Clinical Questions on ENT and Immunology

<p>Amoxicillin (A)</p> Signup and view all the answers

<p>Clindamycin (C)</p> Signup and view all the answers

<p>Ciguatera toxicity (D)</p> Signup and view all the answers

<p>Scombroid reaction (B)</p> Signup and view all the answers

<p>Shellfish allergy (D)</p> Signup and view all the answers

<p>S.aureus preformed heat-stable toxin (A)</p> Signup and view all the answers

<p>S.aureus preformed heat-stable toxin (B)</p> Signup and view all the answers

<p>IgA deficiency (B)</p> Signup and view all the answers

<p>Anaphylaxis after blood transfusion (C)</p> Signup and view all the answers

<p>IgA anti-tissue transglutaminase (A)</p> Signup and view all the answers

<p>Candidal infections since childhood (B)</p> Signup and view all the answers

<p>When A-a gradient is greater than 35 (B)</p> Signup and view all the answers

<p>Chromosome 16 (B)</p> Signup and view all the answers

<p>Perform a lumbar puncture (C)</p> Signup and view all the answers

<p>Liver (B)</p> Signup and view all the answers

<p>MR angiogram of the Circle of Willis (D)</p> Signup and view all the answers

<p>Hepatic fibrosis (D)</p> Signup and view all the answers

<p>Bacterial meningitis typically has high protein and low glucose. (C)</p> Signup and view all the answers

<p>Confusion (B)</p> Signup and view all the answers

<p>Latex agglutination (C)</p> Signup and view all the answers

<p>Amphotericin B + flucytosine followed by fluconazole taper (B)</p> Signup and view all the answers

<p>Careful evaluation is necessary to avoid tonsillar herniation. (A)</p> Signup and view all the answers

A common immunodeficiency characterized by recurrent sinopulmonary infections, especially in older children, that may be accompanied by autoimmune phenomena (e.g., atopy, vitiligo) and gastrointestinal issues like Giardia infections.

A rare, primary immunodeficiency disorder characterized by chronic, recurrent candidal infections, typically beginning early in life.

A diagnostic procedure involving the collection and analysis of fluid from the alveoli of the lungs, often used in the diagnosis of Pneumocystis jirovecii pneumonia (PJP).

An indicator of respiratory impairment and potential for worsening PJP, used to determine when to add steroids to TMP/SMX treatment.

A widely used classification of statin eligibility based on age, LDL cholesterol levels, and diabetes status.

Inflammation of the external ear canal, most commonly caused by Pseudomonas aeruginosa.

A severe form of otitis externa that involves the mastoid bone, potentially leading to complications like brain abscess.

A common childhood ear infection that affects the middle ear.

A condition characterized by persistent, abnormal dilation of the bronchi, often caused by chronic infections or cystic fibrosis.

A type of pneumonia caused by anaerobic bacteria, typically treated with clindamycin.

A food poisoning caused by consuming fish that contain ciguatoxin, a potent neurotoxin that blocks sodium channels. This can lead to symptoms like temperature dysesthesia, where hot feels cold and cold feels hot.

A food poisoning caused by the accumulation of histamine in fish due to bacterial decomposition. This can cause allergic-like symptoms, such as dyspnea. It is often mistaken for a seafood allergy, but it's distinct from a true allergic reaction.

A food poisoning caused by preformed heat-stable toxins produced by Staphylococcus aureus. These toxins are typically found in foods like meat, custards, creams, and potato salad and cause rapid onset of vomiting.

A true allergic reaction to shellfish, causing symptoms such as hives, itching, swelling, and respiratory distress. It can be life-threatening and requires prompt medical attention.

Food poisoning caused by consuming food contaminated with bacteria such as EHEC, Yersinia enterocolitica, Campylobacter, Shigella, or Salmonella. These bacteria produce toxins that cause diarrhea, often with blood, and abdominal cramps. The onset of symptoms is typically within 1-3 days after ingestion.

A pediatric condition where the right middle lobe of the lung develops bronchiectasis due to persistent inflammation and infection. This is distinct from the typical presentation involving chronic coughing and foul-smelling sputum, often seen in adults. This condition may be associated with recurrent infections.

Autosomal recessive polycystic kidney disease (ARPKD) is a genetic disorder causing multiple cysts in the kidneys, presenting in childhood and often leading to liver fibrosis.

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder causing multiple cysts in the kidneys, usually presenting in adulthood, often starting to become symptomatic around 30-40 years old.

Serial blood pressure checks are the primary screening method for patients with ADPKD. MR angiogram is only recommended if they have a family history of aneurysm.

The most common extra-renal site for cysts in patients with ADPKD is the liver.

A neurologic exam should not be performed when there's a suspected mass lesion because a lumbar puncture (LP) could cause tonsillar herniation and death. Signs for a potential mass lesion include confusion that interferes with the exam, a decreased Glasgow Coma Scale (GCS) score, a seizure, focal neurologic signs (motor or sensory), papilledema, or an inability to visualize the optic fundi.

Characterized by low glucose, high protein, and high neutrophils (polymorphonuclear cells or PMNs) in the cerebrospinal fluid (CSF).

Characterized by normal glucose, normal (or slightly elevated) protein, and high lymphocytes in the CSF.

Characterized by lots of red blood cells (RBCs) in the CSF due to temporal lobe hemorrhage. CT is often negative, but EEG sometimes shows wave slowing or temporal complexes.

Cryptococcal meningitis is diagnosed using latex agglutination if it's listed as an option. Alternatively, mucicarmine staining can also be performed. The treatment involves amphotericin B + flucytosine, followed by a fluconazole taper.