APEA EENT 2023 SOLVED

APEA EENT 2023 SOLVED APEA EENT 2023 SOLVED For tx of blepharitis, pts should be instructed to apply erythromycin ointment to the affected eye using: - ANSWERSA 1 cm ribbon 5 times daily for 7 days The ophthalmic preparation that is NOT available OTC is: - ANSWERSHydroxypropyl cellulose (Lacrisert), a lubricant Oseltamivir (Tamiflu) is an antiviral agent, further classified as a(n): - ANSWERSNeuraminidase inhibitor The duration of action of ocular decongestants such as oxymetazoline (Visine-LR) is approximately: - ANSWERS6 hours-pts should be advised to apply 1-2 drops in the affected eye q 6 hours The mechanism of action for macrolides is to: - ANSWERSblock the dissociation of peptidyl tRNA from ribosomes 2nd generation antihistamines: - ANSWERShave a variety of anti-inflammatory properties-including decreased mast cell mediator properties and downregulation of adhesion molecule expression After the administration of olopatadine (Pataday) ophthalmic for allergic conjunctivitis, contact lenses should not be inserted for at least: - ANSWERS10 minutes-do not insert if eyes are red Which of the following is NOT a mechanism of action of ocular steroids? - ANSWERSPromotes capillary proliferation and dilation The mechanism of action of polymyxin B/trimethoprim ophthalmic is: - ANSWERSIncreased cell wall permeability/inhibition of nucleic acid and protein synthesis Sulfacetamide/prednisolone (Blephamide) is NOT indicated in: - ANSWERSOcular mycobacterial infection (ocular tuberculosis) The mechanism of action of pheniramine is that it: - ANSWERSAntagonized histamine-1 receptors The duration of action of meclizine (Antivert) is: - ANSWERS8 hours-1st gen antihistamine , onset ~1 hr with half-life of 6 hours The mechanism of action for mast cell stabilizers is: - ANSWERSInhibition of histamine release and slow reacting substances of anaphylaxis The brand name for sulfacetamide ophthalmic is: - ANSWERSBleph-10 The vasoconstrictive properties of alpha- agonist medications make them beneficial for the tx of: - ANSWERSSinus congestion-used to reduce edema and inflammation within sinus cavities The generic name for Dramamine is: - ANSWERSDimehydrinate Which risk factor would NOT prohibit the NP from prescribing prednisolone acetate (Pred Forte)? - ANSWERSSuperficial punctate keratitis Which of the following organisms is NOT susceptible to sulfacetamide ophthalmic (Bleph-10)? - ANSWERSPsuedomonas aeruginosa- does not provide adequate coverage against Neisseria species A medication that acts on the hypothalamus to produce antipyresis is: - ANSWERSAcetaminophen Azelasine (Astelin), for tx of allergic rhinitis, is classified as a nasal: - ANSWERSAntihistamine A serious adverse reaction to clindamycin (Cleocin) is: - ANSWERSClostridium difficile-related colitis If ocular steroids are to be used for more than 10 days, monitoring should include: - ANSWERSOcular pressure The most effective tx for eradication of group A streptococcus in those who are apparent carriers is: - ANSWERSOral clindamycin (Cleocin) for 10 days Oxymetazoline nasal spray, a nasal decongestant, is manufactured under the brand name: - ANSWERSAfrin Which of the following is a cholinergic agonist used in the tx of glaucoma? - ANSWERSPilocarpine (Pilopine HS) ophthalmic A common side effect related to the administration of cetirizine (Zyrtec) is: - ANSWERSDrowsiness-admin at bedtime The onset of action of oxymetazoline (Afrin) is: - ANSWERS1o minutes, 2-3 sprays in each nostril q 10-12 hours First-line tx for children who are diagnosed with Strep pharyngitis is: - ANSWERSAmoxicillin (Amoxil) Brand names of sulfamethoxazole/trimethoprim do NOT include: - ANSWERSAzulfidine (sulfasalazine) The duration of action of azelastine (Optivar) ophthalmic drops is: - ANSWERS8 hours Naphazoline/pheniramine (Naphcon-A) is indicated in the treatment of: - ANSWERSAllergic conjunctivitis Ocular steroids indicated for the tx of allergic conjunctivitis can be used in pts with: - ANSWERSHerpes zoster keratitis Polycin-B is the brand name for: - ANSWERSPolymyxin B and bacitracin The brand name for meclizine is: - ANSWERSAntivert Due to potential drug-drug interactions, therapy should be monitored when a pt is receiving erythromycin (Eyemycin) ointment and: - ANSWERSWarfarin-may increase serum concentration of Vit K antagonists such as warfarin Due to the potential development of pseudo tumor cerebri, tetracycline (Sumycin) should not be administered concomitantly with: - ANSWERSIsotretinoin (Claravis)-may enhance the adverse/toxic effect of retinoic acid derivatives A benefit of prescribing an ophthalmic antihistamine with mast cell stabilizer property would be that the mast cell stabilizer provides: - ANSWERSAn extended duration of action-due to their high affinity to the H-1 receptor Ocular decongestants such as oxymetazoline (Visine-LR) are used to reduce: - ANSWERSRedness Pts should be advised to administer polymyxin B/trimethoprim q: - ANSWERS3 hours, maximum 6 doses in 24 hour period The most common symptoms of penicillin allergy includes hives, itchy eyes, and: - ANSWERSSwollen lips Bacitracin (Ocu-tracin) ophthalmic ointment inhibits bacterial cell wall synthesis by: - ANSWERSPreventing the transfer of mucopeptides into the growing cell wall When prescribing polymyxin B sulfate/bacitracin zinc (Polycin-B), pts should be instructed to: - ANSWERSComplete therapy, even if sx resolve Prolonged use of bacitracin ophthalmic may result in: - ANSWERSFungal overgrowth Which of the following is classified as a 2nd gen antihistamine? - ANSWERSFexofenadine (Allegra) Hydroxyzine-1st gen Pts being treated with trifluridine (Viroptic) for herpes simplex 1 keratoconjunctivitis should be advised to return to the clinic if they do not experience sx improvement within: - ANSWERS7 days Polymyxin B/trimethoprim ophthalmic is NOT indicated for: - ANSWERSOphthalmia neonatorum-does not treat the most common bacterial causes The mechanism of action of trifluridine (Viroptic), an ophthalmic antiviral, used the treatment of herpes simplex conjunctivitis is: - ANSWERSInterference with viral replication by inhibiting thymidylate synthetase A common side effect of oral phenylephrine (Sudafed), a decongestant is: - ANSWERSAnxiety Cephalosporins are classified as: - ANSWERSBeta-lactam antibiotics Ophthalmic cromolyn inhibits the degranulation of sensitized mast cells. It is indicated in the treatment of: - ANSWERSVernal conjunctivitis Dosing of oseltamivir (Tamiflu) for older adult pts with active influenza and a creatinine clearance between 30-60 mL/min is: - ANSWERS30mg PO BID for 5 days Which of the following is NOT a potential adverse effect of sulfacetamide ophthalmic (Bleph-10) for the tx of acute conjunctivitis? - ANSWERSAcute renal insufficiency The brand name of prednisolone acetate ophthalmic is: - ANSWERSPred Forte Pts who are using a glucocorticoid nasal spray should be advised to: - ANSWERSPrime the pump prior to first use or if unused for more than a week Which of the following does NOT cause a drug-disease interaction when using a decongestant/antihistamine medication such as Naphazoline/pheniramine (Naphcon-A)? - ANSWERSHypothyroidism Mydriasis is a term used to describe: - ANSWERSDilation of the pupil Causes of sensorineural hearing loss include all of the following except: - ANSWERSperforated tympanic membrane-this is conductive hearing loss A pt c/o a sore tongue. Findings reveal a smooth and erythematous tongue. This condition is termed: - ANSWERSGlossitis Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the: - ANSWERSVein "winds" down on either side of the artery Raised or flat, deep purple colored lesions noted in the mouth may be suggestive of: - ANSWERSKaposi's sarcoma Redness, bleeding, pain, and swelling of the gums is most likely: - ANSWERSGingivitis A softening of the skin at the angles of the mouth which may be due to nutritional deficiency is commonly referred to as: - ANSWERSAngular cheilitis When examining the conjunctiva and sclera, have the patient look upwards and then: - ANSWERSDepress both lower lids with your thumbs, exposing the sclera and conjunctiva All of the following are examples of causes of sensorineural hearing loss in children except: - ANSWERSThe presence of cerumen impaction When assessing extraocular movements: - ANSWERSInclude the cardinal directions of gaze A pt c/o seeing specks that obscure his line of vision when he looks in a certain direction. This impairment could be caused by: - ANSWERSscotomas On exam of the pupils, both are round but the right pupil appears larger than the left and reacts much slower to light. This condition may be indicative of: - ANSWERSa tonic pupil or Adele's pupil The gradual loss of vision with a change in color and size of the optic disc is referred to as: - ANSWERSGlaucoma A pt presents with c/o burning, itching, tearing, and some pain in the eye. Findings reveal red, scaly, greasy flakes and thickened, crusted lid margins. This would be suggestive of: - ANSWERSBlepharitis Surgical perforation of the tympanic membrane to allow drainage of middle ear secretions is termed: - ANSWERSA myringotomy A 50-year-old pt c/o being unable to read the hymnal at church. This describes - ANSWERSPresbyopia-may begin in the 5th or 6th decade of life A 57-year-old man with a hx of diabetes complains of difficulty hearing on the telephone and muffled sounds while watching the television at a low volume. He should be further evaluated for: - ANSWERSPresbycusis-most common type of sensorineural hearing loss caused by natural aging of the auditory system A person who has been blind since birth presents for a physical exam. Expected findings of the pupillary reaction when light is shown would be: - ANSWERSIt depends-on type of blindness. In order to visualize the opening of Stensen's duct, examine the: - ANSWERSBuccal mucosa opposite the 2nd molar Sudden bilateral and painful visual loss is rare but can be associated with: - ANSWERSRadiation exposure Painless vision loss associated with medications Examples of sudden, painful, unilateral visual loss include all the following except: - ANSWERSRetinal detachment When comparing veins and arteries in the eyes of older adults, the arteries appear: - ANSWERSLess brilliant A condition that involves optic nerve damage and visual field changes is termed: - ANSWERSGlaucoma-leading cause of blindness in the United States Which disorder of the eye can be detected with the cover0uncover and the Hirschberg test? - ANSWERSStrabismus-misalignment of the eyes A 30-year-old pt presents with a moderate "aching" in his right eye. Findings reveal a small and irregular shaped right pupil. The cornea appears cloudy with a slight erythematous area around the corneal limbus. There is no ocular discharge noted. These findings are consistent with: - ANSWERSAcute iritis-vision is decreased and photophobia present, considered an emergency and is usually related to Herpes zoster infection or tuberculosis Where in the mouth would redness areas, nodules, or ulcerations that are suspicious of malignancy be present? - ANSWERSTongue-sides and undersurface of the tongue and the floor of the mouth Examination of the eye reveals a painful, erythematous, and tender area around the nose and lower eyelid. This condition is most likely: - ANSWERSDacryocystitis-inflammation of the lacrimal sac In patients who have allergic rhinitis, the nasal mucosa appears: - ANSWERSPale All of the following sx in a 10-month-old would be indicative of acute otitis media (OM) except: - ANSWERSIncreased mobility of the tympanic membrane-decreased in AOM The immediate sx response in allergic conjunctivitis is due to the rupture of: - ANSWERSMast cells Thrush is most commonly caused by: - ANSWERSCandida albicans Herpes simplex virus (HSV) type 1 is more commonly associated with: - ANSWERSOrofacial lesions-HSV2 is genital What is the term for hemorrhage into the anterior eye chamber as a result of iris rupture? - ANSWERSHyphema-may occur spontaneously but is usually a result of blunt trauma to the eye, ophthalmic emergency The primary site of inoculation by rhinovirus is the: - ANSWERSNasal mucosa Viral rhinitis is typically transmitted to the paranasal sinuses through: - ANSWERSNose blowing Epstein-Barr virus is NOT spread via: - ANSWERSContaminated food-mononucleosis is caused by human herpes virus 4 (HHV-4)-spreads through bodily fluids Complications of acute otitis media can include: - ANSWERSMastoiditis Erythema, edema and narrowing of the diameter of the external auditory canal is most likely related to: - ANSWERSOtitis externa Mastoiditis is most commonly caused by: - ANSWERSStreptococcus pneumoniae The process that is NOT associated with the progression of mastoiditis is: - ANSWERSTemporal bone reconstruction and increased septal vascularity Subjective tinnitus is thought to be caused by: - ANSWERSAbnormal neuronal activity An acute inflammation in the supraglottic region of the oropharynx is most likely: - ANSWERSEpiglottitis Which one of the following is the eye condition in which objects in close proximity are clear and objects in the distance are blurry? - ANSWERSMyopia (nearsightedness) Normal intraocular pressure is: - ANSWERS10-23 mmHg Hearing loss that occurs due to tympanic membrane's inability to vibrate in response to sound is known as: - ANSWERSSensorineural hearing loss Transmission of rhinovirus: - ANSWERSMay occur via hand-to-hand contact Light that is focused behind the retina causes the visual disturbance known as: - ANSWERSHyperopia-normal finding in children younger than 6 years old. Sensorineural hearing loss is due to dysfunction of the: - ANSWERSInner ear The majority of epistaxis episodes occur in the anterior portion of the septum, which is known as: - ANSWERSKiesselbach's plexus Recurrent epistaxis in children is most often caused by: - ANSWERSStaphylococcus aureus The early allergic response is mediated by: - ANSWERSMast cells & basophils The failure of one or both eyes to achieve normal visual acuity despite normal structural health is called: - ANSWERSAmblyopia Which of the following produces and releases leukotriene C4 and histamine into tear fluid during allergic response? - ANSWERSEosinophils The common pathogen associated with otitis media is: - ANSWERSStreptococcus pneumoniae Peritonsillar abscess is a complication of: - ANSWERSTonsillitis The inability of the brain to interpret sound that enters the ear normally is called: - ANSWERSAuditory neuropathy spectrum disorder Persistent overflow of tears over the lower lid margin is: - ANSWERSEpiphora An inflammation of the nasolacrimal sac that is caused by nasolacrimal duct obstruction or infection is termed: - ANSWERSDacryocystitis Which one of the following processes does NOT transform sound waves into something that can be heard? - ANSWERSInterpretation of sound by the cochlear nerve A factor that may affect the onset and severity of presbycusis is: - ANSWERSHypertension-age-related hearing loss, factors that may affect onset are white ethnicity, low socioeconomic status, noise exposure, ototoxins An abnormal growth of squamous epithelium in the middle ear and mastoid is: - ANSWERSCholesteatoma Which form of glaucoma is characterized by a slow rise in intraocular pressure? - ANSWERSOpen-angle Which of the following pathogens is the most likely cause of epiglottitis? - ANSWERSHiB In pts who have allergic rhinitis, sneezing and itching are due to: - ANSWERSStimulation of sensory nerves A group of disorders characterized by elevated intraocular pressure is: - ANSWERSGlaucoma The most common etiologic agent of the common cold is: - ANSWERSRhinovirus Which one of the following is NOT a potential sequelae of streptococcal pharyngitis? - ANSWERSMeningitis Which of the following is a cause of conductive hearing loss? - ANSWERSCerumen impaction Which of the following symptoms is associated with the initial appearance of measurable histamines in a pt with allergic rhinitis? - ANSWERSSneezing An inflammation or infectious process in the mucous membrane of a newborn's eye is: - ANSWERSNeonatal conjunctivitis A nonspherical curvature of the cornea or lens of the eye that causes light to focus at different points is: - ANSWERSAstigmatism Fluid accumulation in the middle ear without evidence of infection is called? - ANSWERSOtitis media with effusion (OME) Infection of the palatine tonsils may become severe quickly because: - ANSWERSThe area is composed of loose connective tissue The most common cause of otitis externa is: - ANSWERSSwimming Which one of the following helps prevent infection by maintaining the acidic environment of the ear canal? - ANSWERSCerumen The inability of ossicles to properly conduct sound in the ear is described as a(n): - ANSWERSConductive hearing loss Macular degeneration causes a loss of: - ANSWERSCentral vision Local nasal irritation that causes blood vessels to become exposed and break is likely to cause: - ANSWERSEpistaxis Which immunoglobulin is responsible for the sx in a pt who has allergic rhinitis? - ANSWERSIgE A nontraumatic inflammation or irritation of the connective tissue of the eye is: - ANSWERSConjunctivitis Inflammation or infection of the eyelids associated with bacterial infection, dry eyes and/or rosacea is: - ANSWERSBlepharitis Lymphadenopathy associated with a peritonsillar abscess will be evident in: - ANSWERSAnterior cervical lymph nodes Which autoimmune disorder is characterized by dry eyes and dry mouth? - ANSWERSSjogren's syndrome The principle mediator in allergic rhinitis is: - ANSWERSHistamine Which one of the following statements is true about the lacrimal excretory system? - ANSWERSThe lacrimal excretory system collects tear film and drains it into the nasal cavity The most common fungal pathogen associated with otitis externa is: - ANSWERSAspergillus A toddler with a suspected hearing loss would: - ANSWERSLikely communicate through gestures A deviated uvula without swelling may be suggestive of a: - ANSWERSvagus nerve lesion A reduction in vision in one or both eyes causing loss of binocular vision is termed: - ANSWERSAmblyopia A localized Staphylococcal infection of the hair follicles at the lid margin is suggestive of: - ANSWERSa hordeolum Round or oval shaped lesions surrounded by erythematous mucosa and noted on an area of the oral mucosa mat be: - ANSWERSAphthous ulcers A whispered voice test allows the examiner to screen for: - ANSWERSgeneral hearing loss Ophthalmoscoptic examination of the retina reveals AV banking. This appears as if the: - ANSWERSvein is twisted on the distal side of the artery The ethmoidal sinuses: - ANSWERSare located between the eyes One cause of nasal septum perforation may be: - ANSWERSintranasal use of cocaine