Nose and Throat

Question 1

What classifies rhinosinusitis as subacute?

Answer 1

Between 4-12 weeks in length

Question 2

What is the most common site of origin of sinus inflammation?

Answer 2

The ostiomeatal complex

Question 3

Which sinus is most often affected by sinusitis in adults?

Answer 3

Maxillary or Frontal sinuses

Question 4

Which sinus is most often affected by sinusitis in children?

Answer 4

Ethmoid sinus

Question 5

Most common antecedent to rhinosinusitis?

Answer 5

Allergic rhinitis

Question 6

What type of organisms most often cause nosocomial rhinosinusitis?

Answer 6

Gram-negative:

• Pseudomonas
• E. coli
• Klebsiella

Question 7

What fungi can cause rhinosinusitis?

Answer 7

• Bipolaris
• Curvularia
• Aspergillus

Question 8

What type of rhinosinusitis is associated with double sickening, maxillary pain (especially unilateral), tooth pain, and purulent secretions?

Answer 8

Bacterial rhinosinusitis

Question 9

Gold standard for diagnosis of type of rhinosinusitis?

Answer 9

Sinus puncture w/ aspiration

Question 10

Should you give ABX for acute rhinosinusitis?

Answer 10

No, it usually self-resolves.

Question 11

If you decide to prescribe ABX for ARS, what is first-line?

Answer 11

Amoxicillin

Question 12

What antibiotic should we give for recurrent RS that is believed to be caused by MRSA?

Answer 12

Bactrim

Question 13

What ABX is best for recurrent RS caused by pseudomonas?

Answer 13

Cipro

Question 14

Tx for chronic/recurrent RS?

Answer 14

• Augmentin
• Quinolones
• Cef… drugs

Question 15

Preferred imaging study for endoscopic sinus surgery?

Answer 15

Coronal CT scan

Question 16

What syndrome is characterized by telangiectasias of the lips, nasal mucosa, and tongue?

Answer 16

Oscar-Weber-Rendu

-Hereditary hemorrhagic disorder

Question 17

Which kind of epistaxis is unilateral, continuous, moderate, and usually venous?

Answer 17

Anterior epistaxis

Question 18

Which kind of epistaxis is bilateral, brisk, and arterial?

Answer 18

Posterior epistaxis

Question 19

Tx for anterior epistaxis?

Answer 19

• Epinephrine, phenylephrine, or oxymetazoline on cotton ball
• Ocean spray drops
• Petrolatum-caution
• More agressive: cocaine, lidocaine, surgery

Question 20

Tx for posterior epistaxis?

Answer 20

• Monitor Hct, BP, pulse
• Cocaine or oxymetazoline for vasoconstriction
• Cautery, packing, tamponade
• Admit and observe for hypercarbia/hypoxia

Question 21

What type of medicines can cause rhinitis medicamentosa?

Answer 21

Azole decongestants

Question 22

What is the most common cause of chronic sinus congestion?

Answer 22

Allergic rhinitis

Question 23

What chronic inflammatory conditions can contribute to chronic sinus congestion?

Answer 23

• Sarcoidosis

- Wegener’s disease

Question 24

What hormonal conditions can contribute to chronic sinus congestion?

Answer 24

• Pregnancy

- Hypothyroidism

Question 25

First-line treatment for rhinitis?

Answer 25

Antihistamines

Question 26

What drugs can cause rhinitis?

Answer 26

- ACEI, reserpine, beta blockers, prazosin, methyldopa - Chlorpromazine - ASA and NSAIDS - Oral contraceptives

Question 27

Most effective treatment for rhinitis?

Answer 27

Nasal steroids

Question 28

When should oral steroids be used to treat rhinitis?

Answer 28

- Intractable rhinitis | - Significant polyposis

Question 29

What oral steroid should be used to treat rhinitis?

Answer 29

Prednisone

Question 30

What adjunct drug should be used for gustatory or exercise rhinitis?

Answer 30

Cromolyn

Question 31

Non-infectious causes of pharyngitis?

Answer 31

- GERD | - Chronic sinus drainage

Question 32

Most common viral cause of pharyngitis?

Answer 32

Adenovirus - Parainfluenza - Rhinovirus

Question 33

What virus causes pharyngitis associated with a prodrome of fever, sore throat, cervical nodes; exudate, palatal petechiae, splenomegaly, and hepatomegaly?

Answer 33

Epstein-Barr virus

Question 34

What test diagnoses EBV?

Answer 34

Monospot for IgM or IgG

Question 35

What viral pharyngitis is associated with exudates and shallow ulcers on palate?

Answer 35

HSV

Question 36

What viral pharyngitis is associated with tonsillar pillar/soft palate vesicles and ulcers?

Answer 36

Coxsackievirus (herpangina)

Question 37

What type of pharyngitis is associated with adherent whitish blue pharyngeal exudate?

Answer 37

Corynebacterium diptheriae

Question 38

Most common bacterial causes of pharyngitis?

Answer 38

GAS - Spirochetes (syphilis) - Yersinia (adults w/o enteritis) - Gonorrhea - Corynebacterium

Question 39

What serious complications can follow bacterial pharyngitis?

Answer 39

- Acute rheumatic fever - Abscesses - Acute glomerulonephritis

Question 40

How do we diagnose a strep throat?

Answer 40

Rapid strep antigen test | -Culture if RSA is neg. but still suspicious

Question 41

What are the Centor criteria?

Answer 41

- Tonsillar exudate - Tender cervical nodes - Fever - No cough

Question 42

Most common cause of one-sided vocal cord paralysis?

Answer 42

Virus

Question 43

What ABX should we use for bacterial pharyngitis?

Answer 43

Broad spectrum: - Clindamycin - Augmentin