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HEENT Flashcards

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1
Q

If left untreated, strabismus can lead to what condition?

A

Amblyopia (or “lazy eye”)

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2
Q

Which cranial nerve palsies are associated with strabismus?

A

3rd (occulomotor)
4th (trochlear)
6th (abducens)

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3
Q

What are the 5 criteria for the Centor scoring system?

A

Used to determine need to complete a throat culture for strep pharyngitis
1. Fever
2. Tonsillar exudate
3. Anterior cervical adenopathy
4. Absence of cough

Rapid antigen testing should be done with scores greater than 2

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4
Q

What potential febrile condition can develop as a result of untreated group A strep pharyngitis?

A

Acute rheumatic fever

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5
Q

What is the most common cause of blepharitis?

A

Dysfunctional meibomian gland

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6
Q

What is the most common type of oral cancer?

A

Squamous cell carcinoma

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7
Q

What is the most common cause for auricular hematomas?

A

Blunt trauma to the ear (wrestlers) leads to blood accumulation

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8
Q

In conductive hearing loss, Weber will localize to what ear?

What is the most common cause of conductive hearing loss?

A

The affected ear

Cerumen impaction

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9
Q

What is the normal intraocular pressure?

A

10-20

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10
Q

What are the three auditory ossicles?

A

Malleus, incus, and stapes

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11
Q

Name three things that increase the risk of otitis media in a child?

A
  • Smoker in the house
  • Bottle Feeding
  • Day Care
  • Younger age
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12
Q

What is the most commonly affected sinus in acute sinusitis?

A

Maxillary

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13
Q

How do you treat allergic rhinitis?

A

Intranasal corticosteroid and antihistamines

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14
Q

Describe the results of a Weber test for a patient with conductive hearing loss

A

Sound is heard louder in the affected ear

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15
Q

What is the most common site of epistaxis?

A

Kiesselbach’s plexus

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16
Q

List a few possible causes of unilateral hearing loss

A
  • Labyrinthitis
  • Foreign body
  • Acoustic neuroma
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17
Q

How long do typical episodes of vertigo last in Meniere disease?

A

1-6 hours

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18
Q

What is the first line treatment for seasonal allergies?

A

Intranasal steroids

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19
Q

Are anterior or posterior nosebleeds more common?

A

Anterior

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20
Q

Define conductive hearing loss

A

Problem is with conducting sound waves into the ear

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21
Q

Describe the results of a Weber test for a patient with sensorineural hearing loss

A

The sound will be louder in the unaffected ear

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22
Q

What is the treatment for an external ear hematoma

A

Drainage ASAP

If > 7 days urgent referral to ENT or plastic surgeon

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23
Q

What is a good first line antibiotic for otitis media

A

Amoxicillin x10 days

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24
Q

A patient presents with a hot potato or muffled voice. What is the most likely diagnosis?

A

Peritonsillar abscess

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25
What is the first line treatment for small nasal polyps?
Topical intranasal corticosteroids for 1-3 months
26
Where do you place the tuning fork for a Weber test?
Middle of the forehead
27
A 45 year old female complains of feeling the ground rolling under her feet from time to time. The episodes are short. What is the most likely diagnosis?
Benign paroxysmal positional vertigo
28
What is the treatment of choice for strep throat?
Penicillins are the preferred choice; Penicillin V in adults and Amoxicillin in kiddos Macrolides or cephalasporins may be used if there is an allergy
29
Small grouped vesicles on the vermillion border should make you think of what diagnosis?
Herpes
30
What is the longest time limit for using phenylephrine?
Five days due to rebound nasal congestion
31
How do you administer the Rinne hearing test?
Place a tuning fork on the mastoid and then move it next to the ear
32
Positive heterophile antibody should make you think of what diagnosis?
EBV - infectious mononucleosis
33
What does Kiesselbach's plexus refer to?
A group of veins in the anterior nose, which are the most common site of epistaxis
34
Where is the problem located with sensory hearing loss?
The inner ear or the vestibulocochlear nerve
35
How do you make a definitive diagnosis of an acoustic neuroma?
MRI
36
What is the most important function of the Eustachian tube?
Equalizing pressure across the tympanic membrane
37
Are oral herpes best treated with topical or systemic antivirals?
Topicals are first-line
38
What is the first line treatment for symptomatic vertigo?
Antihistamines such as Meclizine
39
What is the most common presenting sign of an acoustic neuroma?
Unilateral hearing loss
40
A patient presents with right sided hearing loss and otorrhea. Otoscopic exam reveals a TM perforation with keratinized debris. What is the most likely diagnosis?
Cholesteatoma
41
A child presenting with an erythematous sandpaper rash and erythematous tongue should make you think of what diagnosis?
Scarlet Fever
42
A patient presents with a round ulcer in her mouth that is yellow-grey and has a red halo. It is on the buccal mucosa and it is painful. What is the most likely diagnosis?
Aphthous ulcer
43
A patient presents drooling, with stridor and in a tripod position. What diagnosis should you be concerned about?
Epiglotitis
44
A patient presents with a history of smoking presents with a new onset of hoarseness. This has been persistent. What is the most likely diagnosis?
Laryngeal squamous cell carcinoma
45
Describe the results of a Rinne test in a patient with conductive hearing loss
Sound will be louder with the tuning fork on the mastoid
46
No light reflex and a bulging tympanic membrane should make you think of what diagnosis?
Otitis media
47
If a patient is being seen with hearing loss related to cerumen impaction what will the Rinne test show?
Sound will be louder with the tuning fork on the mastoid
48
White oral lesions which can be scraped off leaving punctate bleeding should make you think of what diagnosis?
Oral candida
49
A white oral lesion which cannot be scraped off should make you think of what diagnosis?
Oral leukoplakia
50
What are the most common pathogens causing otitis externa?
Psuedomonas and Enterobacteria
51
What is required to make the clinical diagnosis of otitis media?
* Bulging tympanic membrane on exam * Signs of acute inflammation (marked erythema of the TM, fever, or ear pain) * Middle ear effusion
52
What are the most common etiologies of acute otitis media?
**S. pneumonia**, H. Influenza (more common to cause bilateral OM), chlamydia (< 6 months)
53
What are the indications for tympanostomy tubes? | What are other names for ear tubes?
* > 3 episodes of OM in the past 6 months * > 4 episodes of OM in the past 12 months | Tympanostomy, myringtomy
54
What is the most common cause of fungal pharyngitis?
Inhaled steroid use
55
What is the presentation of mononucleosis? | What is the name of the viral test for mono?
* Fever * Sore throat * Lymphadenopathy * Splenomegaly | Heterophile agglutination test (monospot)
56
What is the Centor Score?
Used to diagnose strep pharyngitis Centor Score 1. Absence of a cough 2. Exudates 3. Fever (> 100.4 F) 4. Cervical lymphadenopathy | If 3/4 criteria are met get a rapid strep test
57
What type of lymphadenopathy is present in strep pharyngitis?
Cervical Lymphadenopathy
58
What is the first line treatment for group A strep? | What are complications associated with strep?
Penicillin Azithromycin if penicillin-allergic | Rheumatic fever and post strep glomerulonephritis
59
What is the treatment for mononucleosis?
Symptomatic and avoid contact sports; antibiotics such as amoxicillin or ampicillin may cause a rash For strenuous contact sports patients should stay out for four weeks after illness onset
60
A 4 year old girl presents with purulent yellow discharge around her eyes. You notice crusting. Her mother says she wakes up with discharge in her eyes and it improves throughout the day. What is the most likely diagnosis?
Bacterial conjunctivitis
61
Contact lens users are at a higher risk for conjunctivits caused by what pathogen? | What is the treatment?
Pseudomonas | Fluorquinolone (ciprofloxacin)
62
What are the 3 D's of epiglotitis?
* Dysphagia * Drooling * Respiratory Distress
63
What virus causes supraglottic inflammation and obstruction of the airway?
Haemophilus influenza type B (Hib)
64
What classic finding is seen on x-ray with epiglotitis?
Thumbprint sign on lateral neck film from the swelling
65
A 2 year old arrives at the ED with a swollen and erythematous eyelid, proptosis, pain with movement of the eye, and an inability to adduct or abduct his eye. What is the most likely diagnosis? | What is the treatment?
Orbital Cellulitis | Hospitalization and IV abx (vanco)
66
What is the treatment for otitis externa?
Ciprofloxacin and dexamethasone drops for 7 days
67
What is exotropia?
Outward turning of the eyes
68
What is esotropia?
In turning of eyes
69
What results if strabismus isn't treated before age 2?
Amblyopia (lazy eye)
70
A 10-year-old patient presents with nasal congestion and a clear nasal discharge for the past three weeks. He also has a frequent cough, especially at night. What is the most likely diagnosis?
Allergic Rhinitis
71
An 11-year-old boy with a peanut allergy suddenly develops hoarseness, difficulty breathing, and swollen lips after eating a snack at a party. The most immediate action should be:
Administer epinephrine
72
A 6-month-old female infant is brought to the clinic by her parents as a new patient for well-child examination. The patient was delivered at term and has been healthy. However, the parents are concerned that the patient sometimes seems cross eyed. Strabismus is suspected. Which test is most likely to confirm this diagnosis?
Cover Test
73
What class of antibiotics is non-ototoxic and can be used in a tympanic membrane perforation?
Floxacin drops
74
What is the name of a benign tumor of cranial nerve VIII?
Acoustic neuroma
75
What type of hearing loss is associated with normal aging?
Sensory

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