Module 2 Polls ENT, Foreign Bodies and More
Mental Health Screening
1. Depression Screening (PHQ-2) involves 2 questions – one about interest/pleasure and one about feeling down/depressed/hopeless
o True
o False
2. One drink = 12 oz beer, OR 5 oz wine, OR 1.5 liquor (one shot)
o True
o False
3. Risky drinking for men is more than 4 drinks on any occasion, more than 14 drinks per week. Risky drinking for women is more than 3 drinks on any occasion, more than 7 drinks per week.
o True
o False
BPPV
1. American Academy of Otolaryngology strongly recommends clinicians diagnose BPPV when patients present with vertigo associated with torsional, up-beating nystagmus provoked by the Dix Hallpike maneuver
o True
o False
2. American Academy of Otolaryngology recommends against radiographic imaging for a patient who meets the diagnostic criteria for BPPV and against routinely treating BPPV with vestibular suppressant medications such as antihistamines or benzodiazepines
o True
o False
3. Half summersault is another evidence based manner for patients and providers to treat BPPV. Epley Maneuver requires rotation and rest for 1-2 minutes at each rotational site for best re-positioning of crystals in the semi-circular canals.
o True
o False
Ring removal
1. Before using a ring cutter, methods to remove rings in Urgent Care include:
try to elevate the hand, use ice or cold water, use lotion or oils, and try dental floss
o True
o False
2. Jewelers, Fire Departments, and Urgent Care and Emergency Departments can remove rings with a ring cutter, and patients also try this at home with a popsicle stick and a needle file
o True
o False
Foreign body removal – fish hook, splinter, nasal
1. After fish hook removal, patients need Tdap, but no need for antibiotics unless hook
was deeply embedded in an infection-prone area (fingertip, ear cartilage)
o True
o False
2. After anesthesia accomplished using Lidocaine, providers doing splinter removal must remember not to cut down deeper into tissue to expose the splinter than can be closed with superficial sutures
o True
o False
Tick removal
1. Consider single dose doxycycline 200 mg orally for patients:
o In highly endemic areas
o If tick is identified as adult or nymphal lxodes species
o Adherent for at least 36 hours
o Doxycycline can be given within 72 hrs of tick removal.
o All of the above
2. Provider should order Lyme titers to establish positive/negative Lyme disease during initial visit to Urgent Care
o True
o False
Eye assessment
1. Sending patients home with Tetracaine eye anesthesia (for home use) is a great way to manage eye discomfort related to minor corneal abrasions
o True
o False
2. Initial basic eye assessment exam includes all of the following except:
o Visual acuity
o Tetracaine eye drops
o EOM- PERRLA
o Fluorescein staining
o Anterior chamber assessment
3. Assessment for corneal abrasion should always include flipping up the upper lid to look for the presence of foreign bodies
o True
o False
Nursemaid’s Elbow
1. Mother wanting to go one direction, child wanting to go the other direction – causing
radial head subluxation – has up to almost a 40% recurrence rate
o True
o False
2. X rays are not necessary in assessment of childhood nursemaid elbow unless there has been trauma, a fall, or the caregiver cannot fix the elbow with multiple attempts at supination/flexion.
o True
o False
Nosebleed
1. Posterior nosebleeds are more ominous, they occur mostly in older adults, are more
severe, and often require hospitalization.
o True
o False
2. Anterior nosebleed has many causes and is generally occurring in the younger adult. It is a sign of untreated hypertension.
o True
o False