Eye, Ear, Nose And Throat Disorders

Front 1

what is the maximal duration of ARS?

Back 1

which sinus issue can last up to 4 weeks?

Front 2

what is ABRS?

Back 2

what is a secondary bacterial infection of paranasal sinuses, usually following a viral URI

- relatively rare

Front 3

prior to choosing an antimicrobial therapy, what are questions to ask?

Back 3

to which situation to the following questions apply:

- what is/are the most common pathogen(s) causing this infection?

- what is the spectrum of a given antimicrobial's activity?

- what is the likelihood of a resistant pathogen?

- what is the danger if there is treatment failure?

Front 4

what is the most common causative bacterial organism for ABRS, AOM and CAP?

Back 4

S. pneumonia is the most common bacterial pathogen for which maladies?

Front 5

Gram + diplococci, ABRS causative organism in adults 38%, children 21-33% - describes which organism?

Back 5

what is the gram stain, morphology, and percentage of ABRS caused by S. pneumonia?

Front 6

what is the percentage of drug resistance (DRSP) for S. pneumonia?

Back 6

which organism has >= 25% DRSP?

Front 7

in patient's with recurrent infection and tobacco use, what is the most common pathogen for ABRS, AOM and CAP?

Back 7

H. influenza is the most common pathogen for which maladies especially under which patient conditions?

Front 8

which common pathogen is a G - bacillus?

Back 8

H. influenzae has what gram stain and morphology?

Front 9

>= 30% PCN resistance via beta-lactamase is characteristic of which organism causing ABRS, AOM and CAP?

Back 9

H. influenzae has which % of resistance using which resistance mechanism?

Front 10

what is the less common pathogen associated with ABRS and AOM and an uncommon cause of CAP?

Back 10

M. catarhallis is a less common pathogen causing which maladies?

Front 11

Gram negative coccus uncommonly associated with ABRS, AOM and rarely associated with CAP

Back 11

M.catarhallis has what gram stain and morphology?

Front 12

which pathogen has >= 90% PCN resistance via beta-lactamase production?

Back 12

M. catarhallis has what % of abx resistance to which abx?

Front 13

in the treatment of ABRS, under what three conditions do you consider initiating antimicrobial therapy?

Back 13

under the following conditions of ABRS, what is your next move?

- persistent and not improving >= 10 days

- severe >= 3-4 days

- worsening or double sickening >= 3-4 days

Front 14

what is a special consideration for the following populations when choosing abx?

- < 2 yo or >65 yo

- prior abx w/in the past 2 months

- prior hospitalization w/in past 5 days

- comorbidities

- immunocompromised

Back 14

what are patient characteristics that put them at risk for antimicrobial resistance?

Front 15

when is the appropriate time to use intranasal corticosteroids in ABRS?

Back 15

ABRS + allergic rhinitis allows the use of which medication for symptom relief?

Front 16

what is first line therapy for ABRS?

Back 16

amoxicillin-clavulanate (875/125 BID or 500/125 TID) is which line therapy for which malady?

Front 17

what is second line therapy for ABRS?

Back 17

amoxicillin-clavulanate (2000/125) or doxycycline (100 BID or 200 daily) is which line of therapy for which malady?

Front 18

what is/are the indicated therapy/ies for ABRS in a pt with a beta-lactam allergy?

Back 18

in the treatment of which malady in a pt with this allergy, these are the indicated therapies:

- doxycycline (100 BID or 200 daily)

- levofloxacin (500 daily)

- moxifloxacin (400 daily)

Front 19

in ABRS, if there is a risk for antibiotic resistance or failed initial therapy what/which antibiotic(s) are recommended?

Back 19

- Amoxicillin-clavulanate 2000/125

- Levofloxacin 500 daily

- Moxifloxacin 400 daily

are indicated for ABRS treatment under which circumstances?

Front 20

what are first line treatments for allergic rhinitis (AR)?

Back 20

intranasal corticosteroids (-sone, -sonide: Flonase, Nasacort, nasonex) are first line treatment for which malady?

Front 21

leukotriene receptor antag (LTRA) or leukotriene modifiers (LTM) aka montelukast (Singulair) is best for AR when used alone or in combination with this other rx?

Back 21

antihistamines work well in combination with which med(s) for AR?

Front 22

mast cell stabilizers (cromolyn) are more or less effective than intranasal corticosteroids for control therapy of AR?

Back 22

this class of AR controller medications is less effective than intranasal corticosteroids for sx relief BUT their ocular formulation are effective for ocular sx

Front 23

what are the three major classes of reliever (rescue) therapy for AR?

Back 23

- antihistamines (oral, nasal, ophthalmic)

- decongestants

- anticholinergics

are all which types of meds for AR?

Front 24

for relief of nasal congestion in AR, which class of medications are most effective?

Back 24

intranasal corticosteroids are most effective for relief of which AR symptom?

- nasal antihistamines are less effective

Front 25

examples of second generation oral antihistamines include?

Back 25

loratadine (Claritin), desloratidine (clarinex), cetirizine (Zyrtec), levocertrizine (Xyzal) and fexofenadine (Allegra) are all examples of which meds used in the treatment of AR?

Front 26

when are short-term PO corticosteroids indicated for use in AR?

Back 26

which medication(s) used in AR indicated for severe or intractable nasal symptoms or significant polyposis?

Front 27

what are adverse effects of anticholinergics?

Back 27

what class of meds cause the following sx:

- dry as a bone

- red as a beet

- mad as a hatter

- hot as a hare

- can't see

- can't pee

- can't spit

- can't (something that rhymes with spit [constipation])

Front 28

which CN controls the puff out your cheeks?

Back 28

CN VII controls which common neuro assessment technique?

Front 29

which CN controls using eyes to follow fingers without moving head?

Back 29

CN III controls which common neuro assessment?

Front 30

which CN controls shoulder shrug?

Back 30

CN XI controls which common neuro assessment?

Front 31

which CN controls stick out tongue?

Back 31

CN XII controls which neuro assessment?

Front 32

what are the physical exam findings of a normal TM?

Back 32

these describe a TM in which state?

- pale, gray, translucent appearance

- cone of light and bony landmarks visible

- mobile with pneumatic otoscopy

Front 33

what are the physical exam findings of a TM with otitis media with effusion (aka serous otitis)?

Back 33

these describe a TM in which state?

- air-fluid level visible (often with air bubbles)

- opaque yellow or blue color

- cone of line and bony landmarks diminished or absent

- TM mobility with pneumatic otoscopy limited

Front 34

what is the treatment for otitis media with effusion (aka serous otitis)?

Back 34

Tx of underlying cause (such as allergic rhinitis) and/or spontaneous resolution 1-3 weeks without special intervention

Front 35

what are the pt statements in their history regarding otitis media with effusion (aka serous otitis)?

Back 35

with this middle ear pathology, the pt will c/o:

- ear fullness or pressure

- otalgia or ear itch

- conductive hearing loss

- no fever or otorrhea

Front 36

what are the pt statement(s) in their history regarding acute otitis media?

Back 36

with this middle ear pathology, pt will c/o:

- otalgia

- ear fullness, pressure

- conductive hearing loss

- fever (common)

Front 37

what TM findings are common with acute otitis media?

Back 37

what middle ear pathology has these PE TM findings?

- TM redness

-TM bulging

- cone of light and bony landmarks absent

- absent TM mobility with pneumatic otoscopy

- otorrhea possible with TM rupture

Front 38

what is the treatment for acute otitis media?

Back 38

this/these are the tx(s) for which middle ear pathology?

- analgesia, ABX

- however, high rate of spontaneous resolution without abx tx

Front 39

on funduscopic exam, the finding of a deeply-cupped optic disc indicates ?

Back 39

what is the funduscopic exam finding of acute angle-closure glaucoma?

Front 40

which of the following ophthalmologic conditions is considered an emergency:

open angle glaucoma or angle closure glaucoma?

Back 40

angle closure (aka acute angle closure) glaucoma is considered an emergent or non-emergent eye condition?

Front 41

which of the following ophthalmologic conditions is considered a chronic condition:

open angle glaucoma or close angle (or angle closure) glaucoma?

Back 41

open angle glaucoma is considered a chronic condition or emergency?

Front 42

when is surgical intervention indicated for acute angle closure glaucoma?

Back 42

surgical intervention is indicated once the IOP is normalized in which type of glaucoma?

Front 43

AV nicking is a funduscopic examination finding in which pathological state?

Back 43

on funduscopic examination of a patient with longstanding uncontrolled HTN, what would you expect to find?

Front 44

Papilledema on funduscopic examination indicates which pathological state?

Back 44

Increased ICP is indicated by which funduscopic finding?

Front 45

untreated open angle glaucoma is at times called the "silent thief" - why?

Back 45

slow progressive peripheral vision loss esp in the elderly is usually caused by which pathological state?

Hint 45

the silent thief

Front 46

what two types of medication are used for the tx of open angle glaucoma?

Back 46

reduce production of intraocular fluid

- topical beta-adrenergic antagonists

- topical alpha-2 agonists

- less selective sympathomimetic

- topical carbonic anhydrase inhibitors

increased fluid outflow

- prostaglandin analogs

- miotic agents (parasympathomimetics)

Front 47

what is the treatment for acute angle closure glaucoma?

Back 47

treatment for which type of glaucoma includes:

- prompt ophthalmologic referral

- relief of acute intraocular pressure (eyedrops: beta-adrenergic antag, alpha-2 agonist, carbonic anhydrase inhibitors)

- increase fluid outflow (prostaglandin analog, hyperosmotic agents)

-SURGERY once IOP is normalized

Front 48

components of the eye emergency triad?

Back 48

- acute vision change

- eye redness

- eye pain

constitute which eye malady?

Front 49

what are the three eye emergencies?

Back 49

trauma, anterior uveitis (aka iritis) and angle closure glaucoma all have what in common?

Front 50

what is the clinical presentation of anterior uveitis (aka iritis)?

Back 50

- keratic precipitates in cornea (white patches in a red cornea)

- pupil usually constricted

- irregularly shaped pupil

- perilimbal injection (ciliary flush)

are indicative of which ophthalmologic emergency?

Front 51

what is the intervention for anterior uveitis (aka iritis)?

Back 51

- referral to ophthalmology

- topical or systemic corticosteroids

- cycloplegics

- more intervention determined by etiology bc this is often r/t autoimmune dz or rxn (ankylosing spondylitis, IBD, reactive arthritis [Reiter's syndrome], psoriatic arthritis)

are the interventions for which eye emergency?

Front 52

what is the PE findings for angle-closure glaucoma?

Back 52

- slit-lamp evaluation may reveal corneal edema, synechiae, corneal edema

-irregular pupil shape

- segmental iris atrophy

- cornea and scleral injection

- ciliary flush (red sclerae emerging from iris)

are PE findings for which ophthalmologic emergency?

Front 53

amsler grid test is used to determine which pathological state?

Back 53

early detection of macular degeneration is detected by which screening test?

Front 54

what are the interventions necessary for acute angle closure glaucoma?

Back 54

- referral to ophthalmology

- block aqueous production, reduce vitreous volume, facilitate aqueous outflow with Diamox (actetazolamide), topical beta blocker, and pilocarpine

Front 55

tonometry is what?

Back 55

what is the test for glaucoma (inc IOP)?