HEENT

Question 1

Most commonly affected nerve in cavernous sinus thrombosis & findings:

Answer 1

CN VI, abducens nerve, inability to abduct affected eye (lateral gaze palsy - cannot move eye laterally) with horizontal diplopia.

Question 2

Cavernous sinus thrombosis, common presentations:

Answer 2

• High fever
• Chemosis, periorbital edema, proptosis
• Decreased visual acuity
• CN palsies (CN VI most common)

Question 3

Direct trauma to the eye followed by diplopia and lack of upward gaze in the affected eye is indicative of:

Answer 3

inferior orbital wall fracture (blowout fracture) with entrapped inferior rectus muscle.
(If evidence of inferior rectus entrapment - ED ophthalmology consult.)

Question 4

Most common bacteria in acute otitis media (3):

Answer 4

H. influenzae (#1), Streptococcus pneumoniae, and Moraxella catarrhalis

Question 5

Treatment for corneal abrasion in pt who wears contacts?

Answer 5

Anti pseudomonal topical abx (Tobramycin)