3/23/25, 9:01 EENT Clinical Questions (Clin Med Exam 2) |
AM
EENT CLINICAL QUESTIONS (CLIN MED EXAM 2) QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS VERIFIED
Terms in this set (76)
A 42-year-old man presents with a 4- Rhinovirus
day history of worsening headache, stuffy
nose, and clear-to-green nasal (acute viral rhinosinusitis)
discharge. He admits to facial pain and
a dry cough. He denies shortness of
breath, abdominal pain, nausea, or
vomiting. He is a non-smoker, has no
significant past medical history, and is only
taking acetaminophen. On exam, he has a
slight fever of 99.2°F taken orally, pulse
86/min, BP 120/76 mm Hg left arm
sitting, and SPO2 94% on room air.
Lungs are clear and abdomen normal.
Nasal mucosa appears boggy, and
there is tenderness with palpation over
the facial bones (maxillary area). Pharynx
is without exudates.
Which organism is most likely the cause of
his symptoms?
A 42-year-old man presents with a 10-day Length of time the symptoms have been present
history of worsening headache, stuffy nose,
greenish nasal discharge, and a low
grade fever. He has body aches and facial
pain, as well as a dry cough. He denies
shortness of breath, abdominal pain,
nausea, or vomiting. He is a non-smoker,
has no significant past medical history,
and is only taking acetaminophen. On
exam, he has a temperature of 100.9°F
taken orally. Pulse is 86/min, BP is 120/76
mm Hg left arm sitting, and SPO2 is 94%
on room air. Lungs are clear and
abdomen normal. Nasal mucosa appears
boggy, and there is tenderness with
palpation over the facial bones
(maxillary area). Pharynx is without
exudates.
What component of the history is the most
informs your decision to prescribe
antibiotics for this patient?
1/26
,3/23/25, 9:01 EENT Clinical Questions (Clin Med Exam 2) |
AM
A 19-year-old woman presents with a topical corticosteroids
painful sore in her mouth that has
been present for 3 days. She denies oral (aphthous ulcer)
trauma. She describes a single painful
lesion that feels like a bump between
her cheek and gum line. She has not tried
any treatments at home. She denies
history of similar lesions. She has
otherwise been feeling well and denies
recent flu-like symptoms.
Her past medical history is unremarkable,
with no known medical conditions or
history of surgery; she takes no
medications and has no allergies. She
lives in an apartment with her
boyfriend; she works at a convenience
store; and she denies the use of
alcohol, tobacco (including chewing
tobacco), and recreational drugs.
On physical exam, her vitals are normal.
A single tender lesion is identified on
the buccal mucosa, just across from the
lower right jaw. It is a small shallow
ulcer approximately 3 mm diameter
with a yellow-gray center surrounded
by a red halo. The remainder of her exam
is normal.
What is the best intervention for this
patient?
A 4-year-old boy presents with a 4-day Nasal foreign body
history of frequent sneezing, noticeable
congestion, nasal discharge, and irritability;
his mother has a history of airborne
seasonal allergies and believes her son
may have a problem with his sinuses.
The mother denies noticing any
shortness of breath, problems breathing,
or fever; the boy has not been in close
contact with sick individuals in the last
few weeks. Physical examination reveals
unilateral purulent nasal drainage from
the left nare and a foul odor.
Diagnosis?
2/26
, 3/23/25, 9:01 EENT Clinical Questions (Clin Med Exam 2) |
AM
A 10-year-old boy presents due to a beclomethasone disproportionate (inhaled corticosteroid therapy)
lesion on his gums. For the past 2 days,
he has reported soreness around his (thrush)
teeth and inside his cheeks. When his
mother looked closely in his mouth with a
flashlight, she noted bright red areas
and patches of white curd-like lesions.
There are no ill contacts in the last few
weeks. There has been no fever or
shortness of breath. The patient's past
medical history is positive for severe
seasonal allergies and mild persistent
asthma. Daily medications include:
pediatric multivitamin, cetirizine
hydrochloride 10 mg 1 tablet at bedtime,
montelukast sodium 5 mg 1 chewable tablet
in the morning, beclomethasone
disproportionate HFA 40 mcg 2 puffs
twice daily in the am and pm, and
albuterol sulfate inhalation powder 2
inhalations every 4-6 hours as needed
for wheezing and 15 minutes before
physical activity.
Examination reveals adherent thick white
plaques with underlying erythematous
tender mucosa on the gingival and buccal
surfaces.
Which medication has increased this
patient's risk for developing this condition?
A 23-year-old man presents with a 2-day decongestants/saline lavage
history of watery nasal discharge, malaise, (acute rhinitis)
sneezing, and nasal congestion. On
examination, you notice inflammation of
the nasal mucosa; pulse is 80/min, BP is
130/84 mm Hg; temperature is 98.8°F. The
rest of the examination is normal.
How should you treat this patient?
A 74-year-old man presents with a 90- Acute angle closure glaucoma
minute history of severe pain and
blurred vision in his left eye. He reports
headache and some nausea along with
halos surrounding lights. Upon
examination, his left eye is
erythematous with a steamy cornea
and a poorly reactive mid-dilated pupil.
An ophthalmologic consult is ordered
and tonometry is completed, revealing
an elevated intraocular pressure.
Gonioscopy was used to confirm the
diagnosis and examine the fellow eye,
showing narrow anterior chambers in both
eyes.
Diagnosis?
3/26
AM
EENT CLINICAL QUESTIONS (CLIN MED EXAM 2) QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS VERIFIED
Terms in this set (76)
A 42-year-old man presents with a 4- Rhinovirus
day history of worsening headache, stuffy
nose, and clear-to-green nasal (acute viral rhinosinusitis)
discharge. He admits to facial pain and
a dry cough. He denies shortness of
breath, abdominal pain, nausea, or
vomiting. He is a non-smoker, has no
significant past medical history, and is only
taking acetaminophen. On exam, he has a
slight fever of 99.2°F taken orally, pulse
86/min, BP 120/76 mm Hg left arm
sitting, and SPO2 94% on room air.
Lungs are clear and abdomen normal.
Nasal mucosa appears boggy, and
there is tenderness with palpation over
the facial bones (maxillary area). Pharynx
is without exudates.
Which organism is most likely the cause of
his symptoms?
A 42-year-old man presents with a 10-day Length of time the symptoms have been present
history of worsening headache, stuffy nose,
greenish nasal discharge, and a low
grade fever. He has body aches and facial
pain, as well as a dry cough. He denies
shortness of breath, abdominal pain,
nausea, or vomiting. He is a non-smoker,
has no significant past medical history,
and is only taking acetaminophen. On
exam, he has a temperature of 100.9°F
taken orally. Pulse is 86/min, BP is 120/76
mm Hg left arm sitting, and SPO2 is 94%
on room air. Lungs are clear and
abdomen normal. Nasal mucosa appears
boggy, and there is tenderness with
palpation over the facial bones
(maxillary area). Pharynx is without
exudates.
What component of the history is the most
informs your decision to prescribe
antibiotics for this patient?
1/26
,3/23/25, 9:01 EENT Clinical Questions (Clin Med Exam 2) |
AM
A 19-year-old woman presents with a topical corticosteroids
painful sore in her mouth that has
been present for 3 days. She denies oral (aphthous ulcer)
trauma. She describes a single painful
lesion that feels like a bump between
her cheek and gum line. She has not tried
any treatments at home. She denies
history of similar lesions. She has
otherwise been feeling well and denies
recent flu-like symptoms.
Her past medical history is unremarkable,
with no known medical conditions or
history of surgery; she takes no
medications and has no allergies. She
lives in an apartment with her
boyfriend; she works at a convenience
store; and she denies the use of
alcohol, tobacco (including chewing
tobacco), and recreational drugs.
On physical exam, her vitals are normal.
A single tender lesion is identified on
the buccal mucosa, just across from the
lower right jaw. It is a small shallow
ulcer approximately 3 mm diameter
with a yellow-gray center surrounded
by a red halo. The remainder of her exam
is normal.
What is the best intervention for this
patient?
A 4-year-old boy presents with a 4-day Nasal foreign body
history of frequent sneezing, noticeable
congestion, nasal discharge, and irritability;
his mother has a history of airborne
seasonal allergies and believes her son
may have a problem with his sinuses.
The mother denies noticing any
shortness of breath, problems breathing,
or fever; the boy has not been in close
contact with sick individuals in the last
few weeks. Physical examination reveals
unilateral purulent nasal drainage from
the left nare and a foul odor.
Diagnosis?
2/26
, 3/23/25, 9:01 EENT Clinical Questions (Clin Med Exam 2) |
AM
A 10-year-old boy presents due to a beclomethasone disproportionate (inhaled corticosteroid therapy)
lesion on his gums. For the past 2 days,
he has reported soreness around his (thrush)
teeth and inside his cheeks. When his
mother looked closely in his mouth with a
flashlight, she noted bright red areas
and patches of white curd-like lesions.
There are no ill contacts in the last few
weeks. There has been no fever or
shortness of breath. The patient's past
medical history is positive for severe
seasonal allergies and mild persistent
asthma. Daily medications include:
pediatric multivitamin, cetirizine
hydrochloride 10 mg 1 tablet at bedtime,
montelukast sodium 5 mg 1 chewable tablet
in the morning, beclomethasone
disproportionate HFA 40 mcg 2 puffs
twice daily in the am and pm, and
albuterol sulfate inhalation powder 2
inhalations every 4-6 hours as needed
for wheezing and 15 minutes before
physical activity.
Examination reveals adherent thick white
plaques with underlying erythematous
tender mucosa on the gingival and buccal
surfaces.
Which medication has increased this
patient's risk for developing this condition?
A 23-year-old man presents with a 2-day decongestants/saline lavage
history of watery nasal discharge, malaise, (acute rhinitis)
sneezing, and nasal congestion. On
examination, you notice inflammation of
the nasal mucosa; pulse is 80/min, BP is
130/84 mm Hg; temperature is 98.8°F. The
rest of the examination is normal.
How should you treat this patient?
A 74-year-old man presents with a 90- Acute angle closure glaucoma
minute history of severe pain and
blurred vision in his left eye. He reports
headache and some nausea along with
halos surrounding lights. Upon
examination, his left eye is
erythematous with a steamy cornea
and a poorly reactive mid-dilated pupil.
An ophthalmologic consult is ordered
and tonometry is completed, revealing
an elevated intraocular pressure.
Gonioscopy was used to confirm the
diagnosis and examine the fellow eye,
showing narrow anterior chambers in both
eyes.
Diagnosis?
3/26
