Fam Ii Test 1

Front 1

tx for rhinitis

Back 1

allergy meds if allergic
oral decongestant if vasomotor

Front 2

tx for sinusitis

Back 2

Amoxicillin with or without clavulanate

Front 3

tx for smell/taste disterbances

Back 3

Treat underlying cause. Refer to appropriate specialist as needed.

Front 4

tx for tumors/polyps of the nose

Back 4

Polyps: inhaled nasal steroid.
Refer to ENT if not successful.

Front 5

4 types of rhinitis:

Back 5

neutrophilic (infectious)
seasonal allergic
perennial allergic
vasomotor

Front 6

Neutrophilic/infectious rhinitis:

Back 6

occurs in early childhood
nasal smear: neutrophils, bacteria, debris
from recurrent viral respiratory illnesses

Front 7

seasonal allergic rhinitis

Back 7

a complex of symptoms following sensitization to wind-born pollens
bluish/pale mucous membranes

Front 8

vasomotor rhinitis

Back 8

poorly understood etiology
Not associated with itching of eyes, nose or sneezing.
Occurs in response to environmental triggers that include cold air, strong smells, irritants, changes in weather, medications (ACE, beta blockers), stress, exercise, foods.
Year round, chronic
Idiopathic

Front 9

epistaxis

Back 9

rare in infancy, common in childhood
Most common location is Kiesselbch’s plexus

Front 10

sinusitis: 2 types

Back 10

acute and chronic

Front 11

acute sinusitis length and tx:

Back 11

2-3 weeks
40% recover spontaneously
tx: nasal steroid sprays, nasal saline spray, NSAIDS and cough suppressant

Front 12

acute sinusitis tx:

Back 12

augmentin (amoxicillin/clavulanate) for 10-14 days for children or 5-7 days for adults
Doxycycline if PCN allergy
If worsening or no improvment after 72 hours, change abx

Front 13

to dx acute bacterial sinusitis:

Back 13

Child with a URI presents with:
- Persistent illness (nasal discharge [of any quality] or daytime cough or both lasting more than 10 days without improvement)
- A worsening course (worsening or new onset of nasal discharge, daytime cough, or fever after initial improvement)
- Severe onset (concurrent fever [temperature ≥39°C/102.2°F] and purulent nasal discharge for at least 3 consecutive days)

Front 14

chronic sinusitis length:

Back 14

>3 weeks

Front 15

chronic sinusitis tx:

Back 15

nasal congestion, discharge, pain not as severe as in acute
Beta lactamase abx for 2 to 4 weeks, typically prescribed by ENT after diagnosis confirmed.
you chronically lactate = chronic sinusitis. chronic = lactamase

Front 16

Vasomotor rhinitis

Back 16

The presence of nasal polyps excludes diagnosis of vasomotor rhinitis.
Does not respond to antihistamines.
Oral decongestant every 6 hours, continuous.
Intranasal steroids.
Avoidance of aggravating factors.

Front 17

anosmia
hyposmia

Back 17

Loss of smell
smell distortion

Front 18

hypogeusia
aliageusia
dysgeusia

Back 18

Diminished taste
Unpleasant taste
persistant taste

Front 19

Most common malignant tumor/polyp of nose:

Back 19

squamous cell carcinoma

Front 20

Most common benign tumor/polyp of nose:

Back 20

inverted papilloma

Front 21

dental caries tx:

Back 21

Dental treatment using silver amalgam or plastic restorations/crowns can restore teeth
If pulp involved, needs pulpotomy or pulpectomy
If extraction is needed, a space maintainer will be used

Front 22

Dental absecess

Back 22

Dental Abscess
Results from untreated dental caries
Occurs when dental pulp is invaded
Pulpitis progresses to necrosis
Bacterial invasion of the alveolar bone occurs = abscess

Front 23

Pharyngitis/Tonsillitis: common age group

Back 23

Peaks at 4-7 years, continues throughout later childhood and adult life

Front 24

what causes acute pharyngitis:

Back 24

Group A B-Hemolytic Strep

Front 25

tx of pharyngitis:
viral:
Strep:

Back 25

viral: no tx
Strep: PCN with in the first 9 days

Front 26

Epiglottitis: peak incidence:

Back 26

3.5 years of age
less common now that we have HIB vaccine

Front 27

Parotitis and tx

Back 27

Inflammatory reaction of parotid gland.
tx: beta lactamase resistant penicilliin or cephalosporins – amoxicillin/clavulanic acid, clindamycin

Front 28

Aphthous ulcers

Back 28

canker sores
Minor: Most common, range from 2-10 mm, heal in 10 to 14 days.
Major: 2-3 cm, scarring can occur.
Herpetiform: Small, 2-3 mm, widely scattered or closely grouped. Viral cultures are negative.

Front 29

tx of aphthous ulcers

Back 29

Symptom relief: triamcinolone in Orabase, steroid mouth rinse with betamethasone.
May also try liquid Benadryl and Kaopectate/Mylanta (1:1) swish and spit 6x/day.

Front 30

stomatitis and tx

Back 30

Inflammation of the soft tissues of the oral cavity
tx: Avoid offending substances.
Encourage good oral hygiene.

Front 31

Thrush tx:

Back 31

Nystatin oral suspension, swish and swallow, QID.
Antifungal lozenges.
Nystatin powder to dentures.
Continue 48 hours after symptoms resolve.
Monitor BG in diabetics and treat appropriately.

Front 32

Glossitis and tx:

Back 32

Inflammation of tongue
Treatment:
Good oral hygiene.
Avoid irritants.
Treat cause if known (abx, etc.).
Dietary changes and supplements if needed.

Front 33

Geographic Tongue and tx

Back 33

Benign map-like appearance of the tongue due to irregular patches on its surface.
May be related to B vitamin deficiency.
Patches can move and change daily.
Some have burning or pain.
No treatment.

Front 34

Oral Lichen Planus

Back 34

Inflammatory condition of the mucus membranes of mouth.
Inside of cheeks (most common), tongue, throat, esophagus, inside of lips
tx: cause if IDed

Front 35

Pepto-bismol tongue

Back 35

black tongue from the bismuth

Front 36

most common pathogen for sinusitis:

Back 36

strep pneumo

Front 37

IDSA guidlines 1st line tx for sinusitis

Back 37

augmentin

Front 38

strep pharangitis tx:

Back 38

amoxicillin 500-875 po bid for 10 days

Front 39

who appears w cobblestone throat?

Back 39

allergy

Front 40

most common cause of parotitis:

Back 40

viral mumps

Front 41

describe viral mumps:

Back 41

rapid onset of fever, chills, malaise, edema, usually bilateral and pain (worse with mastication)

Front 42

when to add a decongestant to the antihistamine?

Back 42

if nose is excessively runny or ear/eustachian tube fullness

Front 43

precaution for decongestant

Back 43

HTN

Front 44

how to tx peritonsilar abcess tx:

Back 44

abx, oral steroids, refer to ENT for drainage, refer to ENT immediately

Front 45

if recurrent tonsillitis when need surgery?

Back 45

surgery if recurrent 3 episodes in 1 year

Front 46

common causes of pharangitis in children:

Back 46

adenovirus, enteroviruses, rhinoviruses, RSV, then think Group A B-hemolytic strep

Front 47

what is the primary benefit of tx of strep pharangitis?

Back 47

prevention of acute rheumatic fever