HEENT

Question 1

Hepatic keratitis

Answer 1

From herpes simplex or zoster (trigeminal cranial nerve 5)
One side of face effected 
Can lead to corneal blindness
Emergency
Cipro or ofloxacin
NO STEROIDS or patch
May valtrex

Question 2

Acute angle closure glaucoma

Answer 2

Acute and sudden eye pain, ha, vomiting, decreased vision,  halos around lights
Pupil oval shaped, cornea cloudy
Optic nerve cupping
Rise in iop
Emergency

Question 3

Optic neuritis

Answer 3

New or intermittent loss of vision in one eye
Associated with symptoms of MS
Fatigue, neuro symptoms
Refer to neuro emergently

Question 4

Orbital cellulitis

Answer 4

Swollen eyelid with proptosis (bulging eye)
Can't  do eye ROM
recent hx of URI
More common in kids
Refer to ED

Question 5

Retinal detachment

Answer 5

Sudden onset of floaters, looking through curtain, or flashing lights
Refer to ed

Question 6

Cholesteatoma

Answer 6

Cauliflower like growth
Foul smelling discharge from ear
Can't see TM because of tumor
Hx of chronic otitis media 
Can damage facial nerve 7
Tx with antibiotics and sx
Refer to otolaryngologist

Question 7

Battle sign

Answer 7

Racoon eyes and bruising behind ears 2 to 3 days after trauma
R/o occipital or temporal skull fx

Question 8

Clear golden drainage from ear or nose

Answer 8

Indicative of basilar skull fx
CSF leak
Test with urine dipstick to check for glucose…this means its CSF fluid

Question 9

Peritonsilar abscess

Answer 9

Severe throat pain, trouble/pain swallowing, jaw spasms, hot potatoe voice
Unilateral swelling, displaced uvula
Fever, chills
Refer to ed

Question 10

Diphtheria

Answer 10

Sore throat, fever, swollen “bull” neck,
Grey to yellow colored coating on throat that is hard to displace
Very contagious
Contact isolation
Refer to ed

Question 11

Presbyopia

Answer 11

Far sighted

Age related normal change starting around 40 yo

Question 12

Nasal passages with allergic rhinitis

Answer 12

Boggy, pale, pale

Question 13

Cartilage of nose

Answer 13

Does not regenerate

Call plastics if its messed up

Question 14

Leukoplakia

Answer 14

White to light gray patches in mouth

Rule out oral cancer

Question 15

Apthous stomatitis

Answer 15

Canker sores in mouth
Painful
Heal in 7 to 10 days
Give magic mouthwash

Question 16

Sialolithiasis

Answer 16

Salivary stone blocked by a stone

Question 17

Color of exudate for mono

Answer 17

White

Question 18

Color of exudate for strep

Answer 18

Yellow or green

Question 19

Koplik spots

Answer 19

Clusters of small red bumps with white center in inside of cheeks
Associated with measles

Question 20

Hearing test results for sensorineural loss

Answer 20

Weber: Lateralization to good ear
Rhine: AC > BC

Question 21

Hearing loss results for conductive loss and otitis media

Answer 21

Weber test: Lateralization to bad ear
Rhine: BC>AC

From obstruction and blockage

Question 22

Subconjunctival hemorrhage

Answer 22

Blood trapped under conjunctiva due to burst blood vessel
Resolves in 1 to 3 weeks
No visual loss or pain
Just watch

Question 23

Open angle glaucoma

Answer 23

Increased iop >30 is emergency
Lose vision, peripheral first
Tx with timolol ( BB), latanoprost

Don’t give bb is patient has heart and lung issues

Question 24

Blepharitis

Answer 24

Chronic inflammation of eyelids
Itching, crusting, gritty sensation
Wash eyes, erythromycin

Question 25

Strep throat

Answer 25

Tonsilar exudate
Anterial cervical adenopathy
Fever 
No cough
Treat with PCN or amox

Question 26

Otitis media

Answer 26

Red and bulging TM
caused by pneuma and influenzae
treat with amox, augmentin, levaquin

Question 27

papilledema

Answer 27

Optic disc swelling
increased eye pressure
with blurred edges
caused by abscess, tumor

Question 28

What causes missing red reflex

Answer 28

white colored opacities (cataracts) or white spots (leukocoria), retinoblastoma, glaucoma

Question 29

Strabismus

Answer 29

Misalignment of the eye.

• Horizontal strabismus: esotropia (inward turning of the eyes) or exotropia (outward turning of the eyes).
• Vertical strabismus may be hypertropia (one eye higher than the other) or hypotropia (one eye lower than the other).

Question 30

Macular Degeneration

Answer 30

• Loss of central visual fields results in loss of visual acuity and contrast sensitivity
• age related

Question 31

Epiglottitis

Answer 31

Acute and rapid onset
high fever, chills
sore throat, drooling, not eating, hot potato voice
sits with hyperextended neck with mouth breathing, stridor
treat with rifampin

Question 32

Meniere’s dz

Answer 32

hearing loss, vertigo, tinnitus

do rhomberg test

Question 33

3 types of red tongue

Answer 33

• Glossitis: smooth red tongue
• B 12 insuffiency: beefy red tongue
• Kawasaki and scarlet fever: strawberry tongue