N675 PRACTICE QUIZZES | 188 QUESTIONS | WITH
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?
Answer - Viral pharyngitis
What are factors associated with acute suppurative parotitis? (Select all that
apply.) Answer - Anticholinergic medications
Diabetes mellitus
Group A strep pharyngitis: Answer - 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: Answer - 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? Answer - Cipro HC
,Which physical examination finding suggests viral rather than bacterial
parotitis? Answer - 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: Answer - 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? Answer - 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? Answer - 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? Answer - 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. Answer - 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? Answer - 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? Answer - 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? Answer - 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? Answer - 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? Answer - Prescribe Amoxicillin-Clavulanate
today.
Swimmer's ear question on practice test Answer - 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? Answer - 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?
Answer - 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? Answer - 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? Answer
- Tugging on ears, difficulty sleeping, and appetite.
A 70 year old male has a yellowish, triangular nodule near the iris this is
probably a Answer - 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. Answer -
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? Answer - Pterygium.
Previous quiz question about 32 diabetic patient w/ sinus infection. Answer -
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
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?
Answer - Viral pharyngitis
What are factors associated with acute suppurative parotitis? (Select all that
apply.) Answer - Anticholinergic medications
Diabetes mellitus
Group A strep pharyngitis: Answer - 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: Answer - 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? Answer - Cipro HC
,Which physical examination finding suggests viral rather than bacterial
parotitis? Answer - 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: Answer - 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? Answer - 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? Answer - 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? Answer - 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. Answer - 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? Answer - 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? Answer - 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? Answer - 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? Answer - 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? Answer - Prescribe Amoxicillin-Clavulanate
today.
Swimmer's ear question on practice test Answer - 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? Answer - 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?
Answer - 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? Answer - 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? Answer
- Tugging on ears, difficulty sleeping, and appetite.
A 70 year old male has a yellowish, triangular nodule near the iris this is
probably a Answer - 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. Answer -
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? Answer - Pterygium.
Previous quiz question about 32 diabetic patient w/ sinus infection. Answer -
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
