Emergency Medicine Practice Test 2025 – Complete Exam Preparation

The presentation of a patient with worsening sinusitis often includes ongoing facial discomfort, which can manifest as pain or pressure in the areas around the eyes, cheeks, or forehead. Yellow nasal secretions indicate the presence of inflammation and infection, often associated with bacterial sinusitis. As the condition progresses, patients can experience persistent discomfort due to the blockage of sinus drainage pathways, leading to increased pressure and pain.

In the scenario described, "coughing less with persistent facial discomfort" reflects the situation accurately. Initially, coughing may occur due to post-nasal drip from the nasal secretions, but as sinusitis worsens, the focus shifts more to the facial pain and pressure rather than a productive cough. This indicates an advanced stage of sinusitis where the primary symptom is the discomfort rather than other respiratory symptoms.

Other choices depict conditions or symptoms that don’t align well with worsening sinusitis. Clear nasal secretions are typical of a viral upper respiratory infection rather than a bacterial sinusitis, while the resolution of fever after 5 days suggests recovery rather than worsening. Persistent mucosal edema without discharge might imply chronic sinusitis but does not correlate with the acute worsening described in the question.