Term
| A 7-year-old is brought to the physician because of a persistent mucopurulent nasal discharge for 2 weeks following a common cold. The child does not appear critically ill, but he complains of mild pain in the maxillary region and nasal obstruction. Rhinoscopic examination reveals purulent fluid coming from the inferior meatus. The rest of the physical examination is normal. Which of the following is the most likely diagnosis? |
|
Definition
| acute bacterial sinusitis |
|
|
Term
| A 7-year-old boy has a 14 day history of purulent nasal discharge, increased problems with nighttime cough. He is active and has not missed school. Temperature and respiration are normal. Physical examination reveals boggy turbinates with yellow green discharge noted in the left nostril. The rest of the exam is unremarkable. The next best step in management is: |
|
Definition
| give antibiotics because it is probably a sinus infection (in class she said symptoms had to persist for more than 7 days to be an infection and not just the common cold) |
|
|
Term
| A 20-year-old male sustains a blow to his nose during a disagreement with some friends 5 or 6 days prior to his visit today. He complains that his breathing progressively worsened despite the outward swelling decreasing. Your examination shows soft fluctuant swelling of the septum bilaterally. This area is not tender to palpation. What is your treatment plan? |
|
Definition
| Pt probably has a septal deviation/subluxation; treat with septoplasty |
|
|
Term
| The most common cause of chronic cough in adults is which of the following? |
|
Definition
| Chronic sinusitis & postnasal drip |
|
|
Term
| A 20 year-old man comes to the student health clinic with complain of feeling “blah” and having a sore throat for the past 4 days. He states he has had low grade fever and body aches. His temperature is 38. 1°C (100.6°F). Physical examination shows an erythematous pharynx with exudates, enlarged cervical lymph nodes , and a palpable spleen tip. The presence of atypical lymphocytes on lab studies would suggest: |
|
Definition
| That he has Infectious Mononucleosis, or Mono |
|
|
Term
| These cells provide physical support, nourishment and electrical insulation for olfactory receptors. |
|
Definition
|
|
Term
| Which of the following papillae do not contain taste buds? |
|
Definition
|
|
Term
| A 16-year-old girl is brought to the ER because of difficulty swallowing. Three days ago she started having a sore throat and fever. Pediatrician prescribed liquid Amoxicillin for tonsillitis. This morning her throat was so sore that she could barely swallow the Amoxicillin. (Last night temp. rose to 40 degr. C (104.0 F). Otherwise she is healthy. Temperature now is 39.1 degr. C (102.4 F). She appears ill and is holding a cup into which she periodically spits saliva. She has moderate trismus and you have difficulty examining her oral cavity. With the help of two tongue blades you manage to see that both tonsils are inflamed but the right one appears significantly larger than the left. The soft palate is edematous on the right and the uvula is deviated to the left. She has enlarged lymph nodes on both sides of the neck. The most appropriate intervention at this time is to: |
|
Definition
| Consult ENT for drainage of peritonsillar abscess |
|
|
Term
| A 12-year-old boy comes to the ER complaining of earache. Past medical history is unremarkable. On examination, right ear slightly swollen, erythematous with a foul smelling purulent discharge in the ear canal. The most appropriate step in management is to: |
|
Definition
| Ear Drops (most likely external otitis) |
|
|
Term
| A 54 year-old woman with hyperlipidemia and polyarticular pain comes to the office because of lightheadedness and a feeling the room is spinning to the point that she needs to hold onto a piece of furniture in order to steady herself. In addition, the spinning is noted to occur when lying supine and made worse with rapid turning of the head. She denies vomiting, ear pain, or fever. She takes simvastatin and diclofenac. The presence of hearing loss in this patient would suggest: |
|
Definition
|
|
Term
| A patient presents with a 3-day history of vertigo associated with turning over in bed, which lasts for several minutes. There are no other symptoms of the ear. Positional testing shows rotary nystagmus, which diminishes with repeated testing. Which of the following is the most likely diagnosis? |
|
Definition
| Vestibular neuritis or Labyrinthitis |
|
|
Term
| A 40-year-old man consults a physician because of dizziness. The patient has noticed that every time he lays with the right side of his head down, he develops a whirling sensation within a few seconds. This symptom will last as long as the position is maintained, but resolves when a new head position is taken. He does not experience tinnitus or hearing changes during these episodes. Otoscopic examination is within normal limits. Which of the following is the most likely diagnosis? |
|
Definition
| Benign paroxysmal positional vertigo |
|
|
Term
| A 48-year-old man presents to the physician’s office with progressive hearing loss in his right ear for the past several months. He describes a ringing and hissing sound in his right ear, and he feels unsteady on his feet, as if he is losing his sense of balance. His past medical history includes syphilis, which was treated at age 20, and bronchial asthma which is controlled with medications. On physical examination, right-sided facial numbness is noted, Rinne test shows air conduction that is greater than bone conduction. Routine lab profile is normal. Which of the following is the most likely diagnosis? |
|
Definition
| acoustic neuroma, or benign tumor |
|
|
Term
| A 40-year-old man presents to a physician because he has been experiencing episodes of severe vertigo accompanied by nausea and vomiting. He has had five of these episodes for the past 6 months. The episodes frequently begin with a sense of fullness in his right ear, which is often accompanied by tinnitus and a sense of hearing loss in the affected ear. Each episode lasts hours to days and then resolves. Otoscopic examination of the affected ear is within the normal limits. Which of the following is the most likely diagnosis? |
|
Definition
|
|
Term
| A 34 year-old woman comes to the ER complaining that her throat is very sore. Her vital signs are normal except for her pulse which is 110/min. In the examination room she is sitting upright in bed with her head turned to the ceiling slightly. Her voice is slightly muffled and occasionally some saliva runs out of the corner of her mouth. You shine a light in her mouth and see that her palate and oropharynx show moderate erythema. Her tonsils are slightly enlarged with no exudates. The most appropriate next step in management is: |
|
Definition
| This is an emergency case (b/c she is having trouble swallowing her saliva), therefore she needs to be sent to an ENT specialist for immediate treatment |
|
|
Term
| Previously healthy 4-year-old boy is brought to the ER by his mother for evaluation. She is concerned about noisy breathing. She reports that he has had a sore throat over the past 24 hours that has worsened progressively, as well as fever. He has refused anything to eat or drink during the past 12 hours. Vital signs: temp. 38.8 degr. C ( 101.8 F), respiration 32/min (normal 16/min), oxygen saturation 100% (normal). Moderate respiratory distress with inspiratoty stridor and he is drooling. Physical examination positive for equal breath sounds bilaterally with superimposed upper airway sounds and evidence of retraction with respiratory efforts. The most appropriate next step is: |
|
Definition
| Make arrangements for direct laryngoscopy and intubation in the operating room |
|
|
Term
| A 4-year –old Moroccan boy waits in the ER . He sits quietly, leaning forward, and has audible inspiratory stridor. An X-ray shows the “thumbprint sign”. When intubating this patient you note a cherry-red epiglottis. Administration of which of the following would most likely have prevented this boy’s condition? |
|
Definition
| Haemophilus influenza type B vaccine |
|
|
