CMN-568 Test Questions With 100% Verified Solutions

CMN-568 Test Questions With 100% Verified Solutions Foreign Body in Nose - ANSWER have child blow nose. If that is not effective, use alligator forceps after restraining child and application of lidocaine. Refer if necessary. if not removed, unilateral, foul- smelling runny nose with halitosis, bleeding or obstruction. monitor for necrosis of mucosa or cartilage. Batteries are an emergency! acute stomatitis - ANSWER Canker sores usually on the inner aspect of the lips or tongue. cause is unknown. could be behcet disease, mediterranean fever, or PFAPAP. apply bethamethasone valerate ointment BID to sore. avoid salty or acid food. Gingivostomatitis (Herpes Simplex) - ANSWER 10 or more samll ulcers of the buccal mucosa, tonsillars, lips, tongue, or gums. ulcers last 7-10 days. Initial exposure of the virus occurs 3-50 days before the onset of symptoms. treatment is usually symptomatic. can give acyclovir if started early. DO NOT GIVE CROTICOSTEROIDS. monitor hydration status. Thrush - ANSWER oral candidia. usually only invades the mouth if it is abraded or if the pt is immunocomproised. the use of broad sprectum ABX or inhaled corticosteroids may also contribute. presents with oral pain and refusal to eat. white curdlike plaques on cheeks and tongue, which cannot be washed away. (plaques can be red and on the dorsum on the tongue in HIV pts). Treat with oral nystatin. large plaques can be removed. If not responding, give IV antifungal. remove all contaminated objects Viral Pharyngitis - ANSWER 90% of sore throat and fever in children is viral. Symptoms include cough, hoarseness, URI, stomatits, rash, or diarrhea. Mono-exudate on tonsils, cervical adenitis, fever, and enlarged spleen. potisitve mono spot test. DONOT GIVE AMOXICILLIN! Herpangina-ulcers on tonsils, uvula, and soft palate. Caused by coxsackie viruses. self limiting. Hand, foot, mouth Dx-ulcers anywhere in the mouth, palms of the hands, soles of the feet, interdigital area, and butt. caused by enterovirus. Pharyngoconjunctival fever- exudate on tonsillitis, conjunctivitis, lymphadenopathy, and fever. caused by adenovirus. treatment is symptomatic Bacterial Pharyngitis - ANSWER sudden onset of sore throat, painful swollowing, fever, headache, cervical node adenopathy, palatal petchiae, red uvula, and tonsillar exudate. Most likely group A strep. M. pneumoniae is also very common. Must have CERVICAL LYMPHADENOPATHY, TONSILLAR EXUATE, FEVER, AND POSITIVE STREP TEST to dx. (A positive strep test indicates S. pyogens). Treat with PCN, cephalosporin, or IM injection of PCN. If not responding, give Amoxiciilin-clavulanate or azithomycin. Monitor for rheumatic fever, glomerulonephritis, abscess, cellulitis, septicemia, or scarlet fever. (give longer than 10 days if rheumatic fever) Peritonsillar Cellulitis/Abscess - ANSWER Tonsillar infection spreads to surrounding tissues. can lead to necrosis and abscess. present with unilateral tonsil bludge, soft palate and uvula are displaced, high fever, drooling, or ear pain. usually from Strep or S. pneumoniae. Hospitalize for IV PCN or clindamycin. monitor airway. Refer for drainage. Retropharyngeal Abscess - ANSWER infection of the retropharygeal node. this is an emergency and can lead to abscess if untreated. present with fever, resp distress, hyperextended neck, drooling, dysphagia, and gurgling. Usually from Strep or S aureus. Immediate hospitalization is needed with IV ABX of PCN or clindamycin. refer for surgical drainage. (easily misdiagnosed for retropharyngeal adenitis. give 24 hrs of ABX to differenciate) Ludwig Angina - ANSWER cellulitis of submandibular space. can lead to airway compromise and death. presents with fever, enlarged tongue, upward displacement of tongue, and swelling of floor of mouth. usually found in adults with dental disease. Group A strep is most common. Give IV clindamycin or ampicillin plus nafcillin. hospitalize and monitor airway, intubation may be requried. refer for drainage. Aute Cervical Adenitis - ANSWER local infection of ENT can involve a regional node and cause abscess formation. Usually unilateral anterior cervical node. Commonly from strep, staph, or viruses. need labs and cultures. early ABX and drainage is necessary. Cat Scratch Dx - ANSWER B. henselae. causes "cold adenopathy", papule on the scratch site of the face. with fever and malaise. node with spontaneous resob in 1-3 months. ABX is contraversal. Azithromycin may help. Cervical Lymohadenitis - ANSWER can be caused by nontuberculous mycobacterial or mycobacterium avium. a violaceous appearance develops over time and without systemic signs or pain. May also be: neoplasms such as hodgkin's dx, thyroglossal duct cycst, brachial clefy cyst, lymphatic cysts, parotitis, ranula, or sternocleiodmastoid muscle hematoma. Tonsillestomy & Adenoidesctomy - ANSWER removal of tonsils and adenoids due to hypertrophy, recurrent infections (tonsillitis, rhinosinusuits, or AOM), or obstructive sleep pattern. always monitor for bleeding and hemorrhage, nasopharyngeal stenosis, mandibular fracture, etc. CONTRAINDICATED IN CHILDREN WITH CLEFT PALATE. Cheilitis - ANSWER dry, cracked, or scaling lips for sun or wind exposure. may also be from contact dermatitis. use lip balm. Epstein Pearls - ANSWER a retenetion cyst caused by the obstructiob of the mucous membrane structures. often found on the hard palate or gums of newborns, resolve spontaneously in 12 months. (may appear on the uvula, tonsils, or palate of older children and need to be drained)