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NR511 MIDTERM DIFF DIAGNOSIS ACTUAL EXAM
COMPLETE QUESTIONS AND DETAILED
ANSWERS|ALREADY GRADED
_____________ should be used with all acne medication wash face _________ daily with antibacterial soap Correct Ans- sunscreen twice 1 - 2mm red papules interdigital web staples, wrists, axillary folds, and periumbilical? Correct Ans- scabies 2 types of meds that can relieve pressure from barotrauma Correct Ans- nasal steroids or oral decongestants 3 risk factors for developing fungal skin infection Correct Ans- hot, moist areas, immunocompromised pts, pts on abx 7 categories of third party payer for reimbursements Correct Ans- medicare, medicaid, indemnity insurance companies, managed care organization, workers compensation, veterans administration, auto libility A female bartender presents with yellow fingernails for months. She denies any pain or itching at site. What is the diagnosis Correct Ans- subungual candida
a male who works as a dishwasher in Olive Garden presents with a painful abscess on the 1st finger of the right hand which looks red, hot, swollen? what is it? Correct Ans- candidal paronychia ability of a test to correctly identify pt has disease true positives divided by # of people who have disease Correct Ans- sensitivity acoustic reflectometry, tympanometry, acoustic reflex measurement are used to detect? Correct Ans- middle ear fluid in patients with tinnitus Actinic keratosis: refer or treat? what can it develop into? Correct Ans- refer to prevent progression precancerous can develop into squamous cell carcinoma An obese female with red, itchy, weepy rash with maceration in the perianal, groin and interdigital areas Correct Ans- intertriginous candidiasis annual lesions with scaly borders and central clearing, ring shaped, on trunk Correct Ans- tinea corporis Antibiotic choice for group A beta hemolytic streptococcal pharyngitis? 1st line, kids?
causes of sensorineural hearing loss Correct Ans- meniere's disease, presbycusis, medications, tumors chalazion lasts >4 weeks without any improve... what should you do? Correct Ans- refer to ophth for I/D, bx and glucocorticoid injections Characteristics and treatment of acute otitis media Correct Ans- bulging, red tympanic membrane, diminished hearing, inflammed eustachian tube Tx- amoxicillin/clavulanate PCN allergy- doxycycline or levofloxacin characteristics of mononucleosis? Correct Ans- POSTERIOR CERVICAL LYMPH SWELLING, fever, sore throat, nuchal stiffness, hepatosplenomegaly spread through saliva and epstein barr virus contagious, red, rash on face and extremities, turns into vesicles with yellow crusts Diagnose Correct Ans- impetigo contagious, red, rash on face and extremities, turns into vesicles with yellow crusts Diagnose Correct Ans- impetigo
Corticosteroid eye drops and anesthetic drops should or should not be used for epiphoria? Correct Ans- should not criteria for sinusitis diagnosis Correct Ans- upper resp infection for at least 7d, presence of 2 or more symptoms ; colored nasal discharge, poor response to decongestants, facial pain aggravated by postural change, headache Diagnose: Pt persents with pain over sinuses, mucopurulent rhinorrhea, tooth pain, nasal congestion, pain exacerbated by coughing/moving Correct Ans- sinusitis Diagnose: Pt presents with clear rhinorrhea, post nasal drip, cobblestone appearance of mucosa, pale and boggy mucosa, gray/blue nasal polyps Correct Ans- rhinitis diagnose. Noncancerous growth behind tympanic membrane, granulation tissue, crust, foul smelling drainage Correct Ans- cholesteatoma Diagnosis of open angle glaucoma Correct Ans- Measurement of intraocular pressure, visual field testing, visual acuity, dilated eye exam
HIV
herpes differential diagnosis for scabies (5) Correct Ans- dermatitis impetigo insect bites liver disease folliculitis differential diagnosis of hoarseness? Correct Ans- papillomatosis Differentiate between bacterial, allergic and viral conjunctivitis. Correct Ans- bacterial- purulent drainage allergic- stringy, mucoid viral- clear, watery diffuse, generazlied, hyperpigmentation, especially on skin creased d/t increased adrenocorticotropic hormon Correct Ans- addison's disease example of scabicides lotion Correct Ans- permethrin and malathion lotion Extremely tender, bright red in color, location in groin, developed over several days, pus draining from center
diagnose. Correct Ans- furuncle filiform/digitate warts are easily treatable but _________ Correct Ans- recur flat to slightly elevated brown papules and plaques that scale when rubbed against hypopimentation, puritic, commonly on shoulders and trunk Correct Ans- tinea versicolor Follow up of pt with acute otitis media Correct Ans- f/u in 48-72h if not resolved, f/u after completing abx, f/u 4-6 weeks after tx, monthly otoscopic exams foods to avoid that can decrease tinnitus Correct Ans- chocolate, alcohol, smoking, salt, caffeine hallmark sign of HSV-1 or HSV-2 conjunctivitis? Correct Ans- corneal infection with dendrite appearance health teaching for those with pruritus Correct Ans- short, tepid showers, no baths, no scratching, cool compresses, emollients highly _________ tests will lead to positive findings for patients with a disease Correct Ans- sensitive
in both bollous and nonbollous types of impetigo, ________________________ is involved. Correct Ans- regional lymphadenopathy, whereever the lesions are the adjacent lymph nodes will be enlarged in dermatitis ________ occurs before ________ Correct Ans- itchiness before rash Individuals at risk for epiphoria Correct Ans- (excessive tearing) elderly allergies lacrimal obstruction excessive tx of dry eye bells palsy inflammation of the tongue is known as... Correct Ans- glossitis Jock itch-groin Correct Ans- tinea cruris location of atopic dermatitis in infants and older children Correct Ans- Infants and young children - cheeks and diaper area Older children - flexural surfaces marigold and tea tree oil topically is used to treat ________ Correct Ans- acne
mask of pregnancy hyperpigmentation of face during pregnancy Correct Ans- cholasma (melasma) multiple boils, develops into large erythematous lump that drains from multiple openings, can be hyperpigmented Correct Ans- carbuncle non pharm treatment of hordelum and chalazion Correct Ans- warm compresses, gentle massage, gentle scrubs w/ baby shampoo, no eye makeup/lenses noncancerious skin growths in elderly causing itching and irritation from friction raised, scaly, hyperpigmented, brown-gray, stuck on Correct Ans- seborrheic keratosis Nonpharmacological Treatment for impetigo Correct Ans- NS, or plain tap water, or burrow solution for 10-20 mins 4 times a day will help debride crusts so lesions can dry out NP action of sudden sensorineural hearing loss? Correct Ans- refer to ENT, if unknown cause- high doses of corticosteroids
pt has persistent sore throat, fever, malaise and has not response to tx, what tests should be performed? Correct Ans- infectious mono and streptococcal abx sensitivity then monospot test Pt presents with yellow/white tender pustules surrounded by erythema, on different areas of the scalp, denies itching. diagnose... Correct Ans- folliculitis purulent, thick drainage from eyes, crusty eyelids, sandy, gritty feeling, normal eyesight, photophobia Diagnose? Correct Ans- Bacterial conjunctivitis rash on forehead with eye swelling, redness, pain, fever, tingling of skin, allodynia, cloudy or clear cornea, tx with antiviral acyclovir Correct Ans- Herpes Zoster ophthalmicus red rash, itchy, stinging of face, burning, on forehead, cheeks, nose and chin Correct Ans- rosacea red, small, erythematous, macules or papules, pruritus worse at night, mostly scalp Correct Ans- pediculosis (lice) Risk factors for seborrheic keratosis Correct Ans- elderly, light skinned, sun exposure, inherited scaly, dry, rough patch, sandpaper like, in sun exposed areas
diagnose. Correct Ans- actinic keratosis severe throat pain, difficulty swallowing, copious oral secretions, stridor, fever, no pharyngeal erythema or cough Correct Ans- epiglottitis Sexually active male with small erythematous eroded patches tender to touch, rash, and itching of glans penis Correct Ans- balanitis Stringy mucoid discharge, itching, burning, concurrent w/ rhinorrhea, and sneezing Diagnose. Correct Ans- allergic conjunctivitis teaching for patients with mononucleosis Correct Ans- do not play contact sports or activities d/t risk of splenic rupture The __________ of the lesion of malignant melanoma impacts prognosis. Correct Ans- thickness The ability of a test to correctly identify those who do not have the disease
of true negatives divided by total # of people who do not have the
disease Correct Ans- specificity tickle, pruritus, lump in throat, pharyngeal exudate Correct Ans- pharyngitis/tonsillitis
moderate - oral abx - for those at risk for scarring, nodules, want quick relief---clindamycin, erythromycin severe- isotretinoin , hormonal therapy treatment of acute otitis externa Correct Ans- abx + steroids: Ciprofloxacin/ Dexamethasone, Ciprofloxacin/ Hydrocortisone Treatment of bacterial conjunctivitis Correct Ans- - mycin ointments, or ciprofloxacin drops Treatment of carbuncles and furuncles Correct Ans- mupirocin topical, heals spontaneously in 2 weeks, warm compresses Treatment of chronic otitis media Correct Ans- refer to ENT, aural toileting, systemic abx treatment of dry eye Correct Ans- Artificial tears and ointment Artificial tear sacs NS drops Antiinflammatory and immunomodulatory agents- corticosteroids, cyclosporine treatment of intertriginous candidiasis? Correct Ans- nystatin powder
Treatment of oral candidiasis (thrush) (3) Correct Ans- clotrimazole troches (dossolve), miconazole buccal tabs, nystatin swish and swallow Treatment of pediculosis first line second line Correct Ans- Topical insecticides are effective such as permethrin, pyrethrins, and malathion are considered first line Lindaine and ivermectin are second line petroleum jelly or other occlusive substances can be used to suffocate lice. Reapplication in 7-10 days recommended to kill any newly hatched lice. Treatment of staph blepharitis, and ulcerative blepharitis first line and second like Correct Ans- 1st : bacitracin or erythromycin ointment 2: quinolone or sulfacetamine +corticosteroid trismus, drooling, dysphagia, unilateral ear pain, ipsilateral throat pain, progression of strep throat, requires tonsillectomy or drainage is known as what? refer or treat? Correct Ans- peritonsillar abscess refer to ED to maintain airway True or false?
Weber and rinne- hearing loss What are the three systemic antivirals used to treat genital herpes? Correct Ans- famcyclovir, valcyclovir, acyclovir what does an intraepidermal burrow from scabies look like? Correct Ans- white with black specks linear What does Medicare Part A cover? Correct Ans- - Pays for hospital
- deductible $1,316 per year What does Medicare Part B cover? Correct Ans- provider and outpatient services deductible $183 per year What eye disorder is this? "missing portions of words", decrease in peripheral vision, poor night vision, slow increase in intraocular pressure overtime d/t blocking of aqueous humor fluid Correct Ans- open angle glaucoma what is "soak and smear" and what does it help with? Correct Ans- soak skin for 20 mins and apply ointment to wet skin to prevent pruritus What is are the characteristics and management of a dry eye? Correct Ans- gritty, irritation, loss of glossy cornea, blurred vision
refer if blurred vision What is cholinergic urticaria? treatment? Correct Ans- hives on trunk and arms from stress, exercise, anxiety, high body temp, hot showers antihistamines What is done to evaluate tinnitus? Correct Ans- medication list, r/o infection, MRI, CT scan, tympanometry, screen for psych disorders What is done to manage tinnitus? Correct Ans- white noise machine, antidepressants, ear plugs, vitamins, d/c meds that could cause it What is medicare Part A? Part B? Part C? Part D? Correct Ans- A- hospital, nursing care, hospice, home care B- provider visits, sx, labs, medical equipment, preventative exams C- wellness visits, vision and dental exams, eye glasses, hearing aids D- prescription drugs What is the atopic triad? Correct Ans- atopic dermatitis, allergic rhinitis, asthma
