passages
  3. S. pneumoniae
  4. H. influenzae
  5. M. catarrhalis
61
Q 
(Rhino-)Sinusitis
S/S
> -1- over the -2-
> -3-
> Discolored -4- ; halitosis
A
  1. pain & pressure
  2. cheeks
  3. HA
  4. nasal discharge
62
Q

(Rhino-)Sinusitis
S/S
> -1- and cough (usually during day, worse at night)
> -2-, worse when -3-

A
  1. post-nasal drip
  2. dull, throbbing pain
  3. head is dependent
63
Q 
(Rhino-)Sinusitis
Labs/Dx
> Dx is often made on -1-
> Radiological studies are rarely needed
>> -2- preferred over -3-: more sensitive but more expensive; only used for -4-
A
  1. clinical presenation
  2. CT scan
  3. x-ray
  4. more complicated sinusitis
64
Q

(Rhino-)Sinusitis
Mgmt
Uncomplicated w/ mild symptoms, treat outpt:
-1- for -2- or -3- whichever’s longer; -4- to -5- if no -6-

A
  1. Amox-clav
  2. 10 days
  3. 7 days post-symptom
  4. change abx!
  5. a secondary abx such as Levaquin (levofloxacin)
  6. improvement by day 3
65
Q

(Rhino-)Sinusitis
Mgmt
Uncomplicated w/ mild symptoms, treat outpt:
> -1- are not -2- in acute sinusitis but may be used in chronic sinusitis
> -3- managed with -4-
> -5- care

A
  1. Decongestants & antihistamines
  2. useful
  3. pain
  4. acetaminophen
  5. supportive
66
Q

(Rhino-)Sinusitis
Mgmt
Chronic, refractory, or -1-: -2-

A
  1. recurrent sinusitis

2. referral to ENT

67
Q

Epistaxis (Nosebleed)
S/S
> Bleeding usually only from -1- (-2-)
> -3- because of -4- the -5- into stomach

A
  1. one nostril
  2. 2 nostrils is concerning for coagulopathy
  3. stomach upset
  4. blood dripping from
  5. back of the throat
68
Q

Epistaxis (Nosebleed)
S/S
-1-; septal erosion (may be caused by -2-)

A
  1. Friability

2. inhaled substance abuse

69
Q 
Epistaxis (Nosebleed)
Mgmt
> -1-
> -2- (i.e., triangle): -3- of the -4- for 10 minutes
> Apply -5-
A
  1. Sit upright
  2. pressure at Kiesselbach’s plexus
  3. anterior inferior aspect
  4. nasal septum (end of bony ridge)
  5. ice
70
Q

Pharyngitis/Tonsilitis

Def: -1- of the -2- behind the nose and mouth and/or the -3- in the throat, to the side of the root of the tongue

A
  1. Inflammation
  2. membrane-lined cavity
  3. lymphoid masses
71
Q

Pharyngitis/Tonsilitis
Causes/Incidence
> -1-
> -2-

A
  1. Viruses (EBV, flu, RSV)

2. GABHS

72
Q 
Pharyngitis/Tonsilitis
Bacterial Causes/Incidence
> -1-
> -2-
> -3- (-4-)
A
  1. N. gonorrheae*
  2. mycoplasma
  3. chlamydia trachomatis*
  4. *good history in adolescent pts
73
Q 
Pharyngitis/Tonsilitis
S/S
> -1-
> Dysphagia; -2-
> -3-
> -4- (more pronounced in -5- infections)
A
  1. erythematous pharynx
  2. cough
  3. malaise
  4. fever
  5. bacterial
74
Q 
Pharyngitis/Tonsilitis
S/S
> -1- (bacterial)
> -2-
> -3-
> -4- with sandpaper-like -5-
A
  1. anterior cervical adenopathy
  2. painful throat
  3. exudate
  4. scarlet fever
  5. rash
75
Q

Pharyngitis/Tonsilitis
Labs/Dx
> -1- (fever, cough, sore throat, abdominal pain, n/v)
> -2- (15+)
> -3- (2-)
> -4- (-1-‘s symptoms + HA, malaise, myalgias; diarrhea?)

A
  1. Rapid strep
  2. heterophile antibody test (monospot)
  3. RSV PCR
  4. rapid flu
76
Q 
Pharyngitis/Tonsilitis
Mgmt
> -1- care
>> -2-
>> -3-
>> antipyretics (-4-)
A
  1. supportive
  2. fluids/hydration
  3. warm saltwater gargles
  4. acetaminophen
77
Q

Pharyngitis/Tonsilitis
Mgmt
> Abx only for -1-
» -2- 250 mg orally 2-3 times daily for 10 days
» If -3- 20 mg/kg orally 2 times daily for 10 days
» -4- at least -5- initiation

A
  1. Strep infection
  2. PCN VK
  3. allergic, then macrolide (even for mild allergy)
  4. return to school/day care
  5. 12 hours after treatment
78
Q

Epiglottitis
Common pathogens include strept-, pneumococci, and -1-; NOT -2-
Causes/Incidence
Peak incidence occurs b/t the ages of -3-

A
  1. H. influenzae B
  2. Chlamydia Trachomatis
  3. 6 and 12 years
79
Q 
Epiglottitis
S/S
> -1- high fever
> -2- appearance
> -3-
> -4- of the neck
> Rapidly progressive signs of -5-
A
  1. sudden onset
  2. toxic
  3. restless, fearful, garbled speech
  4. leaning forward, hyperextending
  5. respiratory distress
80
Q

Epiglottitis
Labs/Dx
-1- a -2-, appearing on a-3-

A
  1. Thumb sign
  2. thumb-shaped path
  3. radiograph of the neck
81
Q 
Epiglottitis
Mgmt
> -1-
> Do not -2-
> -3- as soon as possible
> -4- until pathogen is identified
A
  1. immediate hospitalization
  2. perform pharyngeal exam
  3. Intubation capabilities
  4. IV 3rd gen cephalosporin (ceftriaxone, cefaxotime, cefdinir)
82
Q

Croup

Def: … infection of the larynx

A

parainfluenza viral

83
Q

Croup
Causes/Incidence
> -1- can -2- from mild to quite severe
> peak incidence is from -3-

A
  1. Severity
  2. range
  3. 6 mo to 3 years of age
84
Q

Croup
Causes/Incidence
> Affects -1- than -2-
> Most common in -3-

A
  1. males more often
  2. females
  3. fall & winter
85
Q 
Croup
S/S
> Recent symptoms of a(n) -1-
> -2-
> Lungs -3-
A
  1. URI
  2. bark-like cough
  3. typically clear
86
Q

Croup
Lab/Dx
> -1-: shows -2- in severe forms
> Appearance of a -3- of the -4- radiograph of the neck (-5-)

A
  1. Pulse ox
  2. hypoxia
  3. “steeple-shaped” narrowing
  4. trachea on frontal
  5. Croup Church–>steeple
87
Q 
Croup
Mgmt
> moderate disease: -1- support; -2-
> may require -3-
> short course of -4-
A
  1. hospitalize for respiratory
  2. IV fluids
  3. nebulized racemic epinephrine
  4. corticosteroids
88
Q

Epiglottitis vs. Croup
> -1- infection vs. -2- infection
> 6-10 years of age vs. 6 mo to 3 years fo age
> X-ray: thumb sign vs. -3-

A
  1. bacterial
  2. viral
  3. steeple
89
Q

Epiglottitis vs. Croup
> bacterial infection vs. viral infection
> -1- of age vs. -2- of age
> X-ray: -3- vs. steeple

A
  1. 6-10 years
  2. 6 mo to 3 years
  3. thumb sign
90
Q

Infectious Mononucleosis

Def: an -1- due to the -2-, occuring most often between -3- of age

A
  1. acute infectious disease
  2. EBV
  3. 15 - 25
91
Q 
Mono
Causes/Incidence
> mode of -1-
> incubation period: -2-
> Usually -3-, but -4- may last for -5-
A
  1. transmission is saliva (resp. droplet)
  2. 1-2 months
  3. self-limited
  4. malaise & fatigue
  5. months
92
Q

Mono
S/S
> -1-
> -2- (most severe)

A
  1. fever

2. pharyngitis

93
Q 
Mono
PE Findings
> -1-
> -2- on -3-
> -4- in 50% of cases, -5- in only 20%
> -6- trunk
A
  1. posterior cervical lymphadenopathy
  2. white exudate
  3. tonsils
  4. splenomegaly
  5. HEPATOMEGALY
  6. maculopapular/petechial rash on
94
Q 
Mono
Lab/Dx
> lymphocytic leukocytosis; -1-
> positive heterophil and -2-
> -3- in EBV
> -4- in EBV
A
  1. neutropenia
  2. Monospot
  3. early (acute convalescent stage) rise in IgM (IMmediate)
  4. permanent rise in IgG (Gone)
95
Q

Mono
Mgmt
> -1- (e.g., -2-, warm saline gargles)
> Oral -3- when -4- threatens -5-

A
  1. supportive care
  2. NSAIDs
  3. corticosteroids
  4. enlarged lymph tissue (tonsils)
  5. airway obstruction
96
Q

Mono
Mgmt
-1- (-2-) to -3- (even without clinically detectable splenomegaly)

A
  1. avoidance of contact sports
  2. 3 weeks to several (3) months
  3. avoid splenic rupture
97
Q 
Corneal Abrasion
> -1- eye injury in children
>> causing -2-
> Can be detected by -3-
>> Topical -4-
A
  1. Common
  2. pain, tearing, photophobia
  3. Wood’s lamp/fluorescein dye
  4. ophthalmic anesthetic (for Ax only, no repeat use)
98
Q

Corneal Abrasion
> Mgmt
» topical ophthalmic -1- times a day for a few days
»> positive response to treatment: -2- days.
» Topical -3-
» Oral -4- intermittently

A
  1. antibiotic applied 4
  2. continue for 2-3
  3. steroids not recommended (lower resistance to infection)
  4. acetaminophen/ibuprofen & cool compresses
99
Q 
Corneal Abrasion
> Mgmt
>> Patching is -1- 
>>> does not -2-
>>> barrier -3-
>> Most steadily -4- 
>>> Persistent/increasing pain/discomfort -5-: refer to ophthalmology
A
  1. no longer recommended
  2. reduce discomfort/speed healing
  3. to antibiotic Tx
  4. heal in 24-48 hours
  5. after 24 hours
100
Q

A one-week history of fever, exudative pharyngitis, cervical lymphadenopathy, and -1- in an adolescent raise suspicion for mononucleosis. The most -2- to order would be a -3-. This is a nonspecific test and is positive in 85% of adolescents with mononucleosis within the -4- of the illness but is often negative in children under the age of -5-.

A
  1. hepatosplenomegaly
  2. appropriate laboratory test
  3. heterophile antibody test (monospot)
  4. first two weeks
  5. 4 years
101
Q

Mono
A -1- does not provide any specific diagnostic information. The -2- tests for recent strep infection, but -3- is a differentiating symptom from strep. CMV is a good differential diagnosis as it can cause -4-, but the presence of -3- & -5- are more specific for mono.

A
  1. complete blood count
  2. antistreptolysin O titer
  3. (hepato-)splenomegaly
  4. fatigue and adenopathy
  5. pharyngitis
102
Q

The most common cause of mono is EBV. -1- can be used for -2- if heterophile antibody testing is negative and there is -3- of mononucleosis, or in -4- in which heterophile antibody tests are -5-.

A
  1. Epstein-Barr titers
  2. preliminary mono testing
  3. still strong suspicion
  4. young children
  5. unreliable
103
Q

Croup is a common illness in children -1- years of age with a predilection for infants and toddlers -2- months of age. Croup can be caused by -3-. Presentation includes fever, rhinorrhea, -4-, -5-, retractions that range from mild to severe, and an increased respiratory rate.

A
  1. younger than 6
  2. 6 to 36
  3. viruses and allergens
  4. hoarse “barking” cough
  5. upper airway stridor
104
Q

Croup
Symptoms usually worsen at night including the -1-, which can be -2- to parents and caregivers. Hypoxia occurs as a -3-. A fever of up to 102˚ F (38.9˚ C) may be -4- or an indication of a more severe illness but, in isolation, does not warrant -5-.

A
  1. cough and stridor
  2. especially frightening
  3. very late sign
  4. part of croup
  5. urgent re-evaluation
105
Q

Croup
Severity progresses from symptoms that are present when -1-, to symptoms present -2-. A barky cough in the morning is a -3- of croup.

A
  1. crying/active/upset (mild)
  2. while at rest (severe)
  3. common feature

PNCB CPNP-PC (19 decks)

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