Name: ________________________________________________________ Date: __/__/_____

Case Clinic NOSE

A healthy 23-year-old man, who consulted for facial pain, frontal nasal congestion, purulent rhinorrhea
of two weeks duration, in the last three days, the patient worsened and presented temperature over
39°C, Anterior rhinoscopy revealed a purulent nasal discharge and the remainder of the examination
was unremarkable. He did not show signs of orbital complication.

1. What is the most likely diagnosis and treatment?

a) Meningitis. Antibiotic.
b) Nasal polyps. Intranasal corticosteroids
c) Cerebral abscess. Antibiotic
d) Acute rhinosinusitis. Antibiotic

2. What is the most common bacterial organism in this disease?

a) Streptococcus pneumoniae
b) Pseudomona aeruginosa
c) Proteus mirabilis
d) Mycoplasma pneumoniae

3. The diagnosis requires that symptoms persist for:

a) 3 days
b) 4 days
c) 6 days
d) 10 days

4. Antibiotic therapy indication, except:

a) Signs that do not improve within seven days or that worsen any time.
b) Temperature greater than 38.3°C.
c) Purulent nasal drainage.
d) Immunocompromised.

5. First-line antibiotic therapy is:

a) Metronidazole
b) Amoxicillin
c) Erythromicin
d) Vancomicin
6. Where is the most common structure involved in complicated sinusitis?

a) Brain
b) Neck
c) Mastoid
d) Orbit

7. Chronic sinusitis is differentiated from acute sinusitis on CT imaging based on the presence of:

a) Frothy secretions within the paranasal sinuses

b) Ostial obstruction
c) Bony sclerosis
d) Mucosal thickening

8. What structure marks the posterior limit of the frontal recess?

a) Aggeri nasi
b) Anterior ethmoid artery
c) Basal lamella
d) Bulla ethmoidalis

9. Which of the following is a minor symptom of chronic rhinosinusitis?

a) Purulence
b) Facial pressure
c) Nasal obstruction
d) Headache

10. The diagnosis of allergic rhinitis is primarily based on:

a) Allergy skin testing

b) Specific IgE levels in serum
c) Thorough history and physical examination
d) Total IgE levels serum