N675 Practice Quizzes - Questions and Answers (Complete Solutions)

N675 Practice Quizzes - Questions and Answers (Complete Solutions) A patient reports a sudden onset of sore throat, fever, malaise, and cough. The provider notes mild erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most likely cause of these symptoms? Viral pharyngitis What are factors associated with acute suppurative parotitis? (Select all that apply.) Anticholinergic medications Diabetes mellitus Group A strep pharyngitis: Can be accompanied by abdominal pain A 61 year old male presents with a 12 hour history of extremely painful left red eye. The patient complains of blurred vision, halos around lights, and vomiting. It began yesterday evening. On exam, the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most likely diagnosis in this patient is: Acute angle glaucoma A patient has an initial episode otitis external associated with swimming. The patient's ear canal is mildly inflamed and the tympanic membrane is not involved. Which medication will be ordered? Cipro HC Which physical examination finding suggests viral rather than bacterial parotitis? Clear discharge from Stensen's duct A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus toward nose. Tearing is present and when pressure is applied to the lacrimal sac, purulent discharge from the puncta is noted. This is suggestive of: Dacryocystitis Pt has painful oral lesions and the provider notes several white verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this? Surgical incision. A Pt is concerned about frequent nasal stuffiness and congestions that begins shortly after getting out of bed in the morning. Pt denies itching, sneezing. A physical exam reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend? Daily intranasal steroid. A pediatric Pt has otalgia, fever 38.8C & recent h/o of URI. The examiner is unable to visualize the tympanic membrane in the Rt ear b/c of cerumen in the ear canal. The Lt ear tympanic is dull gray w/ fluid present. What is correct course of action? Remove cerumen & visualize tympanic membrane. A 70 yr old male Pt c/o a bright red spot that has been present on his Lt eye for 2 days. He denies eye pain, or visual changes or HA's. He has new onset of cough from recent UPR & he takes 1 ASA a day. Advise the Pt that the condition is benign and will resolve spontaneously. This question was on both practice quizzes. During an eye exam of 50-year-old with HTN, Pt c/o severe HA. The borders of the disc margins on both eyes are blurred. What is the name of this clinical finding? Papilledema Child is hit w/ baseball bat during game & sustains injury to nose along w/ transient loss of consciousness. A healthcare provider at the game notes bleeding from nose & displacement of septum. What is the most important intervention at this time? Immobilize the child's head and call 911. A Pt has nasal congestion, fever, purulent nasal d/c, HA, fever & pain and begins treatment with Amox-Clav. At f/u 10-days later, Pt still has purulent d/c, congestion & pain but no fever. What is next course of action? 2nd course of Amox-Clav. A Pt has recurrent epistaxis without signs of localized irritation. Which lab tests may be performed at this time to evaluate his condition? PT, PTT, PT/INR, CBC Platelets. A 32-yr-old is newly dx DM, She has developed a sinus infection. She has had symptoms for 10 days. 6-weeks ago she got amoxicillin for URI. It was cleared up without incident. What's next? Prescribe Amoxicillin-Clavulanate today. Swimmer's ear question on practice test Prescribe Cipro HC A Pt reports severe episodes of vertigo with some lasting up to an hour, the episodes are associated with nausea & vomiting. What is part of the initial diagnostic workup? Audiogram & MRI. A Pt reports a feeling of fullness & pain in both ears & the practitioner elicits pain when manipulating the external ear structures. What is likely diagnosis? Acute otitis externa. During a routine physical exam a provider notes a shiny irregular painless lesion on top of one ear auricle & suspects skin cancer. What will the the provider tell the patient about this lesion? A biopsy should be performed. Which symptoms in children are evaluated using a parent-reported scoring system to determine the severity of pain in children with otitis media? Tugging on ears, difficulty sleeping, and appetite. A 70 year old male has a yellowish, triangular nodule near the iris this is probably a pinguecula. A 20 year old make of Hispanic descent who reports a history of cold that resolved 2 weeks ago except for a dry cough and pain over right cheek that worsens when he bends down. The patient denies fever. The Pt tells you he is very allergic to keflex, and erythromycin. VSS except temp is 99.2 F. Acute sinusitis. During routine physical exam of an elderly woman, a triangular thickening of the bulbar conjunctiva on the temporal side is noted to be encroaching on the cornea. She denies any eye pain or visual changes. Which of the following is most likely? Pterygium. Previous quiz question about 32 diabetic patient w/ sinus infection. Prescribe Amoxicillin-Clavulanate today. Rationale: Amoxicillin is not indicated when a beta-lactamase producing organism and suspected, this is the case as patient took antibiotics 6 weeks ago. Amoxicillin-clavulanate is a good choice as it covers a beta-lactamase producers. And bacteria etiology is suspected as symptoms have persisted for 10 days. A decongestant can be added, however this does not substitute antibiotics in this case A 12-year-old complains of itching in his right ear and pain when the pinna is pulled or the tragus is pushed. Examination reveals slight redness in the ear canal with a clear odorless fluid. This is suggestive of: Otitis Externa. A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain when manipulating the external ear structures. What is the likely diagnosis? Acute Otitis Externa A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this patient? Surgical excision