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. Physical exam of chest
3 months to 3 years old
Rhinovirus - influenza - parainfluenza
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
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;

2. Rhinosinusitis physical exam?
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
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

3. Acute rhino-sinusitis duration of symptoms?
Inflammation of the paranasal sinuses
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
<4 weeks
>12 weeks

4. Tx of sinusitis symptoms <10 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
Symptomatic (steam; nasal irrigation); APAP for pain.
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
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;

5. Which Rx should not be used for viral URI?
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Aspirin: increases viral shedding
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Clubbing - Use of accessory muscles - barrel chest

6. What does mucopurulent indications not indicate?
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Bacterial infection
Measures speed of exhalation; results measure by age and weight
Rhinovirus - influenza - parainfluenza

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

8. What is the most common pathogen for otitis in newborns?
Erythmatous auditory canal - crusting
E. coli
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Pulse ox; Peak expiratory flow; spirometry

9. Common cold symptoms
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Inflammation of the nasal cavity
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)

10. Common Cold (URI - Acute Coryza)
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.
Erythmatous auditory canal - crusting
4-12 weeks

11. Pulmonary diagnostics (1)
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
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
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction
24-72 hrs

12. Rhinosinusitis risk factors?
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Aspirin: Reye's Syndrome
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

13. Abnormal pulmonary findings?
Clubbing - Use of accessory muscles - barrel chest
>12 weeks
Step. pneumoniae; Haemophilus influenzae; group B-strep
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)

14. Symptoms of viral rhinosinusitis
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction
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;
Ipratroprium bromide (e.g. Atrovent); Antihistamines (Cargeul not to overly dry out muscos)
4-12 weeks

15. Rhinosinusitis History?
Rebound congestion 3-5 days
Oflaxicin 0.3% solution BID
TM erythmatous - bulging - light reflex displaced - exudate
Nasal congestion - HA - sinus pain - fever - sore throat - cough

16. Stridor
4-12 weeks
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
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration

17. Acute otitis media
Apena alternating with hyperpnea;
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])

18. Spirometry
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
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
Increased loudness of whispering during auscultation. Indicative of consolidation.

19. Cheyne-stokes
Ear ache - dullness - hearing loss - fever - N/V/D
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
Step. pneumoniae; Haemophilus influenzae; group B-strep
Apena alternating with hyperpnea;

20. What are the symptoms of otitis?
<4 weeks
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
Ear ache - dullness - hearing loss - fever - N/V/D
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;

21. Rhonchi
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Aspirin: Reye's Syndrome
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.

22. Symptoms of acute bacterial rhino-sinusitis (ABRS)?
Persistent; recurrent x4/yr; severe HA; altered mental status
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
Bacterial infection
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell

23. Diagnostics of sinusitis?
Dyspnea when supine - relived by sitting or standing
Apena alternating with hyperpnea;
Aspirin: increases viral shedding
PE: rhinoscopy with otoscope

24. Rx for rhinorrhea and/or allergies?
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
Ipratroprium bromide (e.g. Atrovent); Antihistamines (Cargeul not to overly dry out muscos)
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
TM erythmatous - bulging - light reflex displaced - exudate

25. Wheezes
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

26. Acute viral rhino-sinusitis (AVRS) pathogens?
Rhinovirus - influenza - parainfluenza
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Erythmatous auditory canal - crusting
Nasal congestion - HA - sinus pain - fever - sore throat - cough

27. Cold incubation period
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
24-72 hrs
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
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;

28. Special cases of sinusitis?
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
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
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Macrolides (azithormycin); Doxycycline; TMZ-SMZ

29. Rx for viral URI?
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
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine
24-72 hrs

30. What is the most common pahtogen for otitis media?
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Step. pneumoniae; Haemophilus influenzae; group B-strep
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD

31. Respiratory Examination (Observation)
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
Bacterial infection
>12 weeks
Nasal congestion - HA - sinus pain - fever - sore throat - cough

32. Vesicular breath sounds...
Hardher and more turbulent
Pulse ox; Peak expiratory flow; spirometry
Rebound congestion 3-5 days
Soft sounds in and out

33. Tx for pediatric AOM?
E. coli
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])

34. Respiratory Illness Key Points (3)
Rebound congestion 3-5 days
E. coli
Aspirin: increases viral shedding
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

35. 1st line treatment for bacterial sinusitis?
3 months to 3 years old
92-100%
Ear ache - dullness - hearing loss - fever - N/V/D
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses

36. What are physical exam findings of AOE?
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
Clubbing - Use of accessory muscles - barrel chest
Aspirin: Reye's Syndrome
Erythmatous auditory canal - crusting

37. Normal pulse ox
>12 weeks
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine
E. coli
92-100%

38. Rx nasal congestion?
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
Rebound congestion 3-5 days
Inflammation of the paranasal sinuses
Macrolides (azithormycin); Doxycycline; TMZ-SMZ

39. Peak Expiratory Flow (PEF)
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
Measures speed of exhalation; results measure by age and weight
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
Rhinovirus - influenza - parainfluenza

40. What is the common side effect of sympathomimetics?
24-72 hrs
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
Measures speed of exhalation; results measure by age and weight
Rebound congestion 3-5 days

41. Kussmal's respiration
Symptomatic (steam; nasal irrigation); APAP for pain.
Hardher and more turbulent
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
Deep - rapid - labored - breathing

42. Bronchial breath sounds...
Persistent; recurrent x4/yr; severe HA; altered mental status
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
Hardher and more turbulent
Rhinovirus - influenza - and parainfluenza

43. Pulmonary tests
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses
Ear ache - dullness - hearing loss - fever - N/V/D
Pulse ox; Peak expiratory flow; spirometry
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea

44. Common cold pathogens
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
Rhinovirus - influenza - and parainfluenza
92-100%
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction

45. Crackles (rales)
Dyspnea when supine - relived by sitting or standing
Step. pneumoniae; Haemophilus influenzae; group B-strep
Inflammation of the nasal cavity
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis

46. Bronchophony
Oflaxicin 0.3% solution BID
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
Increased breath sounds or voice remains loud at the periphery during auscultation. Indicative of consolidation.
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days

47. Sinusitis
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
Inflammation of the paranasal sinuses
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days

48. Additional pulmonary diagnostics
Macrolides (azithormycin); Doxycycline; TMZ-SMZ
>12 weeks
Ipratroprium bromide (e.g. Atrovent); Antihistamines (Cargeul not to overly dry out muscos)
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

49. Whispered pectoriloguy
4-12 weeks
Apena alternating with hyperpnea;
Increased loudness of whispering during auscultation. Indicative of consolidation.
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])

50. Subacute rhino-sinusitis duration of symptoms?
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
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
4-12 weeks