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Quiz Questions (31 questions)
1. The nasal cavity is a space within the nose and skull that is lined with mucous membrane.
2. The most probable diagnosis for a 9-month-old infant with unilateral nasal purulent, malodorous bloody discharge not responding to treatment for one month is nasal foreign body.
3. The oropharynx is the part of the throat at the back of the mouth behind the oral cavity.
4. Coxsackie virus is the most probable causative organism for inflamed oropharynx with scattered vesicles on tongue, buccal mucosa, gingiva, lips, and posterior pharynx; also, on hands and feet and buttocks; tend to be painful.
5. Laryngomalacia is a condition where the laryngeal structures are soft and floppy, causing noisy breathing mainly during inspiration.
6. Viral croup is the least likely diagnosis for a 5-month-old boy with noisy breathing mainly during inspiration, and more prominent when he is crying, his symptoms was noted since he was one week of age.
7. The most likely diagnosis for a 3-years-old male child presented to hospital because of sudden onset of respiratory distress preceded by chocking and coughing episodes while he was playing with his toys and diminished air entry and expiratory rhonchi over the right side is Foreign body aspiration.
8. Scarlet fever is the most likely diagnosis for a 4-year-old child presents with fever, diffuse finely papular red rash with circumoral pallor, coated tongue with reddish swollen papillae, and follicular tonsillitis of 1-day duration.
9. S. pneumonia, non-typeable H. influenzae, M. catarrhalis are the most likely expected causative organisms for a 6-year-old child presented with headache, face pain, fever, cough, erythema and swelling of nasal mucosa, nasal congestion and discharge and no history of similar attack.
10. Nebulized epinephrine and corticosteroids is the next step in management of a 7-month-old boy with respiratory difficulty, cough and coryza 3 days ago, and the cough has become barky.
11. Immediate transfer to the operating room for tracheal intubation is the next most appropriate step in management for a 14-month-old girl with a 6-hour history of fever and an increasingly ill appearance, respiratory rate of 70 breaths/minute, and her neck is hyperextended.
12. Group A beta hemolytic streptococci is the most probable causative organism for a 7-year-old girl presents with fever and sore throat, tonsillar erythema and exudates, circumoral pallor and red, finely papular erythematous rash diffusely that feels like sandpaper and can be repeated in the future.
13. Upright, head forward is the best position for an 8-year-old child during nasal compression for repeated episodes of nose bleeding.
14. Coxsackie virus is the most likely causative agent of vesicular rash in the mouth, small vesicular lesions on his palms, soles and buccal mucosa in an 18-month-old child.
15. Choanal atresia is the most probable diagnosis for a 2-day-old baby whose lips looks blue and they turned pink during crying and has difficulty to feed and breath at the same time.
16. Retropharyngeal abscess is the most probable diagnosis for a 5-year-old child presented with fever, irritability, decreased oral intake, neck stiffness, torticollis, refusal to move neck, muffled voice and bulging of posterior pharyngeal wall.
17. Pass catheter 3 cm into nasopharynx is the next step in management for a 3-day-newborn was presented with cyanosis and cyanosis has improved, and his baby turned pink with crying.
18. Displacement of uvula away from the affected side is diagnostic sign to diagnose peritonsillar abscess in a 10-year-old girl presents with fever and sore throat, tonsillar erythema and exudates and asymmetric tonsillar bulge.
19. Stridor in supine that decreases in prone supports diagnosis of laryngomalacia in a 2-month-old infant presented with stridor since birth.
20. Displacement of pinna inferiorly and posteriorly supports diagnosis of acute mastoiditis in a 4-year-old child with persistence of ear pain, high fever and a painful swelling behind the same ear.
21. Group A beta hemolytic streptococci is the most probable causative organism for a 7-year-old girl presents with fever and sore throat, tonsillar erythema and exudates, circumoral pallor and red, finely papular erythematous rash diffusely that feels like sandpaper.
22. No antibiotics are needed for a 5-year-old boy with a history of recurrent acute otitis media and penicillin allergy receives a diagnosis of otitis media with effusion.
23. Barky cough is most helpful in attempting to differentiate croup from epiglottitis in a 3-year-old boy presented with fever and a cough.
24. Choanal atresia is the most probable diagnosis for a 3-day-newborn presented with cyanosis and cyanosis is improved, and his baby turned pink with crying.
25. S. pneumonia, nontypeable H. influenzae, M. catarrhalis are the expected causative organisms for a 6-year-old child presented with headache, face pain, fever, cough and nasal congestion, discharge.
26. Direct laryngoscopy in the operating room is the appropriate next step in patient management for a 4-year-old boy presents with sore throat and fever of sudden onset, difficulty swallowing and his breathing is labored, drooling and sitting upright and leaning forward in a tripod position.
27. Serum glucose 25 mg/dL is the most likely explanation of a 4.3 kg infant delivered to a woman whose diabetes mellitus is poorly controlled who is lethargic, with weak cry, poor suckling, and jitteriness.
28. GABHS, anaerobes, Staphylococcus aureus is the most likely result of culture sensitivity test for a 5-year-old child presented with fever, irritability, decreased oral intake, neck stiffness, torticollis, refusal to move neck, muffled voice and bulging of posterior pharyngeal wall.
29. Nebulized epinephrine is the suitable first line of treatment for a 2-year-old boy presents to the ER with barking cough and stridor and difficulty breathing.
30. Adenovirus is the most probable causative organism for a 3-year-old child presented with fever, inflamed oropharynx and conjunctivitis.
31. Prescribe penicillin is the most appropriate next step for a 7-year-old girl presents with fever and sore throat, tonsillar erythema and exudates and rapid strep test is positive.
Previous Exam Questions (21 questions)
1. The most probable diagnosis of a neonate presenting with stridor since birth that increases in the supine position and improves in the prone position is laryngomalacia.
2. A newborn diagnosed with a specific anomaly (as seen in the photo, which is not provided) might have complications such as otitis media, hearing loss, and speech problems.
3. A 5-year-old child presenting with fever, irritability, decreased oral intake, torticollis, refusal to move the neck, and a muffled voice, with examination showing bulging of the posterior pharyngeal wall, most likely has a retropharyngeal abscess.
4. The first-line treatment for a 1-year-old child with a 3-day history of fever and cold symptoms, now complaining of right ear pain and exhibiting a bulging tympanic membrane with loss of light reflex landmarks, is amoxicillin.
5. A 3-day-old newborn presenting with cyanosis that improves and turns pink with crying most likely has choanal atresia.
6. A 2-year-old child presenting with a barking cough and a plain radiograph of the neck showing a steeple sign most likely has croup.
7. A 16-year-old girl presenting with fever, sore throat, dysphagia, tonsillar erythema and exudates with asymmetric pharyngeal bulge, and a history of recurrent acute pharyngotonsillitis, the diagnostic sign for the most likely diagnosis is displacement of the uvula away from the affected side.
8. During the examination of a 4-year-old previously healthy child presenting to the emergency department with a sudden onset of high fever, sore throat, difficulty swallowing, drooling, sitting in a tripod position, appearing anxious, having muffled speech, and inspiratory stridor, precautions should be taken to not examine the throat unless an anesthesiologist or otolaryngologist is present.
9. A 4-year-old child seen in the outpatient clinic with a 3-day history of fever and cold symptoms, now complaining of right ear pain and exhibiting a bulging tympanic membrane with loss of light reflex and landmarks, most likely has acute otitis media; if two days later, the child presents with persistence of ear pain, high fever, a painful swelling behind the same ear, displacement of the pinna inferiorly and anteriorly, and inflammation of the posterior auricular area with pain on percussion of the mastoid process, the most probable diagnosis is acute mastoiditis.
10. Severe croup, the severe form of the most likely diagnosis for a 12-month-old infant brought to the emergency department because of barky cough, runny nose, fever, and cough, is characterized by mental status changes accompanied by significant respiratory distress and decreasing air entry, indicating impending respiratory failure.
11. The most probable diagnosis of a neonate who presented with stridor since birth that increases in the supine position and improves in the prone position is laryngomalacia.
12. Two complications that a newborn diagnosed with choanal atresia might have are hearing loss and speech problems.
13. The most probable diagnosis for a 5-year-old child presented with fever, irritability, decreased oral intake, torticollis, refusal to move neck, and muffled voice with examination showing bulging of the posterior pharyngeal wall is retropharyngeal abscess.
14. The first line of choice for treating a patient with a bulging tympanic membrane with loss of light reflex landmarks is amoxicillin.
15. The most likely diagnosis for a 3-day-newborn presented with cyanosis that improves and turns pink with crying is choanal atresia.
16. The most probable diagnosis of a 2-year-old child who presented with barking cough and a steeple sign on a plain radiograph of the neck is croup.
17. The diagnostic sign for the most likely diagnosis of a 16-year-old girl presented with fever, sore throat, dysphagia, tonsillar erythema and exudates with asymmetric pharyngeal bulge and a history of recurrent acute pharyngotonsillitis is displacement of the uvula away from the affected side.
18. When examining a 4-year-old previously healthy child who presents to the emergency department with a sudden onset of high fever, sore throat, difficulty swallowing, drooling, sitting in a tripod position, appearing anxious, having muffled speech, and inspiratory stridor, the throat should not be examined unless an anesthesiologist or otolaryngologist is present.
19. The most probable diagnosis for a 4-year-old child seen in the outpatient clinic with a 3-day history of fever and cold symptoms who now complains of right ear pain and has a bulging tympanic membrane with loss of light reflex and landmarks is acute otitis media.
20. The most probable diagnosis for a 4-year-old child who presents two days later with persistence of ear pain, high fever, and a painful swelling behind the same ear, and on examination there is displacement of pinna inferiorly and anteriorly and inflammation of posterior auricular area with pain on percussion of mastoid process is acute mastoiditis.
21. Severe croup is characterized by mental status changes accompanied by significant respiratory distress and decreasing air entry, indicating impending respiratory failure.
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Alright man, let's break down these upper respiratory tract diseases and everything you need to know for the exam. This is really important stuff, so pay attention. **Nasal Cavity and Nasal Issues** The **nasal cavity** is basically the space inside your nose and skull, and it's lined with a mucou...
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