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Clin Med - Mouth and Throat Conditions

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Practice quiz based on focused review points
claire.p.larkin
Quiz by claire.p.larkin, updated more than 1 year ago
claire.p.larkin
Created by claire.p.larkin about 9 years ago
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Question 1

Question
A 15-year-old boy presents with an exudative tonsillitis. Anterior and posterior cervical lymph nodes are enlarged and tender. The rapid antigen test for strep is negative for group A β-hemolytic streptococcus. What is the most appropriate step in treating this disease?
Answer
  • treat presumptively with penicillin
  • check for a history of recurrent tonsillitis
  • wait for confirmation of the disease with a formal culture
  • assume it is viral, and therefore, self-limited
  • perform a serum assay for mononucleosis

Question 2

Question
A febrile, 18-year-old boy presents with a 4-day history of sore throat that has suddenly become much worse. He complains of pain when attempting to eat or drink and has difficulty opening his mouth. He has a “hot potato” voice. On the basis of this clinical presentation, what is your diagnosis?
Answer
  • epiglotitis
  • retropharyngeal abscess
  • croup
  • tonsillitis
  • peritonsilar abscess

Question 3

Question
A 19 year old patient presents with a sore throat, low grade fever, fatigue, and cervical lymphadenopathy. When you do a blood smear you would find an increase in which of the following?
Answer
  • hypersegmented neutrophils
  • atypical lymphocytes
  • eosinophils
  • monocytes

Question 4

Question
After reviewing your patient's blood smear you find an increase of atypical lymphocytes. Which of the following diagnostic tests would be the most appropriate next step?
Answer
  • CBC with differential
  • heterophile antibody test
  • rapid antigen testing for GABHS
  • None of the above

Question 5

Question
Your patient has tested positive for group A beta-hemolytic streptococcus infection, and also tested positive for heterophile agglutination test. Which of the following is the best treatment option?
Answer
  • Ampicillin
  • Azithryomycin
  • Symptomatic OTC treatment
  • Amoxicillin

Question 6

Question
A rapid strep test is 97% sensitive and if your patient tests positive for strep, you should prescribe antibiotics.
Answer
  • True
  • False

Question 7

Question
Which of the following is a complication of streptococcal pharyngitis?
Answer
  • scarlet fever
  • glomerulonephritis
  • rheumatic myocarditis
  • local abscess formation
  • all of the above

Question 8

Question
Which of the following antibiotics would you prescribe for treatment of streptococcal pharyngitis?
Answer
  • Azithromycin
  • Penicillin V
  • Cefuroxime
  • None of the above can be used to treat streptococcal pharyngitis
  • All of the above can be used to treat streptococcal pharyngitis

Question 9

Question
Your patient is a 15 year old female complaining of a sore throat. P/E findings include fever, tender cervical lymphadenopathy, and pharyngotonsillar exudate. Patient denies fatigue and cough. What organism is most likely causing these symptoms.
Answer
  • Group A beta-hemolytic streptococcus
  • Epstein Barr Virus
  • Candidiasis
  • Herpes simplex

Question 10

Question
A 10 year old boy was playing outside for recess and was stung by a bee. He ran to a teacher nearby and expressed that he felt like he couldn’t breathe and appeared to be in a state of panic. What condition is this patient experiencing?
Answer
  • lymphocytosis
  • anaphylaxis
  • urticaria
  • angioedema

Question 11

Question
A patient was given penicillin and 1 hour later developed puritic, erythematous cutaneous lesions on her chest. What condition is this patient experiencing?
Answer
  • lymphocytosis
  • urticaria
  • angioedma
  • anaphylaxis

Question 12

Question
Your patient went out to a seafood restaurant and consumed shrimp, lobster, and crab. Her husband noticed her face begin to swell, particularly around her eyes and lips. What condition is this patient experiencing?
Answer
  • angioedema
  • lymphocytosis
  • urticaria
  • anaphylaxis

Question 13

Question
Your patient is a 32 year old male that you have just diagnosed with epiglotitis. What is the next appropriate course of action?
Answer
  • Admit pt, start IV antibiotics (cefuroxime), give a steroid bolus (dexamethasone), and continuously monitory pulse oximetry
  • Intubate patient as their airway is likely to close at any moment
  • Immediately send the patient to the OR
  • Admit this patient for observation but no treatment is necessary at this time

Question 14

Question
Your patient complains of hoarseness following a URI. You diagnosis this as acute laryngitis. Which of the following is the most appropriate treatment option?
Answer
  • Instruct patient to avoid vigorous use of their voice until laryngitis subsides
  • Prescribe antibiotics
  • Prescribe oral corticosteroids
  • None of the above

Question 15

Question
Your patient is a 32 year old male who comes to the ER complaining of a rapidly developing sore throat with odynophagia. Indirect laryngoscopy shows a red, swollen, epiglottis. What is your diagnosis?
Answer
  • Epiglotitis
  • Tonsillitis
  • Peritonsillar Abscess
  • Streptococcal Infection

Question 16

Question
Your patient is a 45 year old male who comes to the ER presenting with extreme edema, erythema, and pain of the upper neck under the chin. The floor of the mouth is also edematous, erythematous and pustulent. The patient’s tongue is displaced upward and backward. Which of the following is the most appropriate course of treatment?
Answer
  • Secure the airway via intubation or tracheotomy
  • Start IV antibiotics (penicillin + metronidazole)
  • Incise and drain the abscess (send for C/S)
  • All of the above should be conducted

Question 17

Question
80% of salivary tumors appear in the parotid gland.
Answer
  • True
  • False

Question 18

Question
Your patient is a 45 year old man who complains of a sore throat. He presents with a low grade fever and gray tonsillar pseudomembrane. He admits to having alcoholism. What is the most likely diagnosis?
Answer
  • Viral Pharyngitis
  • Streptococcal Pharyngitis
  • Candidiasis Pharyngitis
  • Pharyngeal Diptheria

Question 19

Question
Your patient presents with a red, painful sore throat. Which of the following would be included in your differential diagnosis?
Answer
  • Pharyngitis, Peritonsilar Abscess, GERD
  • Pharyngitis, Peritonsilar Abscess, Trench Mouth
  • Peritonsilar Abscess, Erythroplakia, GERD
  • Pharyngitis, GERD, Glossitis

Question 20

Question
Which of the following organisms may be responsible for viral pharyngitis?
Answer
  • Rhinovirus
  • Adenovirus
  • Epstein-Barr Virus
  • Parainfluenza
  • All of the above

Question 21

Question
Which of the following organisms may be responsible for bacterial pharyngitis?
Answer
  • Gaba A beta-hemolytic streptococcus
  • Neisseria Ghonorrhea
  • Corneybacterium Diptheria
  • H. influenza
  • All of the above

Question 22

Question
Your patient presents with a red, very painful sore throat. P/E findings include erythematous, edematous tonsils with peritonsillar exudate and cervical lymphadenopathy. Rapid strep test comes back negative and you sent the other swab out for culture. You order a CBC with differential and find increased WBCs with a left shift. Which of the following would be the best treatment choice at this point?
Answer
  • Penicillin V
  • Ancillary treatment with OTC medications
  • Fluconazole
  • Oral Corticosteroids

Question 23

Question
Your patient is complaining of a sore throat. P/E findings include an erythematous pharynx with intraoral white papules. You patient is currently using oral inhalational steroids quite frequently. Based on this information, what is the most likely diagnosis?
Answer
  • Diptheria Pharyngitis
  • Viral Pharyngitis
  • Candidiasis Pharyngitis
  • Strep Pharyngitis

Question 24

Question
Your patient is a 15 year old female complaining of extreme fatigue and sore throat. P/E findings include fever, erythematous and edematous pharynx and tonsils, palatal petechiae, lymphadenopathy, and splenomegaly. What is the most likely diagnosis?
Answer
  • Infectious Mononucleosis
  • Candidiasis Pharyngitis
  • Diphtheria Pharyngitis
  • None of the above

Question 25

Question
Your patient is 50 year old man who is complaining of bleeding in the mouth. Patient admits to frequent smoking and alcohol consumption. P/E findings include erythematous tongue, an ulcerative lesion under the tongue which measures at 6 mm deep and 7 mm in diameter, and marked lymphadenopathy. What is the most likely diagnosis?
Answer
  • Thrush
  • Erythroplakia
  • Squamous Cell Carcinoma
  • Oral Lichen Planus
  • Leukoplakia

Question 26

Question
Your patient is complaining of discoloration of his tongue. P/E findings include an erythematous lesion on the tongue that cannot be rubbed off. It is measured at 2 mm deep and 2 mm in diameter. Based on this information, what is the most likely diagnosis?
Answer
  • Erythroplakia
  • Oral lichen planus
  • Squamous cell carcinoma
  • Thrush
  • Leukoplakia

Question 27

Question
Your patient presents with white lesions on the lateral border of their tongue. Hx includes dentures. Using a gauze pad, you are unable to rub the lesion off of the mucosal surface. What is the most likely diagnosis?
Answer
  • Leukoplakia
  • Erythroplakia
  • Oral Lichen Planus
  • Squamous Cell Carcinoma
  • Thrush

Question 28

Question
Your patient is in the hospital receiving chemo therapy and complains of oral discomfort. P/E findings include erythema of the oral cavity and white fluffy patches covering the tongue. With a gauze pad you are able to remove the white patches off of the mucosal surface by gentle rubbing. Below the white patches the tongue appears "beefy red." What is your diagnosis?
Answer
  • Erythroplakia
  • Leukoplakia
  • Oral Lichen Planus
  • Oral Candidiasis

Question 29

Question
You just diagnosed your patient with oral candidiasis. Which of the following is the most appropriate course of treatment?
Answer
  • Fluconazole
  • Amoxicillin
  • Azithromycin
  • Acyclovir

Question 30

Question
You just diagnosed your patient with erythroplakia, what is the most appropriate next step in treatment?
Answer
  • Incisional biopsy and refer to oncologist
  • Tell pt to come back if lesion gets larger
  • Tell pt to come back if mouth begins to bleed
  • Erythroplakia is usually benign and no further treatment is necessary

Question 31

Question
Your patient has oral candida albicans. Which of the following would you use to treat this condition?
Answer
  • Fluconazole
  • Ketoconazole
  • Nystatin mouth rinses
  • Clotrimazole troches
  • All of the above are effective treatments

Question 32

Question
Your patient is a 30 year old male complaining of burning/tingling pain in the mouth. Patient is HIV positive. P/E findings include presence of multiple ulcers (~7) on both the buccal mucosa and tongue. What is your diagnosis?
Answer
  • Herpetic stomatitis
  • Aphthous ulcer
  • Trench mouth
  • Glossitis

Question 33

Question
Your patient presents with burning/tingling pain in the oral cavity. Your patient is HIV positive and has been diagnosed with herpetic stomatitis several times before. You suspect herpes vesicles will begin to appear soon. What is the most appropriate next course of action?
Answer
  • Wait until vesicles or ulcers appear for accurate diagnosis
  • Prescribe acyclovir
  • Prescribe azithromycin
  • None of the above

Question 34

Question
Your patient presents with an erythematous, edematous tongue that is smooth-surfaced and lacks filiform papillae. Your patient denies having any pain. What is the most likely diagnosis?
Answer
  • Glossitis
  • Glossodynia
  • Stomatitis
  • Vincent's infection

Question 35

Question
Your patient complains of burning pain of the tongue. Which of the following best represents this complaint?
Answer
  • Glossodynia
  • Glossitis
  • Stomatitis
  • Vincent's Infection

Question 36

Question
Your patient is complaining of a painful sore in their mouth. P/E findings include the presence of an ulcer on the buccal mucosa that is small, round, with a yellow-gray center surrounded by a red halo. What is your diagnosis?
Answer
  • Wegener’s granulomatosis
  • Oral lichen planus
  • Aphthous ulcer
  • Herpetic stomatitis

Question 37

Question
Your patient complains that they frequently get apthous ulcers. What treatment would you recommend for them?
Answer
  • Topical Steroids (triamcinolone acetonide or flucinonide ointment)
  • Acyclovir
  • Fluconazole
  • Systemic antibiotics

Question 38

Question
Your patient presents with what appears to be lacy leukoplakia but after biopsy, you determine it to be oral lichen planus. Which of the following best describes the etiology and treatment plan for this condition?
Answer
  • chronic inflammatory autoimmune disease - treat with oral or systemic corticosteroids
  • Squamous cell carcinoma - refer to oncologist
  • Candida Albicans - treat with fluconazole
  • Herpes Simplex - treat with acyclovir

Question 39

Question
Necrotizing ulcerative gingivitis is also called Trench Mouth, or Vincent's infection.
Answer
  • True
  • False

Question 40

Question
Your patient is a 23 year old PA student that is quickly approaching a "hell week" (multiple exams) in school. She complains of painful gingiva. P/E findings include gingival inflammation and necrosis, bleeding, halitosis, fever, and cervical lymphadenopathy. What is your diagnosis?
Answer
  • Trench Mouth
  • Herpes stomatitis
  • Glossodynia
  • Oral Lichen Planus

Question 41

Question
You diagnosed your patient with Trench Mouth. Which of the following best describes the etiology and treatment plan for this condition?
Answer
  • spirochetes and fusiform bacilli - penicillin and oral peroxide rinses
  • candida albicans - fluconazole
  • herpes simplex - acyclovir
  • None of the above

Question 42

Question
Your patient complains of a persistently runny nose, occasional epistaxis, sinus pain, malaise, and hemoptysis. What is the most likely diagnosis and treatment?
Answer
  • Wegener’s granulomatosis - corticosteroids
  • Vincent’s Infection - penicillin and peroxide rinses
  • Oral Lichen Planus - corticosteroids
  • Herpetic Stomatitis - acyclovir
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