Nose, Sinus, Mouth, and Throat

Question 1

What two conditions account for the majority of antibiotics prescribed in outpatient clinics even though they are usually self-limiting viral infections?

Answer 1

URIs and otitis media

Question 2

What is the issue with the unnecessary and overuse of antibiotics?

Answer 2

Emergence of super strains of drug-resistant bacteria

Question 3

What is the clinical term for the common cold?

Answer 3

Viral rhinitis

Question 4

What are the signs and symptoms of viral rhinitis?

Answer 4

Symptoms: stuffy nose and sinuses with watery discharge, sneezing, post nasal drip, cough, itchy eyes, nose, and throat
Signs: swollen nasal tissues and cervical lymph nodes

Question 5

What is the major difference between allergic and viral rhinitis?

Answer 5

Allergic rhinitis lasts longer and is recurrent

Question 6

75% of those with what other condition will get sinusitis?

Answer 6

Asthma

Question 7

What are the signs and symptoms of acute sinusitis?

Answer 7

Symptoms: stuff nose and sinuses with green purulent discharge with aggravated face, teeth, or eye pain while bending over
Signs: swollen nasal tissues and cervical lymph nodes

Question 8

What two test findings can be seen indicating sinusitis?

Answer 8

Digital pressure eliciting aggravated pain

No transillumination due to thick discharge

Question 9

What are the grape-like inflammatory swelling of the nasal linings called that are seen in adults who have had allergies or chronic sinus infections for years?

Answer 9

Polyps

Question 10

What issue can nasal polyps cause?

Answer 10

Interference of nasal drainage

Question 11

What is the most common cause of a deviated septum?

Answer 11

Trauma

Question 12

What is the “nasal cycle”?

Answer 12

Normal cycle of mild congestion (unilateral blood vessel engorgement) and decongestion alternating between nostrils about every 4 hours to make it easier to breath out of one side than the other

Question 13

What should be considered first when examining a children with a one-sided runny nose?

Answer 13

Foreign object

Question 14

More than half of the reported cases of loss of smell are due to what causes?

Answer 14

1 head injuries
2 post URIs
3 nasal/sinus conditions

Question 15

What are Mullin’s 5 “Ts” of the mouth and throat that are analyzed during examination?

Answer 15

1 teeth
2 tongue
3 tissues
4 tonsils
5 throat

Question 16

What should be considered when viewing a patient with crowded teeth?

Answer 16

Cranial misalignment

Question 17

What visible sign of the teeth appears due to asymmetrical forces being transmitted into the temporomandibular-cranial-cervical complex?

Answer 17

Malocclusions

Question 18

What is the term for a red, swollen smooth tongue due to the loss of the papillae?

Answer 18

Glossitis

Question 19

What is the form of glossitis where the papillae are temporarily lost leaving smooth, irregular patches with a white outline that can change location on a weekly, sometimes daily, basis?

Answer 19

Geographic tongue (aka migratory glossitis)

Question 20

What is the term for a tongue that presents with grooves of varying depth and width?

Answer 20

Fissured tongue

Question 21

Fissured tongue is frequently associated with what other condition of the mouth?

Answer 21

Geographic tongue

Question 22

What is the timeline of onset and progression for a fissured tongue?

Answer 22

Starts in childhood and becomes more prominent with age

Question 23

What causes a black, hairy tongue?

Answer 23

Long-term antibiotic use

Question 24

What is the anatomical reason for the appearance of a black, hairy tongue?

Answer 24

Failure of the papillae to naturally fall off causing them to elongate allowing fungi or bacteria to attach to them and cause discoloration

Question 25

What is the clinical term for a cankersore?

Answer 25

Aphthous stomatitis

Question 26

What is unique about the healing process of the ulcers of aphthous stomatitis?

Answer 26

Heal without scarring

Question 27

What is the condition of the mouth that is a noncancerous or precancerous oral lesion common to those who use tobacco daily that appears as while leathery ridges on the buccal mucosa?

Answer 27

Leukoplakia

Question 28

What is the clinical term for red, swollen, sensitive, and bleeding gums?

Answer 28

Gingivitis

Question 29

What is the order of progress of developing gingivitis?

Answer 29

Bacteria and saliva form plaque which hardens into tartar then causes gingivitis

Question 30

What can prevent or reverse gingivitis?

Answer 30

Brushing and flossing

Question 31

What are the common locations for an oral carcinoma?

Answer 31

Sides of tongue, lips, floor of mouth

Question 32

What activities are associated with 70-80% of oral carcinoma cases?

Answer 32

Smoking and smokeless tobacco (another risk factor = alcohol)

Question 33

What is the condition of benign exostosis of either the hard palate or mandible?

Answer 33

Torus palatinus and mandibularis

Question 34

When do torus palatinus or mandibularis occur?

Answer 34

Around age 30

Question 35

What is tonsillar debris?

Answer 35

Mucous, sulfur-producing bacteria, and debris condense into small particles and collect in the crypts on the surface of the tonsils

Question 36

Which is more common: viral or bacterial pharyngitis?

Answer 36

Viral (60%)

Question 37

What is the major difference in symptoms between viral and bacterial pharyngitis?

Answer 37

Bacterial is associated with a fever and purulent, colored exudate

Question 38

What are the three forms of pharyngitis?

Answer 38

Viral, bacterial, streptococcal

Question 39

What progressive condition occurs in 1% of strep throat cases?

Answer 39

Rheumatic fever

Question 40

What is rheumatic fever so rare?

Answer 40

Antibiotics are 90% effective at preventing strep throat from progressing

Question 41

What condition is a progression of strep throat that is not prevented by antibiotic treatment?

Answer 41

Post-streptococcal glomerulonephritis

Question 42

What part of the heart may get damaged via post-streptococcal glomerulonephritis?

Answer 42

Mitral valve

Question 43

What conditions are considered upper respiratory conditions?

Answer 43

Common cold, allergic rhinitis, sinusitis, and pharyngitis

Question 44

What is the "in between" condition of upper and lower respiratory conditions?

Answer 44

Laryngitis

Question 45

What condition is inflammation of the mucous lining of the larynx and vocal cords resulting in a sore scratchy throat, hoarseness, or loss of voice?

Answer 45

Laryngitis

Question 46

Laryngitis that last longer than what time span warrants consultation?

Answer 46

4 weeks

Question 47

What cranial nerves can be assessed as part of the mouth and throat exam?

Answer 47

7, 9, 10, and 12

Question 48

How can you test for cranial nerve 7 in the mouth and throat exam?

Answer 48

Sweet and salty tastes of the anterior 2/3 of the tongue

Question 49

How can you test for cranial nerve 9 in the mouth and throat exam?

Answer 49

Sour and bitter tastes of the posterior 1/3 of the tongue

Question 50

How can you test for cranial nerve 9 and 10 together in the mouth and throat exam?

Answer 50

Perform gag reflex

Question 51

How can you test for cranial nerve 10 alone in the mouth and throat exam?

Answer 51

Have patient say, "coo la me"

Question 52

How can you test for cranial nerve 12 in the mouth and throat exam?

Answer 52

Have patient press tongue into each cheek

Question 53

What is another term for blackheads?

Answer 53

Comedones

Question 54

What type of facial eruption are pimples?

Answer 54

Pustules and papules

Question 55

What part of the body is usually affected by erysipelas?

Answer 55

Face and ears

Question 56

Erysipelas is usually secondary to what type of condition?

Answer 56

Preexisting skin infection or wound

Question 57

What causes erysipelas?

Answer 57

Type A beta hemolytic streptococcus (form of cellulitis)

Question 58

How is cellulitis different from erysipelas?

Answer 58

Lacks sharp, raised borders and usually affects limbs

Question 59

What is the mechanism of injury for cellulitis?

Answer 59

Enzymes produced by the organism break down cellular components that would normal contain the infection

Question 60

What condition is a chronic inflammatory disorder resulting in new superficial blood vessels?

Answer 60

Rosacea

Question 61

What population is more likely to be affected by rosacea?

Answer 61

Middle-aged women

Question 62

What sign of rosacea may occur in males?

Answer 62

Rhinophyma (soft tissue hypertrophy of the nose)

Question 63

What is the conventional treatment for rosacea?

Answer 63

Tetracycline

Question 64

What condition presents as red, painful inflammation of the nail fold?

Answer 64

Paronychia

Question 65

What pathogens can cause paronychia?

Answer 65

Bacteria or fungi (Candida)

Question 66

Paronychia due to fungi is more present among children in adults that participate in what activities?

Answer 66

Children that suck their thumb | Adults whose hands are frequently in water

Question 67

What kind of skin eruption is a verruca?

Answer 67

Benign papule

Question 68

What are the common locations of verruca plana?

Answer 68

Face, neck, wrist, back of hands and knees

Question 69

What condition is an eczema that affects hands and the sole and sides of the fingers?

Answer 69

Pompholyx (dyshidrotic eczema)

Question 70

What color should the nail bed be?

Answer 70

Variations of pink

Question 71

Vertical ridges of nails are a normal variation seen in what population?

Answer 71

Elderly

Question 72

Pigment deposits or bands in the nail beds may be normal in what group of people?

Answer 72

Those with darker skin

Question 73

White spots on the nails (leukonychia) are usually due to what?

Answer 73

Mild injury

Question 74

What condition is a fungal infection of the nail plate and appears as a yellow-brownish discoloration even causing the nail to become brittle, bent, and thick?

Answer 74

Tinea unguium

Question 75

What nail signs may occur in severe psoriasis?

Answer 75

Splinter hemorrhages and pitting

Question 76

Splinter hemorrhages are often associated with what condition?

Answer 76

Endocarditis

Question 77

What is the clinical term for nail spooning?

Answer 77

Koilonychia

Question 78

What can cause koilonychia?

Answer 78

Trauma or iron deficiency anemia

Question 79

What is the condition where the nail appears white except for a narrow zone at the distal tip?

Answer 79

Terry nails

Question 80

Terry nails is associated with what underlying serious condition?

Answer 80

Cirrhosis of the liver

Question 81

What condition presents with transverse, white depressions in the nail?

Answer 81

Beau's line

Question 82

Beau's line can be caused by what things?

Answer 82

Malnutrition, coronary artery disease, maybe trauma

Question 83

What is Schamroth's technique?

Answer 83

Placing nails from each hand back to back and observing the space created (normal = diamond shaped due to 160 degree angle of nail base)

Question 84

What nail condition caused the diamond shape observed in Schamroth's technique to disappear due to abnormal enlargement of the distal phalanges?

Answer 84

Nail clubbing

Question 85

Nail clubbing is associated with what kinds of underlying serious conditions?

Answer 85

Respiratory and cardiovascular diseases