ENT Infections

Question 1

top two causes of otitis media (if child is not vaccinated, these two are at top of list)

Answer 1

Streptococcus pneumoniae
Haemophilus influenzae type B

Question 2

most common cause of otitis media in vaccinated children

Answer 2

non-typeable H. influenzae

Question 3

Ab treatment for otitis media

Answer 3

Amoxicillin

Question 4

physical treatment for otitis media

Answer 4

tympanostomy tubes

Question 5

main 2 viruses that cause rhinosinusitis

Answer 5

rhinovirus
influenza

Question 6

main 2 bacteria that cause rhinosinusitis

Answer 6

S. pneumoniae
H. influenzae

Question 7

to treat rhinosinusitis

Answer 7

pseudoephedrine(relieves congestion)
amoxicillin (if bacterial)

Question 8

2 main viruses that cause the common cold (rhinitis/rhinorrhea)

Answer 8

rhinovirus and coronavirus

Question 9

rhinovirus structure

Answer 9

+ssRNA
naked capsule(stable)
VP1(VAP) binds ICAM-1

Question 10

what promotes the spread of rhinovirus by increasing ICAM-1 availability

Answer 10

cytokines

Question 11

why do I always get a cold?

Answer 11

b/c rhinovirus has over 100 serotypes

Question 12

how to treat and prevent the common cold:

Answer 12

treat sx’s
wash hands

Question 13

both rhinovirus and coronavirus are limited to what part of body to replicate

Answer 13

URT
(b/c acid labile)

Question 14

rhinovirus vs coronavirus structure

Answer 14

rhino-naked capsule
corona- enveloped

Question 15

seal-like barking cough, stridor (high-pitched wheeze); swelling of larynx

Answer 15

Croup

Question 16

main viral cause of croup

Answer 16

Parainfluenza

Question 17

to treat croup

Answer 17

dexamethasone (corticosteroid for inflammation)

Question 18

most common cause of pharyngitis (3 viruses)

Answer 18

EBV, Enterovirus, adenovirus

Question 19

bacterial cause of pharyngitis

Answer 19

S. pyogenes (Group A Strep)

Question 20

erythema/edema of pharynx, exudates present, NO COUGH

Answer 20

pharyngitis

Question 21

cause of mononucleosis; B cell reservoir; dsDNA virus; heterophile Ab +; atypical lymphocytes

Answer 21

EBV

Question 22

+ ssRNA, not enveloped; this virus can give you rash inside mouth (herpangina)

Answer 22

Enterovirus

Question 23

dsDNA, non-enveloped; URT; reservoir is public swimming pools; pharyngitis accompanied by conjunctiva

Answer 23

Adenovirus

Question 24

to diagnose and treat adenovirus

Answer 24

PCR
hand wash

Question 25

virulence factor of S. pyogenes

Answer 25

M protein post-strep sequelae superantigen

Question 26

post-strep sequellae from group A strep

Answer 26

Rheumatic fever acute glomerulonephritis

Question 27

potential consequence of SPE toxin that induces cytokine release

Answer 27

scarlet fever

Question 28

DNAse produced by strep is used for what

Answer 28

survival in the body

Question 29

to diagnose strep throat

Answer 29

throat swab rapid strep test ELISA

Question 30

to treat pharyngitis

Answer 30

Penicillin

Question 31

this disease is produced by a phage toxin and causes grey pseudomembrane on pharynx

Answer 31

diphtheria

Question 32

to treat C. diphtheriae

Answer 32

penicillin and antitoxin

Question 33

to prevent diphtheria

Answer 33

vaccine----toxoid (Ab neutralizing response)

Question 34

this stage of B. pertussis antibiotics can cure

Answer 34

Catarrhal stage

Question 35

stage of B. pertussis that has whooping cough and Ab's won't help

Answer 35

Paroxysmal stage

Question 36

stage of B. pertussis where there is a chronic cough and possibility of secondary infections w/ other pathogens

Answer 36

Convalescent stage

Question 37

gram - rod that inhibits mucocilliary escalator

Answer 37

B. pertussis

Question 38

2 toxins produced by B. pertussis

Answer 38

1. exotoxin (A:B)- ADP ribosylation of GTPase(adenylyl cyclase)--increasing resp. secretions---increases cough 2. endotoxin (Lipid A)--- binds TLR4 and triggers cytokine storm

Question 39

to diagnose pertussis

Answer 39

presentation lymphocytosis nasal swab NAAT

Question 40

to treat Pertussis

Answer 40

Azithromycin (Macrolide)

Question 41

to prevent pertussis

Answer 41

vaccine (DTaP)

Question 42

severe sore throat fever dysphagia (sx's of what)

Answer 42

tonsillitis

Question 43

main viral cause of tonsillitis

Answer 43

Herpesviruses (HSV, EBV, CMV)

Question 44

main bacterial cause of tonsillitis

Answer 44

Group A Strep

Question 45

to treat bacterial tonsillitis

Answer 45

penicillin

Question 46

REALLY swollen tonsils (caused by bacterial infection)

Answer 46

peritonsillar abscess

Question 47

how to treat peritonsillar abscess

Answer 47

Ab's drain

Question 48

2 main bacteria that cause peritonsillar abscess

Answer 48

Group A strep Fusobacterium

Question 49

A 25 year old presents with ill feeling, painful gums and mouth for 2 days and getting worse. Ulcers on lips and base of tongue

Answer 49

Herpes Viruses

Question 50

dsDNA virus; enveloped (replicate and bud from nucleus); fever blisters, gingivostomatitis(ulcers)

Answer 50

Herpes Viruses

Question 51

causes oral lesions

Answer 51

HSV-1

Question 52

both of these have equal chance of causing genital lesions

Answer 52

HSV-2 and HSV-1

Question 53

these are used to diagnose_____: PCR tissue culture look for multinucleated giant cells

Answer 53

HSV

Question 54

anti-viral drug used to treat most herpes viruses and MoA

Answer 54

acyclovir: inhibits thymidine kinase

Question 55

anti-viral drug used to treat CMV

Answer 55

ganciclovir

Question 56

3 month old and a 48 yr old HIV+ both present to ED with white plaque in the mouth

Answer 56

oral thrush (candida albicans)

Question 57

NOT true dimorphic yeast, but does change shape in diff. temperature

Answer 57

candida albicans

Question 58

typically develops when immune system has been compromised

Answer 58

thrush

Question 59

number 1 cause of candidiasis

Answer 59

Ab therapy---->dybiosis

Question 60

this fungus can be an early sign of HIV infection (T cells drop below threshold)

Answer 60

thrush

Question 61

to diagnose thrush:

Answer 61

presentation!!!! (culture and microscopy)

Question 62

To treat thrush

Answer 62

Fluconazole Nystatin

Question 63

biofilms make this on teeth

Answer 63

plaque

Question 64

main bacteria found in the oral cavity

Answer 64

Streptococcus mutans

Question 65

inflammation to gums and around teeth (neutrophils and lymphocytes infiltrate)

Answer 65

gingivitis

Question 66

acute necrotizing ulcerative gingivitis aka

Answer 66

trench mouth

Question 67

2 bacteria that cause trench mouth

Answer 67

Fusobacterium Prevotella

Question 68

inflammation and infection of ligaments and bones that support teeth (gum recedes)

Answer 68

periodontitis