NR661\/ NR 661 VISE (Latest 2023\/ 2024 Update) Complete Guide with Questions and Verified Answers| 100% Correct- Chamberlain<\/p>\n\n\n\n
NR661\/ NR 661 VISE (Latest 2023\/ 2024
Update) Complete Guide with Questions and
Verified Answers| 100% CorrectChamberlain
Q: acute maxillary sinusitis – etiology
Answer:
inflammation of the maxillary sinus due to viral, bacterial, or fungal infection or allergic reaction
Q: acute sinusitis
Answer:
symptoms last < 12 weeks \u00b7 Common bacterial causes: strep pneumoniae, haemophilus influenzae, Moraxella catarrhalis \u00b7 Common viral causes: rhonovirus, coronavirus, flu A and B, parainfluenza, RSV Q: recurrent acute sinusitis Answer: at least 3 episodes of acute bacterial sinusitis in a year Q: chronic sinusitis Answer: symptoms of varying severity > 12 weeks; further classified with or without nasal polyps,
abnormal findings on CT scan or nasal endoscopy
\u00b7 Gram negative is more likely
\u00b7 Staph aureus
\u00b7 Pseudomonas aeruginosa<\/p>\n\n\n\n
\u00b7 Anaerobic organisms
Q: sinusitis – presentations
Answer:
\u00b7 Fever may or may not be present
\u00b7 Persistent symptoms of URI (> 10-14 days)
\u00b7 Congestion, purulent nasal discharge
\u00b7 headache, sore throat,
\u00b7 Pain and pressure over cheeks and upper teeth suggest maxillary
\u00b7 Pain and pressure over eyebrows suggest frontal
\u00b7 Pain and pressure\/tenderness behind and between eyes suggests ethmoid
\u00b7 cough, anosmia, halitosis, postnasal discharge, periorbital edema
Symptoms > 10 days that worsen after initial improvement, persistent purulent nasal discharge,
fever, unilateral face or tooth pain is more likely a bacterial infection
Q: sinusitis – diagnostics
Answer:
CBC (elevated WBC),
sinus x-rays for recurrent disease
transillumination: opacification with air-fluid levels if sinus cavity is infected
CT scan for recurrent disease
Consider c and s for treatment resistant infections
Q: sinusitis — nonpharmacological
Answer:
Avoid environmental irritants,
Humidified air
treat otitis media,
sleep with HOB elevated to aid with drainage,
Good hand hygiene
blowing nose, not sniffing.<\/p>\n\n\n\n
Q: sinusitis — pharmacological
Answer:
First line- Augmentin 875 mg\/125 mg PO BID for 5 days,
Allergic to Penicillin then Doxycycline 100mg BID for 5-7 days OR 200mg PO daily for 5-7
days Levofloxacin 500mg PO daily for 10-14 days Monifloxacin 400mg PO daily for 5-7 days
Macrolides no longer recommended due to high resistance
Analgesics for headache and fever
Saline irrigation
Q: sinusitis – f\/u, referral
Answer:
Follow up:
1 week or until clinically free of infection
Referral:
May refer to ENT for recurrent infections or resistance to tx
Consider immediate referral if periorbital cellulitis
ER if meningitis suspected
Q: hyperlipidemia – etilogy
Answer:
may be familial, dietary, obesity, hypothyroid, renal disorders, thiazide or beta blocker use,
alcohol and\/or caffeine intake
Q: hyperlipidemia – presentation
Answer:
\u00b7 Xanthomata (lipid deposits around the eyes)
\u00b7 Corneal Arcus prior to age 50 years (white iris), normal
\u00b7 Angina
\u00b7 Bruits
\u00b7 MI<\/p>\n\n\n\n
\u00b7 Stroke
Q: hyperlipidemia – diagnositics
Answer:
\u00b7 Fasting\/nonfasting lipid profile (total cholesterol, LDL, and HDL minimally affected by eating)
\u00b7 Glucose,
\u00b7 UA and creatinine (for detection of nephrotic syndrome which can induce dyslipidemia),
\u00b7 TSH (for detection of hypothyroidism)
Q: hyperlipidemia – diagnosis
Answer:
ldl >= 190mg\/dL
Q: hyperlipidemia – non-pharmacologic mgt
Answer:
lifestyle modification of diet and exercise
Q: hyperlipidemia – pharmacologic mgt
Answer:
Those who benefit most from statin therapy include:
\u00b7 hx of CVD or stroke,
\u00b7 LDL 190 or greater,
\u00b7 DM with LDL 70-189,
\u00b7 no evidence of ASCVD or DM but have LDL 70-189 PLUS an estimated ASCVD risk of 7%
or greater
\u00b7 High risk:
o Atorvastatin 40 or 80 mg daily
o Rosuvastatin 20 or 40 mg daily
\u00b7 Moderate risk:
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