20% - ANS During the Revolutionary War about _____ of the American population remained loyalist.
The timing of the occasional American victories led to a global situation in which the British needed to salvage the rest of their empire by cutting their American losses. - ANS Which...
the test used to check for corneal light reflex in each eye, and its symmetry is called - ANS
hirshberg test
What is the difference in recurrent sinusitis and chronic sinusitis - ANS recurrent is defined
as successive episodes of bacterial infections of the sinuses each lasting less than 30 days and
separated by intervals of at least 10 days.
chronic is defined as episodes of inflammation of the paranasal sinuses lasting more than 90
days.
first line of treatment of AOM in children? - ANS amoxicillin 80-90mg/kg/day divided by 2
doses
A 3 y/o presents with AOM and mother reports severe allergy to PCN. What is an alternative? -
ANS A macrolide, Bactrim, or clindamycin
5 y/o presents w/AOM and mother reports a mild rash w/PCN medication. What is an alternative
for treatment? - ANS 2nd or 3rd generation cephalosporins
what disease process may be observed by unequal pupils (anisocoria), eyelid ptosis, iris
heterochromia, and anhidrosis? - ANS horners syndrome
what trait can quickly lead to optic atrophy and permanent vision loss with even moderate
elevations of intraocular pressure AND should be tested for all African Americans whose status
is unknown when hyphema is observed? - ANS sickle cell
what would be your treatment plan for an anaphylactic reaction due to a bee sting on an upper
limb? - ANS -For anaphylaxis you'll give EPI 1:1000 ).01 mg/kg (max dose 0.3 in Peds and
0.5 in adults) IM
-Benadryl 1-2mg/kg peds w/max dose 50 mg IV
-ranitidine max dose 1 mg/kd peds w/max dose 50mg/kd IV
-crystalloid bolus (20mg/kg over 1 hour)
-solumedeol 1mg/kg for Peds IV
-sometimes also an albuterol neb
what are the most common antibiotics to cause anaphylaxis - ANS amoxicillin
ampicillin
,TMP-SMZ (trimethoprim-sulfonamide)
what is the 1st line of treatment for allergic rhinitis - ANS -non-sedating antihistamines:
LORATADINE, CETRIZINE
-intranasal corticosteroids
-mast cell stabilizers: CROMOLYN
-Montelukast: SINGULAR
what is the 1st line treatment for Bacterial Rhinosinusitis in adults? - ANS OTC NSAIDS or
acetaminophen
nasal corticosteroids
decongestants
-diagnosis is made when symptoms last longer than 10 days w/o improvement OR worsening of
symptoms w/in 20 days after initial improvement of symptoms.
-for pts w/focal signs such as periorbital edema, severe sinus tenderness, or severe
headache--do not wait 10 days for antibiotics
------1st line therapy: amoxicillin, bactrim, doxycycline, amoxicillian-clavulanate
------1st line therapy after recent abx use: levofloxacin, amoxicillain-clavulanate
what antibiotic do you avoid if you think the patient may have mono? - ANS amoxicillin b/c
drug often precipitates a rash
every pt who complains of hearing loss should be referred for audiologic evaluation except in
what scenario? - ANS when the cause is easily remediable.
example: cerumen impaction or otitis media. have child return at 4 wk intervals to check
progress of effusion. refer for audiology after 3 mo of continuous effusion in children <3yr or at
risk of language delay
what is the 1st line treatment for acute bacterial pharyngitis in adults? in peds? - ANS
Adults & children > 27kg: Penicillin VK 250 mg orally TID or 500 mg BID for 10 days. Penicillin
G IM if compliance or amoxicillin
--erythromycin/azithromycin or cephalosporins are used if PCN allergy.
PEDS: penicillin VK 50-70 mg/kg/d in 3 divided doses, benzathine penicillin 600,000 units IM in
<27kg, 1.2 million units if >27kg, single dose. For PCN allergy use azithromycin
A nurse practitioner is examining the eyes of a 5-year-old. On shining a light onto the cornea so
that it is seen on both eyes, the NP notes that is it at the 10 o'clock in the right eye and 2 O'clock
in the left eye. Interpretation of this finding is:
A. nystagmus
B. Myopia
C. Normal
D. Strabismus - ANS strabismus
The following statement of strabismus is true except:
, A. Esotropia may be intermittent up to age 6 months
B. Exotropia is normal after age 2 months
C. Strabismus may be latent (occurs only under binocular vision)
D. Strabismus requires ophthalmological referral if present after age 1 year - ANS
--exotropia is normal after 2 mo of age
--strabismus requires an ophthalmological referral if present after the age of 1 yr (earlier tx is
better)
A 45 yo mail comes the clinic with c/o right eye pain. It has been occuring constantly over the
last two days and is associated with redness. There has been no increase lacrimation, purulent
discharge, or HA. In addition to the fundusocpic exam, it is crucial that the NP access:
A. visual fields
B. Cranial nerve 7,
C. Visual acuity,
D. The corneal reflex - ANS visual acuity
A 75 yo pt c/o intense eye pain and generalized HA, after watching a movie in the theater. The
NP records the following findings OD with red sclera and dilated pupil, OD > OS, decreased VA
OD, OS WNL, no temporal tenderness. These findings are most appropriately suggest: A. Acute
glaucoma,
B. Open angle glaucoma,
C. Temporal arteritis,
D. retinal detachment - ANS acute glaucoma
A NP suspects that a scratchy feeling in a pt's eye is a corneal abrasion. There is photophobia
and erythema, but no drainage or change in visual acuity. PERRLA is noted. An appropriate NP
intervention at this time would include:
A. immediate referral
B. instillation of anesthetic ocular drops,
C. opthalmic antibiotic gtts and patching the eye
D. instillation of mydriatic gtts - ANS instillation of anesthetic ocular drops
A pt is suspected to have bacterial conjunctivitis OU. The NP performs flourescein test and
notes a dendritic appearance on the cornea. This is probably:
A. glaucoma,
B herpes,
C a neisseria gonorrhea infection
D. hyphema - ANS herpes
On exam of a pt with epistaxis the NP note that there is oozing of blood from the Kisselbach's
plexus. This is:
A. often managed by pinching the nasal ala together for 10 minutes while the pt leans backward
B. can be managed with pheylephrine 0.125-1% solution 1 or 2 sprays C. requires immediate
ENT consult
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