MIDTERM EXAM QUESTIONS WITH
EXPLANATIONS - NR511 / NR 511 (LATEST
2025)REVISION QUESTIONS
Eustachian tube disorder presentation, symptoms, causes: -
CORRECT_ANSWER_Presentation: depends on how it happened. Retracted TM,
nasopharyngeal resemble allergic rhinitis, fusion may be present or not
Symptoms: decreased hearing, muffled hearing, feeling of fullness in ear, inability
to pop ear, disequilibrium, tinnitus, pain
Causes: airplane, scuba diving, any disorder that can cause nasal congestion
(allergic rhinitis, swollen adenoids, sinusitis, etc.)
Eustachian tube disorder treatment: - CORRECT_ANSWER_Treat underlying
problem
Otitis media, sinusitis: treat w/abx
Allergic rhinitis: nasal steroids, decongestants (not in kids <6 or HTN/CV disease)
Chew gum, yawn
,DO NOT hold nose and blow! May pop TM.
TM tubes placed sometimes to equalize pressure
Compare and contrast otitis media and otitis externa. -
CORRECT_ANSWER_Definition:
OE: inflammation of membranous lining of auditory canal and/or contiguous
structures of outer ear.
OM: Inflammation of structures within middle ear
Epidemiology/causes:
OE: 10-20x more likely to occur during warmer/summer months than in cooler
seasons. Adults >50 = greatest risk. No ethnic or gender predispositions.
Immunocompromised people at greater risk (esp of invasive disease). Excess
moisture from any cause increases risk. Seborrheic dermatitis, hearing aids, ear
plugs, cotton swabs all increase risk with extended use.
OM: Incidence increases in winter. Most common in very young or elderly. Native
American (esp Navajo) and Native Alaskans = higher prevalence. Men and women
= risk. More rare in adults. Risk factors: allergies, sinusitis, rhinitis, pharyngitis,
recent/recurrent URI, perforation of eardrum, active/passive smoking.
Pathogens:
OE: Pseudomonas aeruginosa (most common cause of diffuse infection). Staph
aureus. Group A strep pyogenes. Bacteroids. Peptostreptococcus. Aspergillus
niger. Pityrosporum. Candida albicans.
,OM: Strep pneumoniae (most frequent cause in adults). H influenzae. Moraxella
catarrhalis. Strep aureus and strep pyogenes far less common causes.
Clinical presentation:
OE Subjective: acute, severe otalgia that may worsen at night. Worsens with
pulling pinna or applying pressure to tragus. Chewing may exacerbate pain in
severe cases. Initially ear may feel full/obstructed with temporary conductive
hearing loss. May be pruritic. Systemic symptoms may be present with infectious
etiology. Chronic illness may include dryness and pruritis of ear canal.
OE Objective: tenderness on traction of pinna, pain w/pressure of tragus. Purulent
drainage may be present w/bacterial infection. Canal may be reddened and
edematous. Usually lacks cerumen. Auditory canal appears edematous/erythemat
What are the characteristics of nuclear cataracts? - CORRECT_ANSWER_Significant
nearsightedness
Slow, indolent course
What are the characteristics of cortical cataracts? - CORRECT_ANSWER_Does not
significantly impair vision
What are the characteristics of posterior cataracts? - CORRECT_ANSWER_Creates
a subcapsular haze and a severe glare in bright light
, Define diagnostic reasoning - CORRECT_ANSWER_Reflective thinking because the
process involves questioning one's thinking to determine if all possible avenues
have been explored and if the conclusions that are being drawn are based on
evidence.
Seen as a kind of critical thinking.
What is subjective data? - CORRECT_ANSWER_Anything the patient tells you or
complains of regarding their symptoms
Chief complaint
HPI
ROS
What is objective data? - CORRECT_ANSWER_Anything YOU can see, touch, feel,
hear, or smell as part of your exam
Includes lab data, diagnostic test results, etc.
EXPLANATIONS - NR511 / NR 511 (LATEST
2025)REVISION QUESTIONS
Eustachian tube disorder presentation, symptoms, causes: -
CORRECT_ANSWER_Presentation: depends on how it happened. Retracted TM,
nasopharyngeal resemble allergic rhinitis, fusion may be present or not
Symptoms: decreased hearing, muffled hearing, feeling of fullness in ear, inability
to pop ear, disequilibrium, tinnitus, pain
Causes: airplane, scuba diving, any disorder that can cause nasal congestion
(allergic rhinitis, swollen adenoids, sinusitis, etc.)
Eustachian tube disorder treatment: - CORRECT_ANSWER_Treat underlying
problem
Otitis media, sinusitis: treat w/abx
Allergic rhinitis: nasal steroids, decongestants (not in kids <6 or HTN/CV disease)
Chew gum, yawn
,DO NOT hold nose and blow! May pop TM.
TM tubes placed sometimes to equalize pressure
Compare and contrast otitis media and otitis externa. -
CORRECT_ANSWER_Definition:
OE: inflammation of membranous lining of auditory canal and/or contiguous
structures of outer ear.
OM: Inflammation of structures within middle ear
Epidemiology/causes:
OE: 10-20x more likely to occur during warmer/summer months than in cooler
seasons. Adults >50 = greatest risk. No ethnic or gender predispositions.
Immunocompromised people at greater risk (esp of invasive disease). Excess
moisture from any cause increases risk. Seborrheic dermatitis, hearing aids, ear
plugs, cotton swabs all increase risk with extended use.
OM: Incidence increases in winter. Most common in very young or elderly. Native
American (esp Navajo) and Native Alaskans = higher prevalence. Men and women
= risk. More rare in adults. Risk factors: allergies, sinusitis, rhinitis, pharyngitis,
recent/recurrent URI, perforation of eardrum, active/passive smoking.
Pathogens:
OE: Pseudomonas aeruginosa (most common cause of diffuse infection). Staph
aureus. Group A strep pyogenes. Bacteroids. Peptostreptococcus. Aspergillus
niger. Pityrosporum. Candida albicans.
,OM: Strep pneumoniae (most frequent cause in adults). H influenzae. Moraxella
catarrhalis. Strep aureus and strep pyogenes far less common causes.
Clinical presentation:
OE Subjective: acute, severe otalgia that may worsen at night. Worsens with
pulling pinna or applying pressure to tragus. Chewing may exacerbate pain in
severe cases. Initially ear may feel full/obstructed with temporary conductive
hearing loss. May be pruritic. Systemic symptoms may be present with infectious
etiology. Chronic illness may include dryness and pruritis of ear canal.
OE Objective: tenderness on traction of pinna, pain w/pressure of tragus. Purulent
drainage may be present w/bacterial infection. Canal may be reddened and
edematous. Usually lacks cerumen. Auditory canal appears edematous/erythemat
What are the characteristics of nuclear cataracts? - CORRECT_ANSWER_Significant
nearsightedness
Slow, indolent course
What are the characteristics of cortical cataracts? - CORRECT_ANSWER_Does not
significantly impair vision
What are the characteristics of posterior cataracts? - CORRECT_ANSWER_Creates
a subcapsular haze and a severe glare in bright light
, Define diagnostic reasoning - CORRECT_ANSWER_Reflective thinking because the
process involves questioning one's thinking to determine if all possible avenues
have been explored and if the conclusions that are being drawn are based on
evidence.
Seen as a kind of critical thinking.
What is subjective data? - CORRECT_ANSWER_Anything the patient tells you or
complains of regarding their symptoms
Chief complaint
HPI
ROS
What is objective data? - CORRECT_ANSWER_Anything YOU can see, touch, feel,
hear, or smell as part of your exam
Includes lab data, diagnostic test results, etc.
