Nasal / Sinus + Pharynx Disorders
A 65-year-old male with a 40 pack-year smoking history presents to the clinic with persistent hoarseness that has been worsening over the last 6 weeks. He also reports coughing up small amounts of blood-tinged sputum.
Based on the document's guidance regarding adult hoarseness, what in that case is considered a red flag requiring prompt laryngoscopic evaluation and referral?
Persistent dysphonia > 4 weeks and hemoptysis
When counseling parents of pediatrics, how long do you tell them it will take for the antibiotics to work?
2-3 days
what eye condition is marked by normal ocular movement vs the condition marked by limited ocular movement?
preseptal cellulitis
orbital cellulitis
Sphenoid sinuses form at what age? Frontal sinuses form at what age?
sphenoid - 5
frontal - 7
Treatment for AOM with conjunctivitis?
High dose Augmentin
A 45-year-old female presents to the urgent care clinic complaining of sudden, severe episodes of room-spinning dizziness that occur whenever she turns her head to the right in bed. Each episode lasts approximately 30 to 45 seconds before resolving. She denies any hearing loss, tinnitus, or ear fullness. Physical examination reveals horizontal nystagmus with a rotational component after a brief delay when performing the Dix-Hallpike maneuver. What is the most likely underlying pathophysiology?
displacement of otoconia into semicircular canals
What do you prescribe an adult with Acute Bacterial Rhinosinusitis with a PCN allergy? What about a child with a PCN allergy?
An adult - doxycycline
Pediatric - clindamycin
What is the first line treatment for a child with typanostomy tubes?
Topical antibiotics (fluoroquinolone drops)
A 60-year-old male with high myopia presents with flashes of light and a sensation of a 'dark curtain coming down' over his vision in the right eye. Visual acuity exam shows intact 20/20 central vision, and fundoscopy reveals a superior temporal retinal detachment that has not reached the macula. What is the clinical priority?
'Mac-on' emergency surgery to preserve vision
A 45-year-old male presents to the clinic complaining of a persistent dry cough for the past 3 weeks. His medical history is significant for hypertension, for which he was started on lisinopril 4 weeks ago. Physical examination and vital signs are unremarkable. What is the most appropriate next step in managing this patient's cough?
Discontinue lisinopril and switch to an ARB, calcium channel blocker, or diuretic
A 38-year-old female presents with acute, continuous vertigo, severe nausea, and vomiting that started 24 hours ago. She reports a recent upper respiratory tract infection two weeks ago. On examination, she exhibits horizontal nystagmus with the fast phase beating away from the affected side. Otoscopic exam is normal. Notably, her hearing is entirely preserved bilaterally. Which of the following is the most likely diagnosis?
vestibular neuronitis
1st line treatment for a patient with postauricular cellulitis?
hospital admission!
1st line: ampicillin/sulbactam
A 21-year-old male presents with severe, hyperacute unilateral eye pain, marked eyelid swelling, and abundant, continuous purulent ocular discharge. Gram stain of the discharge reveals Gram-negative intracellular diplococci. What is the mandatory systemic therapy required?
IM ceftriaxone or oral cefixime
A 36-year-old musician presents with dizziness provoked specifically when playing loud brass instruments or straining during bowel movements (Tullio phenomenon). He reports hearing his own heartbeats and footsteps in his affected ear. What is the underlying pathophysiology?
deficiency or thinning in the bony covering of the superior semicircular canal
Which of the following best describes the primary mechanism of action of prostaglandin analogs (e.g., Latanoprost) in treating open-angle glaucoma?
increasing aqueous humor outflow through the trabecular network pathway