Quiz questions

Week 1 

What serious underlying condition should be ruled out in adults with persistent otitis media with effusion (OME)?  

  • Nasopharyngeal carcinoma  

  • Eustachian tube dysfunction  

  • Allergic rhinitis  

  • Chronic sinusitis  

 

What is the likely cause of isolated AOM or transient OME in adults?  

  • Viral URI 

  • Allergies  

  • Mechanical Obstruction  

  • Bacterial Infection  

 

Which patient is at a highest risk for developing malignant otitis externa (MOE)?  

  • A. healthy 24-year old swimmer with bilateral otitis externa 

  • B. A 70-year old man with Type 2 diabetes mellitus and persistent unilateral ear pain  

  • C. A 35-year old woman with chronic allergic rhinitis and serous otitis media  

  • D. A 16-year-old adolescent with tympanostomy tube and no systemic disease 
     

Which cranial nerve is most commonly affected in malignant otitis externa?  

  • CN iX (glossopharyngeal)  

  • CN VII (facial)  

  • CN V (trigeminal)  

  • CN XII (hypoglossal)  

 

Which two bacteria are the most common pathogens isolated in adult acute bacterial rhinosinusitis (ABRS)?  

  • Streptococcus pyogenes and Corynebacterium diphtheriae 

  • Pseudomonas aeruginosa and Staphylococcus aureus  

  • Moraxella catarrhalis & Streptococcus pyogenes  

  • Streptococcus pneumoniae and Haemophilus influenzae 
     

Week 2  

Which of the following is most commonly associated with bradykinin-mediated angioedema? 

  • Dermatographis

  • Ace inhibitor use  

  • IgE mediated food allergy  

  • Elevated histamine levels  
     

Which of the following statements regarding chronic urticaria is TRUE? 

  • It is most often caused by viral infection.  

  • Most cases reveal laboratory abnormalities on routine testing.  

  • Autoantibodies to IgE or its receptor can be found in some patients.   

  • It is more common in men than in women.  
     

What is the first-line treatment for anaphylaxis? 

  • Intravenous diphenhydramine 25-50mg  

  • Intramuscular epinephrine 0.3-0.5ml of 1:1000 concentration  

  • IV Solumedrol  

  • Inhaled albuterol and oxygen  
     

Which of the following best supports a diagnosis of sarcoidosis in a patient with bilateral hilar lymphadenopathy? 

  • Necrotizing granulomas on biopsy  

  • Noncaseating granulomas with exclusion of infection and malignancy  

  • A CD4/CD8 ratio <1 in BAL fluid  

  • Negative bronchoscopy and normal ACE level  

 

Which of the following findings is most supportive of sarcoidosis but not diagnostic on its own?  

  • Elevated ACE level  

  • Endobrachial necrosis on bronchoscopy 

  • Caseating granulomas in a mediastinal lymph node  

  • Hypocalcemia and neutropenia  

 
 

Week 3  

Which of the following is the primary variable controlled in volume-controlled ventilation (VCV)? 

A. Inspiratory pressure 
B. Tidal volume 
C. Peak inspiratory flow 
D. Expiratory time 
E. Plateau pressure 

In pressure-controlled ventilation (PCV), which of the following factors determines the tidal volume delivered? 

A. Patient's weight 
B. Respiratory rate 
C. Lung compliance and airway resistance 
D. Set FiO₂ 
E. PEEP level 

Which of the following is the most appropriate initial ventilator setting for a 70-kg male with ARDS using lung-protective volume control ventilation? 

A. Tidal volume 700 mL, RR 10, PEEP 5 cm 
B. Tidal volume 420 mL, RR 20, PEEP 8 cm 
C. Tidal volume 300 mL, RR 12, PEEP 0 cm 
D. Tidal volume 600 mL, RR 8, PEEP 5 cm 
E. Tidal volume 800 mL, RR 10, PEEP 10 cm 

Which of the following is a contraindication to using BiPAP (Bilevel Positive Airway Pressure)? 

A. Obstructive sleep apnea 
B. COPD exacerbation with hypercapnia 
C. Acute pulmonary edema 
D. Respiratory arrest 
E. Obesity hypoventilation syndrome 

Which of the following settings on non-invasive ventilation primarily assists with alveolar recruitment and oxygenation? 

A. Expiratory positive airway pressure (EPAP) 
B. Inspiratory positive airway pressure (IPAP) 
C. FiO₂ 
D. Respiratory rate 
E. Tidal volume 

 

Week 5  

Which of the following is the most common oncologic emergencyleading to acute kidney injury, hyperkalemia, hyperphosphatemia, and hypocalcemia? 

  • Spinal cord compression  

  • Hyperviscosity syndrome  

  • SIADH  

  • Tumor lysis syndrome  

A 64-year-old man with prostate cancer develops new-onset back pain, weakness in both legs, and urinary retention. What is the most appropriate next step in management? 

  • Order an abdominal CT  

  • Schedule outpatient neurology referral  

  • Start IV fluids and monitor  

  • Begin high-dose corticosteroids and obtain MRI of the spine 

Which of the following best explains the mechanism behind hypercalcemia of malignancy? 

  • Parathyroid hormone (PTH) secretion by tumor cells  

  • Tumor lysis and calcium phosphate precipitation  

  • Increased production of parathyroid hormone-related peptide (PTHrP) 

  • Decreased osteoclast activity  

 

A patient with known small-cell lung cancer presents with confusion, seizures, and hyponatremia. What is the most likely diagnosis? 

  • SIADH  

  • Hepatic encephalopathy  

  • Cerebral metastasis  

  • Tumor lysis syndrome  

 

A patient with acute leukemia presents with fever, hypotension, and a WBC count of 1,200/µL. What is the most important initial management step? 

  • Transfuse platelets immediately  

  • Wait for blood culture results  

  • Begin high-dose corticosteroids  

  • Start empiric broad-spectrum antibiotics  

 

Week 6  

Which of the following best distinguishes Toxic Epidermal Necrolysis (TENS) from Stevens-Johnson Syndrome (SJS)? 

  • Presence of mucosal involvement  

  • Positive Nikolsky sign  

  • Percentage of body surface area involved  

  • Presence of fever & malaise  

 

A patient presents with widespread erythematous macules and mucosal erosions after starting a new anticonvulsant. Skin biopsy shows full-thickness epidermal necrosis. Which of the following is the most appropriate next step in management? 

  • High-dose systemic corticosteroids  

  • Immediate transfer to a burn unit or ICU  

  • Start IV Vanco & Zosyn  

  • Administer antihistamines and monitor  

 

Which of the following medications is most commonly associated with triggering SJS/TENS? 

  • Omeprazole  

  • Acetaminophen  

  • Lamotrigine  

  • Metformin  

 

A 32-year-old male suffers deep partial-thickness burns over 25% of his total body surface area (TBSA). What is the most immediate life-threatening concern in the first 24 hours post-burn? 

  • Infection  

  • Electrolyte imbalance  

  • Pulmonary embolism  

  • Hypovolemic shock  

 

Which of the following best describes the pathophysiology of skin injury in SJS/TENS? 

  • Autoimmune deposition of IgG at the basement membrane  

  • Direct bacterial invasion of keratinocytes  

  • Cytotoxic T-cell mediated apoptosis of keratinocytes  

  • Overproduction of histamine by mast cells  

 

IN-PERSON QUIZ QUESTIONS 

  • What is Lemierre’s disease? 

What causes it? Fusobacterium necrophorum 

What is the Triad? Pharyngitis, neck pain, septic lateral thrombi 

 

  • What causes otitis externa? Pseudomonas 

Who is most likely to get it? Elderly, diabetics 

  • What is the acute angle glaucoma triad? 
    Eye pain, blurred vision with halo, increased IOP 

  • What is diagnostic for high IOP? Diagnostic > 20 mmHg 

  • What are the treatments? Acetazolamide, topical beta blocker, topical agonist (check these lol) 

  • What are s/s of retinal detachment? 
    Shield over eyes, flashing lights, floaters 

  • What is first line treatment for anaphylaxis? 
    Epinephrine first tx 

  • What is the hallmark sign of sarcoidosis? 
    Noncaseating granulomas 

  • What does CXR have? Hilar lymphadenopathy is hallmark 

  • What is PEEP? Positive end expiratory pressure 

  • What is Plateau pressure? Airway pressure after inspiratory pause 

  • What pelvic fracture causes the most bleeding? 
    Open book fracture 

  • Know the anatomical boundaries for the neck zones 

  • What constitutes a massive hemothorax? 
    1500 mL dump in chest tube 

  • What scans are needed for lymphoma staging? PET Scan 

 
 

QUIZ QUESTION SET (CONTINUED) 

  1. IOP greater than __ in acute angle glaucoma 
    a. 21 

  2. Acute angle closure treatment 
    a. Topical beta blocker 
    b. Acetazolamide 

  3. Retinal detachment symptoms 
    a. Curtain or shadows over visual fields 
    b. Floaters 
    c. Flashing lights 

  4. Anaphylaxis treatment 
    a. Epi 

  5. Hallmark finding in sarcoidosis 
    a. Noncaseating granulomas 

  6. CXR in sarcoidosis 
    a. Hilar lymphadenopathy 

  7. Plateau pressure 
    a. Pressure after an inspiratory pause 

  8. Open book pelvic fracture causes most hemorrhage 

  9. Neck zone LANDMARKS! 

  10. Initial staging of lymphoma use PET 

  11. CRAB criteria for multiple myeloma 
    a. Calcium elevation 
    b. Renal 
    c. Anemia 
    d. Bone 

  12. 4 lab abnormalities for tumor lysis syndrome 
    a. Hyperkalemia 
    b. Hypocalcemia 
    c. Hyperuremia 
    d. Hyperphosphatemia 

  13. Which cancer most commonly causes spinal cord compression? 
    a. Lung