Chapter 30: Sinusitis Prepared by Drs. Jennifer W. Mbuthia, Walter Reed Army Medical Center, and Tracy Pitt, Winnipeg Children’s Hospital. 1. With respect to sinus development in childhood: A. Maxillary and ethmoid sinuses become radiographically visible from 7 to 15 years of life. B. Frontal and sphenoid sinuses become radiographically visible from 1 to 2 years of life. C. Maxillary and sphenoid sinuses become radiographically visible from 7 to 15 years of life. D. Maxillary and ethmoid sinuses become radiographically visible from 1 to 2 years of life. 2. The most common recovered pathogen responsible for acute sinusitis is: A. Haemophilus influenzae B. Streptococcus pneumoniae C. Moraxella catarrhalis D. Staphlococcus aureus 3. The cell type(s) playing a central role in the pathogenesis of chronic sinusitis: A. Th2 cells B. Th1 cells C. Th2 cells and eosinophils D. Eosinophils 4. Which is true of chronic sinusitis? A. It is defined as symptoms lasting more than 6 weeks. B. Invasive disease is common in children. C. S. aureus and anaerobes tend to be disproportionately associated with protracted, severe, or complicated disease. D. Usually less than 15 percent of children with chronic sinusitis have positive cultures of sinus aspirates. 5. Which of the following statements about the risk factors for chronic sinusitis is true? A. Allergic rhinitis and inhalant allergen sensitization are not associated with sinusitis in children. B. Chronic sinusitis and nasal polyps are hallmark features of cystic fibrosis. C. IVIG therapy should be considered to treat chronic sinusitis in addition to IV antibiotics. D. Studies show siblings of patients with CF have a significantly higher number of episodes of chronic sinusitis. 6. Which of the following statements concerning the American College of Radiology recommendations on radiographic imaging for sinusitis is true? A. Coronal sinus CT is recommended when imaging patients with chronic sinusitis. B. Sagittal sinus CT is recommended when imaging patients with chronic sinusitis. C. The diagnosis of acute and chronic sinusitis should be made on the basis of imaging studies and not made clinically due to increased antibiotic resistance. D. Plain radiographs of the sinuses are discouraged, especially in children under 4 years of age. 7. Intracranial complications from sinusitis are primarily the result of disease in which sinus? A. Ethmoid B. Maxillary C. Sphenoid D. Frontal 8. Which of the following is/are the most likely complication(s) of maxillary sinusitis? A. Mucocele B. Orbital cellulitis C. Orbital cellulitis and preseptal cellulitis D. Cavernous sinus thrombosis 9. Which of the following is LEAST effective in treating acute sinusitis secondary to Moraxella catarrhalis ? A. Amoxicillin-clavulanate B. Cefuroxime C. Clarithromycin D. Clindamycin 10. Consider sinus aspiration for microbiological identification and targeted antimicrobial therapy if disease is: A. Associated with sinus pain and pressure B. In immunocompromised patient C. In patient with concurrent acute otitis media D. Poor response to first-line antibiotics and before initiation of broad spectrum antibiotics Answers 1. D, page 309 2. B, page 310 3. C, page 311 4. C, page 311 5. B, page 312 6. A, page 314 7. D, page 314 8. A, page 314, Table 30-3 9. D, page 316 10. B, page 315 |
|
