Medical Quiz on Rhinosinusitis and Urinalysis

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the recommended duration for treating adults with acute bacterial rhinosinusitis with Amoxicillin-Clavulanate?

10-14 days

7-10 days

5-7 days (correct)

3-5 days

What should be done if a patient with acute bacterial rhinosinusitis does not show improvement within 48 hours?

Increase the dosage of antibiotics

Continue the same treatment

Refer to an ENT specialist (correct)

Switch to over-the-counter medications

What is NOT a recommended supportive management for acute bacterial rhinosinusitis?

Humidifying air

Pain management with ibuprofen

Increased caffeine intake (correct)

Saline drops irrigation

Which of the following is a common symptom of Acute Otitis Media (AOM)?

Earache Signup and view all the answers

What action should be taken regarding allergens and irritants for a patient with acute bacterial rhinosinusitis?

Avoid all irritants Signup and view all the answers

What does a positive result for leukocyte esterase in a urine dipstick test indicate?

Condition of inflammation or infection Signup and view all the answers

Which of the following urinalysis results would most likely indicate dehydration?

Increased specific gravity Signup and view all the answers

What is the primary purpose of performing a urine culture in the evaluation of a urinary tract infection?

To identify the specific pathogens and their antibiotic susceptibility Signup and view all the answers

Which urinary component is considered a contaminant in urinalysis?

Epithelial cells Signup and view all the answers

Which condition can cause an alkaline urine pH in urinalysis?

Infection with urease-producing bacteria Signup and view all the answers

What is a common result of rhinosinusitis due to inflammation of the mucous membranes?

Mucus retention Signup and view all the answers

Which one of the following symptoms is NOT typically associated with rhinosinusitis?

Joint pain Signup and view all the answers

Which of the following bacteria is known to be a pathogen associated with bacterial rhinosinusitis?

Streptococcus pneumoniae Signup and view all the answers

Under which condition can antibiotics be prescribed for rhinosinusitis?

Onset with severe symptoms lasting 3-4 consecutive days Signup and view all the answers

What can lead to an increased risk of rhinosinusitis?

Recent upper respiratory infection Signup and view all the answers

Which of the following factors could contribute to allergic rhinosinusitis?

Exposure to allergens Signup and view all the answers

Which imaging technique is useful if symptoms suggest chronic or recurrent rhinosinusitis?

CT scan of the sinuses Signup and view all the answers

The term 'double sickening' in rhinosinusitis refers to what?

Worsening symptoms after initial improvement Signup and view all the answers

Which nasal spray should ideally be administered 30 minutes before exposure to allergens?

Cromolyn nasal spray Signup and view all the answers

What organism is NOT a common viral pathogen causing pharyngitis?

Group A Streptococcus Signup and view all the answers

Which of the following is a key feature in distinguishing streptococcal from viral pharyngitis?

Swollen anterior cervical lymph nodes Signup and view all the answers

What is the first-line treatment for bacterial pharyngitis caused by Group A Streptococcus in a patient with no penicillin allergy?

Penicillin VK 500 mg Signup and view all the answers

Which symptom is characteristic of allergic pharyngitis but not typically observed in viral or bacterial pharyngitis?

It's accompanied by post-nasal drip Signup and view all the answers

In a case of pharyngitis, which of the following historical factors would most strongly suggest a streptococcal infection?

Acute onset with tonsillar exudates Signup and view all the answers

Which treatment is appropriate for a patient allergic to penicillin who presents with streptococcal pharyngitis?

Azithromycin 500 mg initially, then 250 mg Signup and view all the answers

Which of the following symptoms on examination would suggest a viral origin of pharyngitis?

Presence of conjunctivitis Signup and view all the answers

What is a potential serious complication if viral pharyngitis is left untreated?

Bacterial superinfection Signup and view all the answers

What drug is typically used for symptomatic relief in pharyngitis due to a viral infection?

NSAIDs Signup and view all the answers

What is a common symptom associated with peptic ulcer disease?

Sharp, burning epigastric pain Signup and view all the answers

Which medication should be reserved for patients demonstrating known susceptibility to it for H. pylori treatment?

Clarithromycin Signup and view all the answers

Which of the following is NOT a risk factor for diarrhea?

High stress levels Signup and view all the answers

What type of diarrhea is characterized by blood and pus in the stool?

Acute inflammatory diarrhea Signup and view all the answers

What information is crucial to assess when evaluating diarrhea that awakens someone from sleep?

Normal bowel patterns Signup and view all the answers

In the case of NSAID-induced ulcers, what is the recommended action?

Discontinue NSAID if possible Signup and view all the answers

Which testing is essential for diagnosing H. pylori infection?

H. pylori testing Signup and view all the answers

Which symptom is specific to inflammatory diarrhea?

Fever Signup and view all the answers

What does the presence of hyperactive bowel sounds during an examination suggest?

Diarrhea Signup and view all the answers

What is the first-line antibiotic treatment for C. diff infection?

Fidaxomicin Signup and view all the answers

Which of the following could be a potential cause of chronic diarrhea?

Osmotic factors Signup and view all the answers

Which characteristic is not typically associated with constipation in adults?

Absence of abdominal pain Signup and view all the answers

Which demographic is generally more affected by constipation?

Women and the elderly Signup and view all the answers

What is a significant complication of diarrhea in older adults?

Decreased quality of life Signup and view all the answers

Which time frame is indicated for the peak effect of Savaysa (edoxaban)?

1-2 hours Signup and view all the answers

What is the primary use of Warfarin (Coumadin)?

Vitamin K antagonism Signup and view all the answers

Which of the following conditions is a contraindication for Savaysa in relation to glomerular filtration rate (GFR)?

GFR >95 mL/min Signup and view all the answers

Which test is appropriate for diagnosing Carpal Tunnel Syndrome?

Nerve conduction studies Signup and view all the answers

What is a red flag symptom associated with back pain indicating possible underlying serious conditions?

Fever Signup and view all the answers

Which condition can be excluded through the use of an MRI in a patient with back pain?

Serious underlying lesions Signup and view all the answers

What are common symptoms of De Quervain’s Tenosynovitis?

Pain moving the thumb Signup and view all the answers

In the management of Osteoarthritis, which is a common symptom?

Progressively worsening pain Signup and view all the answers

What is the primary method of screening for Diabetes Mellitus Type 2?

A1C test Signup and view all the answers

Which of the following statements about the acute management of dyspnea is correct?

Severe dyspnea can indicate need for emergency treatment. Signup and view all the answers

Which medication can lead to hypoglycemia, particularly in older adults?

Insulin Signup and view all the answers

For diagnosing lateral epicondylitis, which of the following activities is typically associated with pain?

Resisted wrist extension Signup and view all the answers

What is the primary goal in managing obesity according to established guidelines?

Reducing calorie intake Signup and view all the answers

What is a typical symptom of Carpal Tunnel Syndrome at night?

Intermittent pain in the first three fingers Signup and view all the answers

Study Notes

Allergic Rhinitis

Types: Seasonal (intermittent), Year-round (chronic), Mixed rhinitis (combination of allergic and nonallergic)
History: Includes asthma, atopic dermatitis, family history, and known allergens
Symptoms: Nasal congestion, clear rhinorrhea, sneezing, nasal pruritus, post-nasal drip, non-productive cough
Physical exam: General inspection of face (Dennie's lines, allergic shiners), nasal examination looking for mucosal edema, clear secretions, possible nasal polyps/obstruction, palpating sinuses for tenderness (sinusitis), mouth breathing, and erythema
Eyes: examination of allergic conjunctivitis
Ears: eustachian tube dysfunction, other breath sounds like wheezes
Skin: skin disorders
Neck: lymph nodes
Dx testing: Formal diagnosis based on skin allergy testing or serum testing.
UpToDate: Discusses mild/episodic symptoms and minimally sedating oral antihistamines, as well as topical antihistamine/glucocorticoid nasal sprays, and options for persistent or moderate-to-severe symptoms (glucocorticoid nasal spray + antihistamine spray). Also considers minimally sedating oral antihistamines, decongestants, and immunotherapy

Pharyngitis

Pathogens: Viral (adenovirus, parainfluenza, coronavirus), Bacterial (Group A strep, Gonococcal, etc)
Viral Pharyngitis: Symptoms include coryza (nasal + lacrimal edema and congestion), pharyngeal erythema, tonsillar edema, low-grade or absent fever, pharyngeal or tonsillar exudates, and/or oral ulcers.
Streptococcal Pharyngitis: Symptoms include tender, swollen anterior cervical lymph nodes, patchy tonsillar exudates, pharyngeal erythema and tonsillar edema, and fever. Also often present with exudates, palatal petechiae, and strawberry tongue
Features are Subacute onset of sore throat; a/c URI symptoms; pharyngeal/tonsillar exudates; oral ulcers, and/or viral exanthem
Other findings include symptoms/ signs of difficulty swallowing, drooling which might indicate peritonsilar abscess; determination of onset/duration; cough, rhinorrhea; fever, etc; also patient sexual practice
Diagnostics: include RADT, CBC, and Mono
Treating Pharyngitis : include penicillin VK, Cephalexin, Azithromycin, for various possible infections, depending on the organism and any related allergies. Symptoms can also be treated with common fever reducers, analgesics, decongestants, antihistamine nasal sprays etc
N.gonorrhea treated by a single injection of Ceftriaxone

Rhinosinusitis

Inflammation of the mucous membrane that lines the paranasal sinuses
Results in mucus retention and decreased mucus clearance → predisposes to bacterial growth
Diagnosis: Can receive abx if fits certain criteria, lasting ≥10 days w/o improvement, severe sx of high fever + purulent nasal discharge or facial pain lasting for 3 or more consecutive days.

Acute Otitis Media (AOM)

Etiology: Bacterial (S. Pneumonia), Viral, Fungal.
Symptoms: Earache, fever (may or may not be present), hearing loss or muffled, stuffiness, fullness, vertigo
Physical exam: Cloudy, opacified, full, red, bulging TM, decreased mobility TM, decrease or absent bony landmark, distorted or absent light reflex, increased vascularity of TM
Treatment: Amoxicillin (1000 mg TID for 10 days), or alternatives if PCN allergy (Cephalexin). If no improvement in past 72 hours - add clavulanate

Causes of Rhinosinusitis

Infectious: Viral, Bacterial (Strep pneumonia, H. influenzae)
Noninfectious: Allergic rhinitis, environmental pollutants, or abnormalities in nasal structure or function

Acute Bacterial Rhinosinusitis

Diagnosing possible sinusitis that is non responding to 48 hours of abx use.
Need imaging for orbital, intracranial, or soft-tissue abscesses, clinical findings suggest sinusitis with radiographic imaging

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the treatment and management of acute bacterial rhinosinusitis as well as urinalysis interpretation. This quiz covers symptoms, supportive management, and specific urinalysis indicators, focusing on practical scenarios in medical practice. It is ideal for healthcare students and professionals looking to reinforce their understanding of these topics.