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Acute bacterial rhinosinusitis Nasal congestion, obstruction • Purulent nasal discharge* • Maxillary tooth discomfort • Facial pain, pressure worse with bending forward* Symptoms >10 days without clinical improvement • Onset with severe symptoms (fever, purulent drainage) lasting at ...

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  • August 21, 2024
  • 6
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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APEA ENT-Questions with Correct Answers/ Verified

Acute bacterial rhinosinusitis



Nasal congestion, obstruction • Purulent nasal discharge* • Maxillary tooth discomfort • Facial pain,
pressure worse with bending forward*

Symptoms >10 days without clinical improvement • Onset with severe symptoms (fever, purulent
drainage) lasting at least 3 consecutive days at the beginning of the illness • Symptoms worsened
after initial improvement



Relieve symptoms (nasal stuffiness, rhinorrhea) Promote drainage!!!! or give amoxicillin 5 to 7 days.
remember it is bacterial infection. - ✔✔Inflammation of the paranasal sinuses due to bacterial, viral,
or fungal infection, or allergic reaction



sx:



tx:



• Age >65 years • Hospitalization in last 5 days • Antibiotic use in previous month •
Immunocompromised people • Presence of multiple comorbidities • Severe infection (temp >102F,
severe headache) - ✔✔Who is at risk for pneumococcal resistance (acute bacterial infection)?



CT Scan with contrast• Demonstrates: Almost always diagnostic! Air fluid levels Mucosal edema Air
bubbles

With contrast: helpful for a suppurative complication like cellulitis, intracranial infection -
✔✔periorbital cellulitis. What is the imaging study of choice?



Pharyngitis/Tonsillitis - ✔✔• An acute inflammation of the pharynx/tonsils



Most important and treatable is Group A Strep (accounts for 5-15% of adults with pharyngitis)



Viruses (50%)

, Viruses (50%) • Influenza • Parainfluenza • Coronavirus • Rhinovirus • Adenovirus • Enterovirus •
RSV • Cytomegalovirus • HIV • Epstein Barr virus • Metapneumovirus - ✔✔Pharyngitis/Tonsillitis
viruses?



absent cough

anterior cervical nodes, symmetrical

Temp. greater than 100.4

tonsillar exudate or swelling

3 to 14 years of age get +1



at 1 point for each symptom. if greater than 2 then may have strep - ✔✔strep throat sx center
criteria?



Consider screening if Centor score 2 or >

• Screen adults with Centor score ≥3 with RADT

• Adults at high risk for infections (chronic steroid use, DM poorly controlled, immunocompromised,
etc.), throat culture if RADT negative - ✔✔screening for strep throat if points are greater than 2?



penicillin. - ✔✔group a streptococcus treatment?



infectious mononucleosis - ✔✔Viral infection caused by Epstein-Barr virus (EBV) of the herpes family
of viruses and is characterized by malaise and fatigue



Tetrad 3's and an L

Fatigue can last days to weeks

Fever

Pharyngitis can be painful, severe, exudative

Lymphadenopathy: posterior cervical nodes most commonly



50% have enlarged spleen



Penicillin - ✔✔infectious mononucleosis Assessment Findings?

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