Sinusitis: ABFM practice questions

5 board-style questions on sinusitis in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 35-year-old man presents with 12 days of persistent nasal congestion, facial pressure, and thick yellow-green nasal discharge. His symptoms initially improved after a week but then worsened over the past 3 days. He has a temperature of 38.3°C (100.9°F) and bilateral maxillary sinus tenderness. He has no drug allergies and no recent antibiotic use. Which of the following is the most appropriate initial antibiotic therapy?

  1. Amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days
  2. Levofloxacin 500 mg daily for 10 days
  3. Azithromycin 500 mg day 1, then 250 mg days 2-5
  4. Cephalexin 500 mg four times daily for 14 days

Sample question 2

A 42-year-old man presents with a 3-week history of worsening frontal headache, high-grade fever of 39.5°C (103.1°F), and periorbital swelling over the past 2 days. He was treated for acute bacterial sinusitis with amoxicillin-clavulanate starting 10 days ago but has not improved. Examination reveals right upper eyelid erythema and edema with proptosis, limited and painful extraocular movements, and decreased visual acuity in the right eye. What is the most likely complication and the most appropriate immediate management?

  1. Cavernous sinus thrombosis; immediate systemic anticoagulation only
  2. Frontal osteomyelitis; 6-week course of oral ciprofloxacin
  3. Orbital cellulitis with possible subperiosteal abscess; IV broad-spectrum antibiotics and urgent ophthalmology and ENT consultation
  4. Preseptal cellulitis; switch to oral doxycycline and close outpatient follow-up

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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