H.E.E.N.T

Question 1

• Acute onset of severe eye pain, photophobia, and blurred vision in one eye.
• “Fern-like” lines in the corneal surface are a positive sign.
• Infection permanently damages corneal epithelium, which may result in corneal blindness.

Answer 1

• Herpes Keratitis

Question 2

Diagnostics for Herpes Keratitis is:

Answer 2

• Fluorescein Dye, and…

* Black lamp in a darkened room

Question 3

• An ophthalmologic emergency

* Acute onset of severe eye pain, accompanied by headache, nausea/vomiting, halos around lights, and decreased vision.

Answer 3

• Acute Angle-Closure Glaucoma

Question 4

What does the examination of “acute angle-closure” glaucoma reveal?

Answer 4

• Examination reveals a mid-dilated pupil (oval shape)
• Fundoscopic exam reveals cupping of optic nerve
• Cloudy corneas

Question 5

• Cauliflower like growth accompanied by foul-smelling ear discharge.
• Hearing loss reported on affected ear.
• Tympanic membrane ad ossicles are NOT VISIBLE.
• NON-CANCEROUS

Answer 5

• Cholesteatoma

Question 6

• Cholesteatoma is associated with

Answer 6

• History of chronic Otitis Media

Question 7

• Bilateral condition manifesting as a white ring around the cornea.
• It is a benign variant in the elderly
• It is associated with ↑ cholesterol and ↑ triglycerides in the young adult

Answer 7

• Arcus Senilis

Question 8

• Common “NON-CANCEROUS” growth of the conjunctiva.
• A yellow triangular thickening of the bulbar conjunctiva.
• Located on the “inner and outer margins of the cornea”
• May be associated with long-term sunlight

Answer 8

• Pinguecula

Question 9

• Severe sore throat and difficulty swallowing
• One-sided swelling of the peri-tonsilar area and soft palate.
• Uvula is displaced to one side
• Accompanied by fever, chills, malaise.

Answer 9

• Peri-tonsilar abscess.

* Refer to ED

Question 10

• An acute onset of a bruise behind the ear, over the mastoid process
• Normal seen after a recent trauma
• Indicates a fracture of the basilar skull

Answer 10

• Battle Sign

Question 11

If a basilar skull fracture is noted, what should the practitioner check for?

Answer 11

• Check for CSF FLUID. It can slowly leak through the fracture

Question 12

• Sore throat and “low-grade” fever
• Markedly swollen neck (bull neck)
• Hoarseness and dysphagia
• A “Pseudomembrane” is located on the pharynx, uvula, tonsils, and soft palate.

Answer 12

• Diptheria

Question 13

• A yellow triangular thickening of the conjunctiva that extends on the “nasal or temporal” side of the cornea.
• Caused by UV light damage

Answer 13

• Pterygium

Question 14

• Sore red eyes with increase tearing
• No reports of purulent discharge
• Higher risk with autoimmune disorders (RA, lupus, ankylosing spondylitis), sarcoidosis, and syphilis.

Answer 14

• Anterior Uveitis

Question 15

Part of the eye that is responsible for color and night vision

Answer 15

• Cones (also responsible for high spatial acuity)

Question 16

What is a normal result of the Rinne Test

Answer 16

• Air conduction is greater than bone conduction

Question 17

The Cover/Uncover test is used to screen for?

Answer 17

• Strasismus

Question 18

Vertical nystagmus is _______, but horizontal nystagmus after a lateral gaze is ________

Answer 18

• Vertical Nystagmus is Abnormal

* Horizontal (a few beats) is Normal

Question 19

Peripheral vision is examined with the:

Answer 19

• Visual fields of confrontation

Question 20

Legal blindness is considered when

Answer 20

• Best corrected vision is 20/200

* Visual field is less than 20 degrees

Question 21

The area of the eye that determines 20/20 vision

Answer 21

Fovea (Macula and Fovea)

Question 22

• White spots that appear on the surface and under the tongue.
• May be cancerous.
• A sign in patients with a history of chewing tobacco

Answer 22

Leukoplakia

Question 23

• Normal range of Intraocular Pressure is

Answer 23

• 10-22mm Hg

Question 24

• 1st line Pharmacological treatment for Otitis Externa is:

Answer 24

• Topical floroquinolones (Ciprodex) or,…

* Cortisporin (Neomycin and Hydrocortisone)

Question 25

• Common bacteria found in Otitis Externa is:

Answer 25

• Pseudomonas

Question 26

Over the counter treatment for Cerumenosis is:

Answer 26

• Carbamide Peroxide

Question 27

• Which medications should always be avoided in patients with Mononucleosis?

Answer 27

• Amoxicillin or Ampicillin (they may cause a generalized rash).
• The rash is not an allergic reaction, just a reaction to the Epstein Barr Virus.

Question 28

• Fissures and cracks on the corners of a patients mouth.
• Various oral or peri-oral infections of the mouth
• Commonly associated with Malnutrition, HIV, Advanced Age, or Immunocompromised states.
• Also known as Angular Stomatitis, Perleche, or Cheiliosis.

Answer 28

• Angular Cheilitis.

Question 29

• The various oral or peri-oral infections of the mouth related to “Angular Cheilitis”, “Angular Stomatitis”, “Perleche”, or “Cheiliosis” are caused by what type of bug?

Answer 29

• Candida bugs

Question 30

• Ototoxic medications include:

Answer 30

• Aspirin
• Aminoglycosides
• Vancomycin
• Erythromycin
• Loop diuretics (Furosemide)
• Anti-malarial medications
• Erectile dysfunction medications

Question 31

• Nasal Congestion
• Purulent Nasal Discharge
• Maxillary Tooth Pain/Discomfort
• Facial Pain and Pressure (Both are worse with bending forward)
• The above mentioned are indicative of*

Answer 31

• Acute Rhinosinusitis

Question 32

• A virus that causes a triad of fatigue, pharyngitis, and lymphadenopathy.
• Peak ages of acute infection are between ages of 15 and 24 years of age.
• After acute infection, the virus lies latent in the oropharygeal tissues.

Answer 32

• Infectious Mononucleosis.

Question 33

• Signs and Symptoms of Infectious Mononucleosis includes:

Answer 33

• Fatigue.
• Pharyngitis…Sore Throat.
• Lymphadenopathy..Enlarged Postcervical lymph nodes.
• Splenomegaly and Hepatomegaly - may have abdominal pain.

Question 34

• The main organism found in Mononucleosis is?

Answer 34

• Epstein Barr Virus.

Question 35

• How is Mononucleosis shed/transmitted?

Answer 35

• Via saliva.