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. What are physical exam findings of AOM?
Macrolides (azithormycin); Doxycycline; TMZ-SMZ
TM erythmatous - bulging - light reflex displaced - exudate
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.

2. Additional pulmonary diagnostics
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Rhinovirus - influenza - and parainfluenza
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
Rate; pattern (regular or irregular); effort (labored - accessory muscles)

3. Stridor
Bacterial infection
Symptomatic (steam; nasal irrigation); APAP for pain.
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
E. coli

4. Tx for adult AOE?
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
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
Oflaxicin 0.3% solution BID
Warm - humid environment; rest;

5. What are the symptoms of otitis?
Deep - rapid - labored - breathing
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;
Abrupt onset - burning nose or throat - sneezing - rhinorrhea

6. Pulmonary diagnostics (1)
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI
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
Dyspnea when supine - relived by sitting or standing
4-12 weeks

7. Which Rx should not be used for viral URI?
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;
92-100%
Aspirin: increases viral shedding
Inflammation of the paranasal sinuses

8. Normal pulse ox
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
92-100%
Deep - rapid - labored - breathing
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)

9. Respiratory Examination (Observation)
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine
Oflaxicin 0.3% solution BID
Afebrile viral infection of the the nose - paranasal sinuses - throat - larynx - trachea - and and bronchi.

10. What is the most common pahtogen for otitis media?
Step. pneumoniae; Haemophilus influenzae; group B-strep
Ear ache - dullness - hearing loss - fever - N/V/D
Measures speed of exhalation; results measure by age and weight
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

11. Spirometry
Ear ache - dullness - hearing loss - fever - N/V/D
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
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

12. Rhinitis
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
Inflammation of the paranasal sinuses
Bacterial infection
Inflammation of the nasal cavity

13. Chronic rhino-sinusitis duration of symptoms?
Decongestants (oxymetazoline); glucocorticoids (e.g. fluticasone); mucolytics (e.g. guaifensin)
Rebound congestion 3-5 days
>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

14. Symptoms of acute bacterial rhino-sinusitis (ABRS)?
Rhinovirus - influenza - and parainfluenza
Rhinovirus - influenza - parainfluenza
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
Apena alternating with hyperpnea;

15. Rhonchi
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD
Warm - humid environment; rest;
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
Aspirin: Reye's Syndrome

16. Kussmal's respiration
Inflammation of the paranasal sinuses
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Deep - rapid - labored - breathing
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.

17. Common cold pathogens
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Amoxicillin 1000 mg TID x7 days; Augmentin 2000/125mg BID x7 days
Rhinovirus - influenza - and parainfluenza
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes

18. Egophany (vocal resonance)
Increased breath sounds or voice remains loud at the periphery during auscultation. Indicative of consolidation.
4-12 weeks
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction

19. What does mucopurulent indications not indicate?
92-100%
Deep - snoring sound; indicates fluid or narrowing of airways; common in bronchitis and COPD
Bacterial infection
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days

20. Rhinosinusitis risk factors?
Nasal polyps - deviated septum - hx of trauma - surgery - foreign bodies or recent altitude changes
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days

21. Rhinosinusitis physical exam?
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
Inflammation of the nasal cavity

22. Common cold symptoms
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses
92-100%
Apena alternating with hyperpnea;

23. Rhinosinusitis History?
Increased loudness of whispering during auscultation. Indicative of consolidation.
Aspirin: increases viral shedding
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses

24. Whispered pectoriloguy
E. coli
Increased loudness of whispering during auscultation. Indicative of consolidation.
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
92-100%

25. Rx for viral URI?
NSAIDs for aches - fever; Sympathomimetics: pseudophedrine or phenylephrine
Inflammation of the nasal cavity
Oflaxicin 0.3% solution BID
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration

26. Acute rhino-sinusitis duration of symptoms?
<4 weeks
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Measures speed of exhalation; results measure by age and weight
Warm - humid environment; rest;

27. Nonpharmacological tx for viral URI
Warm - humid environment; rest;
E. coli
Rhinovirus - influenza - parainfluenza
Pulse ox; Peak expiratory flow; spirometry

28. Diagnostics of sinusitis?
Ipratroprium bromide (e.g. Atrovent); Antihistamines (Cargeul not to overly dry out muscos)
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
PE: rhinoscopy with otoscope

29. Pulmonary tests
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Abnormal high pitched caused by blockage in upper airway; usually heard with with inspiration
Pulse ox; Peak expiratory flow; spirometry
92-100%

30. Crackles (rales)
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses
Bacterial infection
Fine or courses; secretions or aveolar collapse; normal if resovle with cough; abnormal: pneumonia; CHF; COPD; pilmonary fibrosis
24-72 hrs

31. Physical exam of chest
Aspirin: increases viral shedding
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;
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
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

32. Proxysmal nocturnal dyspnea
E. coli
Severe dyspnea when lying supine with associated wheezing and coughing - need to sit up abruptly due to severe dyspnea
Aspirin: Reye's Syndrome
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF

33. Subacute rhino-sinusitis duration of symptoms?
4-12 weeks
Rhinovirus - influenza - parainfluenza
Aspirin: Reye's Syndrome
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction

34. Cheyne-stokes
TM erythmatous - bulging - light reflex displaced - exudate
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Apena alternating with hyperpnea;
Step. pneumoniae; Haemophilus influenzae; group B-strep

35. 1st line treatment for bacterial sinusitis?
Inflammation of the nasal cavity
Dyspnea when supine - relived by sitting or standing
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Augementin 2000/124 mg bid for 5-7 days - Peds: 90 mg/kg/day po in divided doses

36. What is the most common pathogen for otitis in newborns?
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)
Nasal congestion - HA - sinus pain - fever - sore throat - cough
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
E. coli

37. Tx for pediatric AOM?
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Deep - rapid - labored - breathing
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
Apena alternating with hyperpnea;

38. Acute viral rhino-sinusitis (AVRS) pathogens?
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
Rhinovirus - influenza - parainfluenza
PE: rhinoscopy with otoscope
Warm - humid environment; rest;

39. Sinusitis
Inflammation of the paranasal sinuses
Hardher and more turbulent
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
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell

40. Abnormal pulmonary findings?
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
Clubbing - Use of accessory muscles - barrel chest
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
<4 weeks

41. What sinusitis symptoms would warrant image studies?
Abrupt onset - burning nose or throat - sneezing - rhinorrhea
Persistent; recurrent x4/yr; severe HA; altered mental status
>12 weeks
Viral inoculation > viral rhinitis > infection of paranasal sinuses > inflammation & edema > mucosal edema - copious secretions - ciliary dyskinesia > sinus congestions and/or obstruction

42. Orthopnea
Dyspnea when supine - relived by sitting or standing
Deep - rapid - labored - breathing
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
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

43. Vesicular breath sounds...
Soft sounds in and out
High pitched voice sound due to transmission of noise across fluid. Indicative of effusion.
Increased loudness of whispering during auscultation. Indicative of consolidation.
Labs: CBC - blood gas - d-dimer - CMP - BNP - Chest CT - MRI

44. What is the common side effect of sympathomimetics?
Rebound congestion 3-5 days
Amoxicillin 80-90mg/kg/day x7 days; Augmentin 90/6.4 mg/kg/day x7 days
Measures speed of exhalation; results measure by age and weight
Apena alternating with hyperpnea;

45. Tx of sinusitis symptoms <10 days
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.
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;
Symptomatic (steam; nasal irrigation); APAP for pain.
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF

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

47. Symptoms of viral rhinosinusitis
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
Rate; pattern (regular or irregular); effort (labored - accessory muscles)
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)

48. What are physical exam findings of AOE?
Persistent; recurrent x4/yr; severe HA; altered mental status
Erythmatous auditory canal - crusting
Purulent discharge - post nasal draiange; cough; sinus pressure - tooth pain; halitosis (changes in taste); alterations of smell
HEENT: rhinoscopy - sinus tenderness - lymphnodes - transillumination of sinuses - CV and PULM.

49. Special cases of sinusitis?
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
Bacterial or viral infection of the middle ear (secondary to URI [e.g. eustachian tube dysfunction])
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Persistent or relapse of infection - chronic sinusitis - fungal infection - extension in CNS (meningitis - orbital cellulitis - osteitis)

50. Wheezes
Aspirin: increases viral shedding
<4 weeks
High pitched sounds; can occur during inspiration or expiration; indicates narrow airways; can occur with asthma - COPD - pneumonia - CHF
Deep - rapid - labored - breathing