HEENT

Question 1

<70 yo blindness

Answer 1

DM retinopathy (MCC)

Question 2

> 70 yo blindness

Answer 2

Macular degeneration

Question 3

Afferent papillary defect, marcus-gunn pupils

Answer 3

Optic nerve lesion. Tertiary syphilis (marcus-gunn)

Question 4

Bilateral DILATED pupils

Answer 4

Anticholinergics, TCA, anti-parkinsonian drugs, profound hypoxemia

Question 5

Bilateral hemianopia

Answer 5

optic chiasm lesion

Question 6

Eye trauma, diplopia. Enophthalmos, hyphema

Answer 6

Orbital blow-out fracture; immediate ophthalmology referral

Question 7

Orbital fx muscle entrapment

Answer 7

inferior rectus muscle

Question 8

Painless, nontender nodule on upper or lower eyelid

Answer 8

chalazion

Question 9

Painful swelling of upper or lower eyelid

Answer 9

hordeolum

Question 10

Painless, yellow triangular nodule on conjunctiva

Answer 10

Pinguecula (more common on nasal side)

Question 11

Curtain or veil over my eyes, new onset floaters

Answer 11

retinal detachment

Question 12

Transient monocular vision loss

Answer 12

Amaurosis fugax - TIA, emboli

Question 13

Painless vision loss. History of TIA, palpitations, arrhythmia, carotid disease, embolic source

Answer 13

CRAO (pale retina, cherry red macula)

Question 14

Vision loss over hours to days, painful EOM

Answer 14

Optic neuritis (assoc. with MS)

Question 15

Recurrent episodes of vision change, diplopia that resolve

Answer 15

MS

Question 16

Red eye, watery discharge, preauricular LAD

Answer 16

viral conjunctivitis

Question 17

Red eye, hyperemia, chemosis, nodular conjunctiva

Answer 17

Allergic conjunctivitis

Question 18

Acute painful red eye, halos (or colored rings around lights), hazy, steamy cornea. Pupil fixed and (mid) dilated. Onset after being in dark room

Answer 18

Acute angle-closure glaucoma

Question 19

Unilateral foul smelling or purulent nasal discharge in a pediatric patient

Answer 19

Nasal foreign body

Question 20

Sneezing, clear rhinorrhea, post-nasal drip, nasal congestion seasonal occurrence

Answer 20

Allergic rhinitis

Question 21

Pale, edematous, boggy turbinates

Answer 21

Allergic rhinitis

Question 22

Otitis media

Answer 22

Strep. pneumonia, H. influenza, Strep. pyogenes, moraxella catarrhalis

Question 23

Swimmer with ear pain, discharge

Answer 23

Otitis externa

Question 24

Tinnitus and metabolic acidosis

Answer 24

Salicylate ingestion

Question 25

Sudden dizzy, vertigo, hearing loss, tinnitus

Answer 25

Meniere's disease; treat with diuretics and low-sodium diet

Question 26

Dix-hallpike maneuver

Answer 26

BPPV

Question 27

Sudden vertigo with changes in head position

Answer 27

BPPV

Question 28

Sudden dizzy, N/V, NO tinnitus, hearing loss. recent URI

Answer 28

vestibular neuronitis, labyrinthitis

Question 29

Sensorineural loss >50

Answer 29

Presbycusis (High frequency sounds first to go)

Question 30

Smoker, white mouth lesion cannot be rubbed off

Answer 30

Leukoplakia, rule out oral cancer

Question 31

College student with sore throat. Enlarged tonsils, posterior cervical LAD. Splenomegaly. CBC - elevated atypical lymphocytes

Answer 31

EBV - mononucleosis

Question 32

Visual loss occurring secondary to vision in only one eye as a result of muscular misalignment

Answer 32

amblyopia

Question 33

Cover/uncover eye test used to dx

Answer 33

strabismus

Question 34

Organism most commonly causing mastoiditis

Answer 34

Strep pneumo

Question 35

Cerumen impaction in left ear causes what PE finding with Weber test?

Answer 35

conductive hearing loss. Weber lateralizes to the affected side. Rinne AC

Question 36

Type of hearing loss associated with exposure to loud noise

Answer 36

Sensorineural hearing loss Weber lateralizes away from SN loss Rinne AC>BC on affected side

Question 37

Triad of Meniere's disease

Answer 37

Tinnitus Progressive SN hearing loss Vertigo

Question 38

"hot potato" sounding voice, severe sore throat, unilateral tonsillar edema

Answer 38

Peritonsillar abscess

Question 39

Thrush

Answer 39

Candida albicans most commonly

Question 40

Conjunctivitis with water d/c

Answer 40

viral

Question 41

Conjunctivitis with mucopurulent d/c

Answer 41

bacterial

Question 42

Bilateral conjunctivitis with stringy d/c

Answer 42

allergic

Question 43

Internuclear ophthalmoplegia

Answer 43

MS

Question 44

Absence red reflex

Answer 44

retinoblastoma

Question 45

Small, infarcted areas of retina in DM

Answer 45

cotton wool spots

Question 46

New, weak vessels on retina - DM

Answer 46

Neovascularization

Question 47

Red eye appearing after straining/valsalva, anticoagulation, HTN

Answer 47

Subconjunctival hemorrhage

Question 48

Headache, jaw claudication, temporal or scalp pain, unilateral

Answer 48

Temporal arteritis Temporal artery bx Tx steroids