Science Quiz / Nibbe ENT Conditions

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Can you name the Nibbe ENT Conditions?

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Also known as peritonsillar abscess. Most often caused by group A beta hemolytic streptococcus.
Presenting symptoms: fever/chills, sore throat, drooling, trismus (difficulty opening mouth) due to pain, tender cervical lymphadenopathy.
Treatment is to thoroughly irrigate ear canal debris and dry, application of salicylate-containing solution to aid uncovering of the skin to be treated, and antifungal drops.
Facial nerve palsy or sudden hearing loss with inflammatory changes of the ear should make you consider ________.
Name a causative organism for Acute tonsillitis.
Physical exam findings: Retracted tympanic membrane, No movement or reverse movement with insufflator, and conductive hearing loss (256 or 512hz tuning forks)Bubbles of fluid behind the ear drum.
Presenting symptoms are pain on swallowing, fever, pain radiating to ipsilateral ear, and oropharyngeal swelling causing hoarseness/voice changes.
Causes and risk factors include Eustachian tube dysfunction, allergic upper respiratory disease, bacterial sinusitis, residual otitis media, cleft palate, and polyps.
Risk factors include tumor, coagulation disorders, warfarin, steroids, trauma, surgery, or steroid use.
Name the treatment for nasal polyps.
Treatment is observation for 2 weeks, Nasal steroids for 4-6 weeks to help decompress Eustachian tube (mainstay). Antibiotics if steroids doesn't work. Myringotomy with T-tube placement may be indicated if antibiotics don't work.
Diagnostic criteria for Acute bacterial tonsillitis are fever, cervical lymphadenopathy, and whitish plaque on ________.
Treatment of Herpes Zoster Oticus includes systemic _________ if facial nerve palsy is present.
Physical exam findings: generalized lymphadenopathy, splenomegaly, hepatomegaly.Fatigue = mono
Infection of the perichondrium most often caused by Pseudomonas Aeruginosa. Can occur after trauma, surgery, burns.
Non-intact tympanic membrane (perforated eardrum) and discharge (otorrhea) for at least the preceding two weeks. Presenting symptoms include chronic drainage & foul-smelling fluid.
Name a complication of Acute and Chronic Otitis Media. Facial nerve paralysis, Scarring and destruction of the middle ear ossicles/tympanic membrane, hearing impairment
Pseudocyst associated with the sublingual glands and submandibular ducts. Appear as blue, fluctuant swellings lateral to midline in the lower mouth.
Treatment of ______ include watchful waiting for 48-72 hours if caused by a virus. Penicillin is first line therapy. Penicillin allergic patients get Sulfa based antibiotic, macrolide, or quinolone
Name a topical treatment for Otitis Externa. Steroid drops if the ear is swollen and painful
Name a DDx of Acute Cough.
Occurs commonly in 60% of adults at some time in life. Female predominance after age 49, possibly relating to decreased estrogen levels.
Chronic cough is more than _____ weeks in duration.
______ Rhinitis is runny nose not due to allergy. Triggers include cigarette, perfumes, and changes in temperature.
Kissing disease caused by EBV. Has an incubation period of 7-9 days.
Presenting symptoms are severe itching and feeling of fullness in the ear. Rare otalgia.
Presenting symptoms include otalgia exacerbated by jaw movement, fullness in the ear, itching of the ear canal, otorrhea, decreased auditory acuity, fever is rare.
Caused by fusiform rods and spirochetes. Unilateral dysphagia, fetid breath odor, unilateral exudate coated ulcer appears on palatine tonsil. Treated by cautery and antibiotics.
Acute cough is less than ___ weeks in duration.
Look for fluid behind the TM to differentiate Chronic Otitis Media from __________.
QuestionAnsweExtra Information
Physical exam findings: Erythematous, bulging TM and effusion behind the membrane.
Presenting symptoms: tonsillitis, fatigue, anorexia, fever, headache, limb pain and myalgia.
Causative organisms are Pseudomonas (95-99%) or Fungal (less than 5%).
Viruses such as RSV cause 45-70% of ______.
Name a complication of nasal polyps.
Presenting symptoms are ear pain, characteristic burning/buzzing sensation often in the absence of physical findings.
Keratinous squamous epithelium found in abnormal location. Desctruction of bone via an inflammatory osteoclastic process.
Fleshy outgrowths of the nasal mucosa. Predisposing factors are allergic rhinitis, CF, chronic aspirin use, and asthma.
Subacute cough is ______ week in duration
Nose picking is the most common cause. Other causes are mucosal hyperemia due to allergic or viral rhinitis, facial trauma, or foreign body.
Name a treatment for Chronic Otitis Media.
Anterior Epistaxis occur in ______ plexus, the region of the vascular waterbed area of the nasal septum.
If this is suspected, CT of the head will clear the diagnosis: clouding of the mastoid air cells, erosion of the structure of the mastoid bones.
Antibiotics should be reserved in sinusitis if symptoms persist or worsen beyond _____ days of conservative management.
Name a complication of Infectious mononucleosis.
_______ treatment is surgical intervention to halt the bony destruction. Tympanoplasty- put a cadaver TM to improve hearing.
Occurs very frequently in children due to the shortness and the angle of the immature Eustachian tube.
Caused by reactivation of prior infection with Varicella Zoster Virus in ganglion cells. Affects CNVII and CNVIII. aka Ramsey-Hunt disease
Classic Triad of Mastoiditis include 1)prominent auricle with retroauricular swelling, 2) tenderness in the mastoid region, and 3)______
Physical exam findings: Inflamed and erythematous skin of the auditory meatus; white, yellow or black membrane lining ear canal. Black membrane caused by mucor fungus. Take out debris and look under the microscope to see spore and hyphae.
Severe inflammation/marked edema of the pharynx and a laryngeal inlet. Causative organisms are Hib, Pneumococcus, and Beta-hemolytic streptococci.
Presenting symptoms include fever, otalgia, decreased auditory acuity, pressure feeling in the ear, and otorrhea if perforation occurs.
Treatment for Mastoiditis.
Name a complication of Mastoiditis.
Name a DDx for Acute tonsillitis.
Most often due to inadequate middle ear ventilation.
Presenting symptoms are rapid onset of high fever, hoarseness, 'hot potato' voice, child will often sit forward to aid breathing. Classic 'THUMBPRINT' sign.
Presenting symptoms include facial pain, pressure sensation in the forehead, behind eyes, and cheeks. This worsens when bending over.
Amoxicillin given to patient with infectious mononucleosis results in a pseudoallergic _______.
Physical exam findings: thick white keratinous malodorous debris in canal, No fluid behind the TM, NEVER extends off the ear. Tenderness with traction of the helix of the pinna, pain upon manipulation of the tragus

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