Upper Respiratory

Question 1

Which sinuses don’t develop until 8-10 years old?

Answer 1

frontal sinuses

Question 2

What is pharyngitis? What are common sx for viral pharyngitis?

Answer 2

inflammation of the pharynx w/ resulting sore throat; common sx include coryza (inflamed mucus membrane), fatigue, hoarseness, and low-grade fever

Question 3

What type of bacterial causes pharyngitis (strep throat)? What are the common sx?

Answer 3

group A beta-hemolytic streptococcus (streptococcus pyogenes); sx include sore throat, HA, fatigue, fever, body aches, and nausea

Question 4

Highest likelihood of streptococcal pharyngitis (strep throat) if…

Answer 4

• children 5-15
• winter and early spring seasons
• absence of cough
• tender anterior cervical lymphadenopathy
• tonsillar exudate
• fever

Question 5

Describe location of 3 types of ear infections (otitis)

Answer 5

• middle (air filled space behind eardrum) -> acute otitis media (AOM)
• outer (outer ear canal) -> otitis externa
• inner (inner ear structures) -> labyrinthitis (causes hearing loss and vertigo)

Question 6

Describe the 3 types of acute otitis media (AOM)

Answer 6

• acute OM -> caused by bacteria or virus
• acute suppurative OM -> purulent material in middle ear
• OM w/ effusion -> inflammation and fluid buildup w/o infection

Question 7

When is otitis media considered chronic? Describe 2 types

Answer 7

• chronic when present more than 6 weeks
• Chronic OM w/ effusion -> when fluid remains in the middle ear w/o infection
• Chronic suppurative OM -> persistent infection that results in tearing or perforation of eardrum

Question 8

What is Otosclerosis? What are the 2 types?

Answer 8

• abnormal bone growth around stapes bone associated w/ hearing loss at ages 10-30
• conductive loss -> ossicle sclerosis into single immovable mass
• sensory loss -> otic capsule sclerosis

Question 9

Describe the Weber test

Answer 9

tuning fork placed on pt’s forehead
Normal: midline and equal hearing
Conductive loss: lateralized to affected side
Sensorineural loss: lateralized to side opposite affected ear

Question 10

Describe the Rinne test

Answer 10

tuning fork placed on mastoid bone behind ear; when pt no longer hears it, place it next to ear
Normal: AC > BC
Conductive loss: BC > AC

Question 11

Name some causes of conductive hearing loss

Answer 11

cerumen impaction, middle ear fluid, trauma, obstruction

Question 12

Name some causes of sensorineural hearing loss

Answer 12

hereditary, MS, trauma, ototoxic drugs, barotrauma

Question 13

What is rhinosinusitis/sinusitis? What are the sx of it?

Answer 13

mucosal lining of paranasal sinuses and nasal cavity become inflamed; sx include nasal discharge, cough, sneezing, congestion, fever, HA, facial pressure

Question 14

What are both infections and noninfectious causes of sinusitis?

Answer 14

Infectious: rhinovirus, influenza virus, and streptococcus pneumoniae
Non-infectious: dental infections, sinus surgery, NG tubes, immunodeficiency, obstruction

Question 15

What causes suspicion of acute bacterial sinusitis?

Answer 15

double sickening (initially getting better than getting worse), purulent rhinorrhea, and elevated ESR; suspected when sx last at least 10 days without improvement

Question 16

What is croup? How will these pts present?

Answer 16

swelling of the larynx, trachea, and bronchi which causes inspiratory stridor and barking cough in children 6 months to 3 years; present w/ fever, nasal flaring, respiratory retractions, and stridor

Question 17

What is epiglottis? How will these pts present?

Answer 17

inflammation of the epiglottis and adjacent structures; pt will have rapid onset of sore throat, muffled voice and drooling; will also present w/ high-grade fever and a toxic appearance

Question 18

What are common causes of eustachian tube dysfunction? What can this cause?

Answer 18

flu, sinus infection, or allergies; can cause vertigo

Question 19

What is benign paroxysmal positional vertigo (BPPV)?

Answer 19

sudden sensation of spinning usually triggered by specific changes in position of your head

Question 20

What is vestibular neuritis?

Answer 20

inflammation of nerve that’s associated w/ balance; results in vertigo but no change in hearing

Question 21

What is Meniere’s disease?

Answer 21

disorder of the inner ear that causes episodes of vertigo along w/ fluctuating hearing loss, tinnitus, and feeling of fullness or pressure in your ear

Question 22

Which sinuses don’t develop until ages 8-10?

Answer 22

frontal sinuses

Question 23

Which sinuses don’t develop until ages 8-10?

Answer 23

frontal sinuses

Question 24

What is the whisper test?

Answer 24

doctor stands behind pt w/ one ear occluded and whispers combo of letters/numbers to pt

Question 25

Describe each of the following: aphthous ulcers, cheilitis, gingivitis, and torus palantinus

Answer 25

• aphthous ulcers: canker sores
• cheilitis: B12 or iron deficiency; red cracks at corners of mouth
• gingivitis: swelling/ulceration of gums
• torus palantinus: benign lump on hard palate