NURS 5335 VERIFIED NOSE AND THROAT EXAM QUESTIONS
AND ANSWERS LATEST UPDATE
A 3 yr old patient presents with respiratory distress, they have strider, is leaning
in tripod position and drooling. X-ray reveals this image....what do you suspect
the patient has?
Epiglotitis (med emergency)
Pharyngitis or tonsillitis that manifests into cellulitis and develops pus between
palatine tonsil and pharyngeal muscles
Upon exam you see deviated uvula and displaced tonsil. What do you suspect?
Peritonsillar Abcess
Must get a CT to confirm and refer out for drainage
inflammation of middle ear with or without effusion
otalgia
fever greater than 102
may be ear drainage
on physical exam you will see decreased tympanic membrane mobility when you
do pneumatic otoscopy
distorted landmarks, displacement of the light reflex, cloudy, dull, opaque or
erythematous tympanic membrane
otitis media
Most common causing organism for otitis media
strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Preventatives for otitis media?
breastfeeding
immunizations
reduce exposure to tobacco smoke
don't bottle feed laying down or with bottle up
Risk factors for otitis media?
, younger siblings
smoking
daycare
allergic rhinitis
bottle feeding laying down or bottle up
treatment for otitis media?
observe for 48-72 hrs first
if still symptomatic or worse treat with
1st line-amoxicillin 80-90 mg/kg per day
2nd line- amoxicillin/clavulanate
what medication can you give for otitis media with a penicillin allergy?
azithromycin
clindamycin
these can cause resistance
treatment for recurrent otitis media 3-4 episodes in 6 months or 4 episodes in last
year with one episode in last 6 months
or for middle ear effusion lasting 3 months or more, speech, learning delays
Myringotomy tubes
use can also use topical antibiotics with these tubes
Complications of otitis media?
perforation of tympanic membrane
tympanosclerosis-hearing loss
mastoiditis
untreated otitis media can result in what?
meningitis
inflammation/infection of external auditory canal, auricle, or both
common in swimmers
acute localized caused by infected hair follicle
chronic > 6 wks
eczematous-dermatological condition
necrotizing malignant-seen in immunocompromised pts
AND ANSWERS LATEST UPDATE
A 3 yr old patient presents with respiratory distress, they have strider, is leaning
in tripod position and drooling. X-ray reveals this image....what do you suspect
the patient has?
Epiglotitis (med emergency)
Pharyngitis or tonsillitis that manifests into cellulitis and develops pus between
palatine tonsil and pharyngeal muscles
Upon exam you see deviated uvula and displaced tonsil. What do you suspect?
Peritonsillar Abcess
Must get a CT to confirm and refer out for drainage
inflammation of middle ear with or without effusion
otalgia
fever greater than 102
may be ear drainage
on physical exam you will see decreased tympanic membrane mobility when you
do pneumatic otoscopy
distorted landmarks, displacement of the light reflex, cloudy, dull, opaque or
erythematous tympanic membrane
otitis media
Most common causing organism for otitis media
strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Preventatives for otitis media?
breastfeeding
immunizations
reduce exposure to tobacco smoke
don't bottle feed laying down or with bottle up
Risk factors for otitis media?
, younger siblings
smoking
daycare
allergic rhinitis
bottle feeding laying down or bottle up
treatment for otitis media?
observe for 48-72 hrs first
if still symptomatic or worse treat with
1st line-amoxicillin 80-90 mg/kg per day
2nd line- amoxicillin/clavulanate
what medication can you give for otitis media with a penicillin allergy?
azithromycin
clindamycin
these can cause resistance
treatment for recurrent otitis media 3-4 episodes in 6 months or 4 episodes in last
year with one episode in last 6 months
or for middle ear effusion lasting 3 months or more, speech, learning delays
Myringotomy tubes
use can also use topical antibiotics with these tubes
Complications of otitis media?
perforation of tympanic membrane
tympanosclerosis-hearing loss
mastoiditis
untreated otitis media can result in what?
meningitis
inflammation/infection of external auditory canal, auricle, or both
common in swimmers
acute localized caused by infected hair follicle
chronic > 6 wks
eczematous-dermatological condition
necrotizing malignant-seen in immunocompromised pts
