Test your basic knowledge |

ENT/Respiratory

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Tx of sinusitis symptoms <10 days
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Symptomatic (steam; nasal irrigation); APAP for pain.
Hardher and more turbulent
Apena alternating with hyperpnea;

2. Pathophysiology of rhino sinusitis?
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction
Bacterial infection
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Apena alternating with hyperpnea;

3. Common cold pathogens
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
Rhinovirus - influenza - and parainfluenza
Soft sounds in and out
Ear ache - dullness - hearing loss - fever - N/V/D

4. Tx for pediatric AOM?
Rhinovirus - influenza - parainfluenza
Persistent; recurrent x4/yr; severe HA; altered mental status
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

5. Abnormal pulmonary findings?
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
Ear ache - dullness - hearing loss - fever - N/V/D
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
Clubbing - Use of accessory muscles - barrel chest

6. Additional pulmonary diagnostics
>12 weeks
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Rhinovirus - influenza - parainfluenza
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

7. Crackles (rales)
Sore throat; nasal congestion; sections mucopurulent/clear; fullness in sinuses and ears; low grade fever; peaks 3-5 days; occasional cough; itchy nose - eyes - throat;
Rhinovirus - influenza - parainfluenza
Hardher and more turbulent
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis

8. Acute rhino-sinusitis duration of symptoms?
<4 weeks
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)

9. Rhinosinusitis risk factors?
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
3 months to 3 years old
Soft sounds in and out
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)

10. Stridor
Warm - humid environment; rest;
Aspirin: increases viral shedding
<4 weeks
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration

11. What is the most common pahtogen for otitis media?
Increased loudness of whispering during auscultation. Indicative of consolidation.
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Step. pneumoniae; Haemophilus influenzae; group B-strep
Measures speed of exhalation; results measure by age and weight

12. Rhonchi
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD
Rhinovirus - influenza - and parainfluenza
Oflaxicin 0.3% solution BID
Clubbing - Use of accessory muscles - barrel chest

13. Peak Expiratory Flow (PEF)
Deep - rapid - labored - breathing
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
Oflaxicin 0.3% solution BID
Measures speed of exhalation; results measure by age and weight

14. Diagnostics of sinusitis?
24-72 hrs
Rhinovirus - influenza - parainfluenza
PE: rhinoscopy with otoscope
Step. pneumoniae; Haemophilus influenzae; group B-strep

15. What are physical exam findings of AOE?
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Deep - rapid - labored - breathing
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Erythmatous auditory canal - crusting

16. Acute otitis media
Ear ache - dullness - hearing loss - fever - N/V/D
Deep - rapid - labored - breathing
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
Sore throat; nasal congestion; sections mucopurulent/clear; fullness in sinuses and ears; low grade fever; peaks 3-5 days; occasional cough; itchy nose - eyes - throat;

17. Subacute rhino-sinusitis duration of symptoms?
4-12 weeks
92-100%
24-72 hrs
Step. pneumoniae; Haemophilus influenzae; group B-strep

18. Normal pulse ox
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Measures speed of exhalation; results measure by age and weight
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
92-100%

19. Respiratory Examination (Observation)
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
Measures speed of exhalation; results measure by age and weight
Apena alternating with hyperpnea;
Macrolides (azithormycin); Doxycycline; TMZ-SMZ

20. What is the common side effect of sympathomimetics?
Is the process upper or lower respiratory system - or both? Is the diagnostic workup necessary or can you initiate empiric treatment? Are antibiotics indicated?If so which ones and for how long? Can this patient be treated in the outpatients setting
Rebound congestion 3-5 days
Aspirin: Reye's Syndrome
>12 weeks

21. Rhinosinusitis physical exam?
Hardher and more turbulent
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Rebound congestion 3-5 days
PE: rhinoscopy with otoscope

22. What is most common age range for otitis?
Warm - humid environment; rest;
Deep - rapid - labored - breathing
3 months to 3 years old
Rebound congestion 3-5 days

23. Cold incubation period
24-72 hrs
<4 weeks
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes

24. Acute viral rhino-sinusitis (AVRS) pathogens?
Measures speed of exhalation; results measure by age and weight
Rhinovirus - influenza - parainfluenza
Is the process upper or lower respiratory system - or both? Is the diagnostic workup necessary or can you initiate empiric treatment? Are antibiotics indicated?If so which ones and for how long? Can this patient be treated in the outpatients setting
Erythmatous auditory canal - crusting

25. Alternative rx for bacterial sinusitis?
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
Macrolides (azithormycin); Doxycycline; TMZ-SMZ
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Aspirin: increases viral shedding

26. What are the symptoms of otitis?
Ear ache - dullness - hearing loss - fever - N/V/D
Symptomatic (steam; nasal irrigation); APAP for pain.
Chest-X-Ray: (ABCDEFG) Airways and lung fields; bone and soft tissue - cardiac contour and mediastinum; diaphragms and costophrenic angles; exam technique; foreign bodies - tubes - and wires; gastric air bubble
Palpation: chest wall for tenderness; tactile fremitus - asymmetric chest wall expansion; Percussion: resonant vs. tympany vs dullness; Auscultation: cough or adventious sounds - lung sounds - pleural friction rubs

27. Symptoms of acute bacterial rhino-sinusitis (ABRS)?
Hardher and more turbulent
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
Pulse ox; Peak expiratory flow; spirometry

28. Special cases of sinusitis?
Palpation: chest wall for tenderness; tactile fremitus - asymmetric chest wall expansion; Percussion: resonant vs. tympany vs dullness; Auscultation: cough or adventious sounds - lung sounds - pleural friction rubs
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
24-72 hrs
Aspirin: increases viral shedding

29. Wheezes
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Inflammation of the nasal cavity

30. Rx for viral URI?
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)

31. Orthopnea
Dyspnea when supine - relived by sitting or standing
Aspirin: Reye's Syndrome
Persistent; recurrent x4/yr; severe HA; altered mental status
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.

32. Egophany (vocal resonance)
3 months to 3 years old
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Warm - humid environment; rest;
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction

33. Common cold symptoms
Inflammation of the nasal cavity
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Warm - humid environment; rest;
Aspirin: Reye's Syndrome

34. Physical exam of chest
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction
Rebound congestion 3-5 days
Palpation: chest wall for tenderness; tactile fremitus - asymmetric chest wall expansion; Percussion: resonant vs. tympany vs dullness; Auscultation: cough or adventious sounds - lung sounds - pleural friction rubs
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration

35. Pulmonary diagnostics (1)
Ear ache - dullness - hearing loss - fever - N/V/D
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
Chest-X-Ray: (ABCDEFG) Airways and lung fields; bone and soft tissue - cardiac contour and mediastinum; diaphragms and costophrenic angles; exam technique; foreign bodies - tubes - and wires; gastric air bubble
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine

36. Tx for adult AOM?
Sore throat; nasal congestion; sections mucopurulent/clear; fullness in sinuses and ears; low grade fever; peaks 3-5 days; occasional cough; itchy nose - eyes - throat;
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration

37. Spirometry
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
92-100%
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
Assess how fast a patient can expire in a second (FEV1) - FEV is the amount of air that normal lung can hold - FEV1 is reduced in asthma and COPD - FEV is reduced when there is restriction of the chest wall

38. Kussmal's respiration
Erythmatous auditory canal - crusting
Step. pneumoniae; Haemophilus influenzae; group B-strep
Increased loudness of whispering during auscultation. Indicative of consolidation.
Deep - rapid - labored - breathing

39. Common Cold (URI - Acute Coryza)
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Erythmatous auditory canal - crusting
Inflammation of the paranasal sinuses

40. Which Rx should not be used for viral URI pecs?

41. Vesicular breath sounds...
Chest-X-Ray: (ABCDEFG) Airways and lung fields; bone and soft tissue - cardiac contour and mediastinum; diaphragms and costophrenic angles; exam technique; foreign bodies - tubes - and wires; gastric air bubble
PE: rhinoscopy with otoscope
Soft sounds in and out
Macrolides (azithormycin); Doxycycline; TMZ-SMZ

42. Which Rx should not be used for viral URI?
Aspirin: increases viral shedding
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Persistent; recurrent x4/yr; severe HA; altered mental status
Hardher and more turbulent

43. What are physical exam findings of AOM?
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD
TM erythmatous - bulging - light reflex displaced - exudate
Step. pneumoniae; Haemophilus influenzae; group B-strep

44. Rhinitis
Deep - rapid - labored - breathing
Aspirin: Reye's Syndrome
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Inflammation of the nasal cavity

45. Bronchophony
TM erythmatous - bulging - light reflex displaced - exudate
Ipratroprium bromide (e.g. Atrovent); Antihistamines (Cargeul not to overly dry out muscos)
Apena alternating with hyperpnea;
Increased breath sounds or voice remains loud at the periphery during auscultation. Indicative of consolidation.

46. Bronchial breath sounds...
Rhinovirus - influenza - and parainfluenza
E. coli
Hardher and more turbulent
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD

47. What sinusitis symptoms would warrant image studies?
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Persistent; recurrent x4/yr; severe HA; altered mental status
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Rhinovirus - influenza - parainfluenza

48. Symptoms of viral rhinosinusitis
Erythmatous auditory canal - crusting
Sore throat; nasal congestion; sections mucopurulent/clear; fullness in sinuses and ears; low grade fever; peaks 3-5 days; occasional cough; itchy nose - eyes - throat;
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction
4-12 weeks

49. Pulmonary tests
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Ear ache - dullness - hearing loss - fever - N/V/D
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Pulse ox; Peak expiratory flow; spirometry

50. What is the most common pathogen for otitis in newborns?
E. coli
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Ear ache - dullness - hearing loss - fever - N/V/D
<4 weeks