HEENT (Exam 2) Flashcards
What oral lesion condition has adherent white patches/plaques?
Leukoplakia
What oral lesion condition is usually benign but can be precancerous for SCC?
Leukoplakia
What oral lesion condition has red, velvety patches?
Erythroplakia
What oral lesion condition has very high risk for malignancy?
Erythroplakia
What oral lesion condition has white mucosal plaques with red, speckled appearance?
Leukoerythroplakia
What oral lesion condition has vertically corrugated adherent white lesions on lateral surface of tongue?
Oral Hairy Leukoplakia
Is Oral Hairy Leukoplakia benign, premalignant or malignant?
Benign
What oral lesion condition has ulcers or masses that do NOT heal?
Oral Squamous Cell Carcinoma (SCC)
What two risk factors is oral SCC typically associated with?
Tobacco use and alcohol use
What oral lesion condition should be considered if there is any pigmentation?
Oral Melanoma
What oral lesion condition has pinkish/blue soft papules or nodules filled with gelatinous fluid?
Mucoceles
What oral lesion condition has grouped vesicles on an erythematous base?
Herpes Simplex Virus (HSV)
What is the most common clinical manifestation of primary HSV in childhood?
Herpetic gingivostomatitis
What is first line treatment for HSV (3)?
Acyclovir, Valacyclovir or Famciclovir
What oral lesion condition spares the gingiva and lips? What is the virus name associated with this?
Hand, Foot & Mouth Disease
- Coxsackie A16 virus
What oral lesion condition has creamy, white patches/plaques with underlying erythema?
Oropharyngeal Candidiasis (“Thrush”)
How is Oropharyngeal Candidiasis (“Thrush”) diagnosed?
KOH prep
What is first line treatment for Oropharyngeal Candidiasis (“Thrush”) (2)?
Topical antifungal (Nystatin, Clotrimazole)
What oral lesion condition has “target-like” lesions on skin accompanied by mucosal erythema, painful erosions or bullae?
Erythema Multiforme Major (EMM)
What virus is commonly associate with Erythema Multiforme Major (EMM)?
HSV
What oral lesion condition has painful, erosive lesions (flaccid, fragile bullae)?
Pemphigus
What is the treatment for Pemphigus and Pemphigoid?
Topical, systemic corticosteroids
What oral lesion condition has tense bullae?
Pemphigoid
What oral lesion condition has shallow, round/oval, painful lesions with a grayish base? What is another name for this condition?
Aphthous Ulcers
- “Canker sores”
What oral lesion condition has painful, recurrent oral and genital ulcers?
Behçhet Syndrome
How is Behçhet Syndrome diagnosed?
Must be recurrent AND include 2 other clinical findings (recurrent genital ulcers, ocular lesions or cutaneous lesions, or positive pathergy test)
If ulcerative oral lesions are present, what differential diagnosis should always be ruled out?
Lupus
What oral lesion condition has reticular involves Wickham’s striae (lacy, white plaques)?
Oral Lichen Planus
What oral lesion condition is benign and involves elongated filiform papillae?
Black Hairy Tongue
What oral lesion condition has erythematous patches on dorsal tongue with circumferential white borders?
Geographic Tongue
What oral lesion condition has atrophy of filiform papillae giving the tongue a smooth, glossy, erythematous appearance?
Atrophic Glossitis
Generally, what type of treatment application should be considered for a few, localized lesions in the mouth?
Gel application
Generally, what type of treatment application should be considered for more widespread lesions in the mouth?
Rinse
What oral lesion condition should be educated about with use of topical immunosuppressants?
Oral candidiasis (“Thrush”)
What ear condition has otalgia (ear pain) worse with manipulation of external ear, and discharge?
Otitis Externa
- “swimmer’s ear”
What is the most common etiology of Otitis Externa (2)?
Bacteria (Pseudomonas, Staph)
What is the first line treatment for bacterial Otitis Externa without TM perforation?
Cortisporin Otic, Ciprodex
What is the first line treatment for bacterial Otitis Externa with TM perforation?
Floxin Otic
What is the first line treatment for fungal Otitis Externa?
Clotrimazole 1%
What type of treatment application is preferred for the ear? Why?
Otic suspensions are preferred to solutions due to lower acidity = less tissue irritation
What ear condition has granulation tissue in external auditory canal (EAC)?
Malignant Otitis Externa
What ear condition has pain worse at night, with chewing? Why is this?
Malignant Otitis Externa
- May be due to infection spreading from skin of EAC to temporal bone (osteomyelitis)
What is the most common etiology of Malignant Otitis Externa?
Pseudomonas
What population is most at risk for Malignant Otitis Externa?
Elderly diabetics
What is the first line treatment for Malignant Otitis Externa?
Admit to hospital for IV Cipro
- Possible surgical debridement by ENT
What ear condition has amber-colored fluid present, but no acute symptoms (no pain, purulence, bulging, inflammation)?
Otitis Media with Effusion (OME/SOM)
What ear condition has inflammation/blockage resulting in negative middle ear pressure?
Eustachian Tube Dysfunction
What Tympanogram result is seen with Eustachian Tube Dysfunction?
Tympanogram Type C
What is the first line treatment for Eustachian Tube Dysfunction?
Afrin
What ear condition has painful, bulging, erythematous TM with poor mobility?
Acute Otitis Media (AOM)
What ear condition involves the mastoid air cells?
Acute Otitis Media (AOM)
What are the two most common etiologies of Acute Otitis Media (AOM)?
Streptococcus pneumoniae, Haemophilus influenza
What is the diagnosis for Acute Otitis Media (AOM) (3)?
Includes any of the following criteria for children ages 6 months to 12 years:
- Moderate/severe TM bulging
- New onset otorrhea not due to acute OE
- Mild bulging AND ear pain for <48 hours or erythematous TM
What is the first line treatment for Acute Otitis Media (AOM)? - include dose
Amoxicillin (90 mg/kg/day)
What is the second line treatment for Acute Otitis Media (AOM)?
Augmentin
When would you treat Acute Otitis Media (AOM) for 5-7 days (2)? When would you treat Acute Otitis Media (AOM) for 10 days (2)?
- Treat for 5-7 days if >2 years with intact TM/no history of recurrent AOM
- Treat for 10 days if <2 years, TM perforation or history of recurrent AOM
What ear condition has inflammation of TM with bulla formation?
Bullous Myringitis
What constitutes Recurrent AOM?
Symptoms return within 30 days after completion of successful treatment
With treatment of Recurrent AOM, what is the first line for if its been <15 days?
IM Rocephin (ceftriaxone)
With treatment of Recurrent AOM, what is the first line for if its been >15 days?
Augmentin
What is scarring, white plaques in TM? What ear condition is this a complication of?
Tympanosclerosis
- AOM complication
What is abnormal growth of squamous epithelium in middle ear/mastoid? What ear condition is this a complication of?
Cholesteatoma
- AOM complication
What condition involves post-auricular pain, edema and erythema? What ear condition is this a complication of?
Mastoiditis
- AOM complication
What condition involves acute onset of severe vertigo; N/V, unilateral hearing loss? What ear condition is this a complication of?
Acute Labyrinthitis
- AOM complication
What physical exam test is positive with Acute Labyrinthitis? What does this look like?
Head Thrust
- Cannot maintain visual fixation when head turned to affected side
What ear condition has painless TM perforation and otorrhea for >2 weeks?
Chronic Otitis Media
What is the most common etiology of Chronic Otitis Media (2)?
Pseudomonas, S. aureus
What does a Tympanogram B result look like? What condition is it associated with?
Little/no mobility of TM (i.e. fluid present or TM perforation)
- Occurs with OME
What does a Tympanogram C result look like? What condition is it associated with?
TM retracted
- Occurs with Eustachian Tube Dysfunction
What condition has rhinorrhea, nasal congestion, “scratchy throat?
Common Cold
What is the most common etiology of Common Cold? What is another, non-seasonal related etiology?
Rhinovirus
- Adenovirus if no seasonal pattern
What condition involves abrupt onset of fever, myalgias, sore throat?
Influenza
When is Influenza most contagious? What treatment can be given during this time?
2 days (peak of viral shedding) - Tamiflu within 2 days
What is the preferred quick diagnosis used for Influenza? What is the gold standard for lab diagnosis?
NAAT (Rapid Molecular Assay) within 3-4 days of symptoms
- Viral culture is gold standard for lab diagnosis
To which population is the high dose of Influenza vaccine given?
High dose if >65 years
What type of pharyngitis is less likely to present with pharyngeal exudate? What are the two pathogen exceptions to this?
Viral Pharyngitis
- Exceptions (aka DO cause pharyngeal exudate): Adenovirus or Mononucleosis
What condition presents with pharyngeal exudate, fever, splenomegaly (50% of time)?
Mononucleosis (Epstein- Barr virus)
What will a CBC test for Mononucleosis (EBV) show?
CBC will show increased atypical lymphocytes
What condition has grey exudate tightly adhered to throat?
Corynebacterium Diphtheria
What is the first line treatment for Diphtheria?
Diphtheria antitoxin and Penicillin or erythromycin
What is the treatment for Mycoplasma pneumoniae?
Azithromycin
What type of bacterial pharyngitis is common in MSM?
Neisseria gonorrhoeae
What is the first line treatment for Neisseria gonorrhoeae?
Rocephin IM (ceftriaxone)
What condition has purulent exudate and palatal petechiae?
Strep pyogenes (Group A Strep)
What are the 4 presentations of Strep pyogenes (Group A Strep) that are evaluated for on exam? How many of the 4 are required to make a diagnosis?
Any 3 of the 4 are present:
- Tonsillar exudate
- Tender anterior cervical lymphadenopathy
- Fever
- No cough
What is the first line treatment for Strep pyogenes (Group A Strep) (4)?
IM Penicillin G, oral Penicillin V, oral Amoxicillin, oral Keflex (cefalexin)
What is the second line treatment for Strep pyogenes (Group A Strep) (2)?
Azithromycin, Clindamycin
What condition has “strawberry tongue”, Pastia’s lines, facial flushing/mouth pallor? What is the a complication of?
Scarlet Fever
- Complication of Strep pyogenes (Group A Strep)
What condition has severe sore throat (unilateral usually), trismus?
Peritonsillar Abscess (PTA)
What condition has “hot potato voice”; uvula deviation to opposite side?
Peritonsillar Abscess (PTA)
What are the two non-oral first line treatments for Peritonsillar Abscess (PTA)?
Unasyn (ampicillin-sulbactum) IV, Clindamycin IV
What are the two oral first line treatments for Peritonsillar Abscess (PTA)?
Augmentin, Clindamycin
How do you differentiate Peritonsillar Abscess (PTA) from Peritonsillar Cellulitis?
Peritonsillar Cellulitis has no trismus or uvular deviation
What condition has drooling, stridor, severe sore throat, toxic appearance?
Epiglottis
How does Epiglottis progress and what should be done first when treating?
RAPID course, be sure to secure airway immediately
How can Epiglottis be diagnosed radiographically?
“Thumb Sign” will show on lateral neck x-ray
What condition is most associated with hoarseness? What group of etiology is most common?
Laryngitis
- Viruses are most common
What condition has purulent drainage AND nasal obstruction and/or facial pain/pressure/fullness? What group of etiology is most common?
Acute Rhinosinusitis (ARS) - Viral is more common
What is the progression timeline (acute vs. subacute vs. chronic) for Acute Rhinosinusitis (ARS)? What is considered recurrent ARS?
- Acute is <4 weeks
- Subacute is 4-12 weeks
- Chronic is >12 weeks
- Recurrent: 4+ episodes/year
How does bacterial Rhinosinusitis (ARS) typically develop? How is it diagnosed?
Viral infection THEN secondary bacterial infection
- Diagnosis: Sinus Aspirate culture (ENT)
When should antibiotics be started for treatment of bacterial Rhinosinusitis (ARS) (3 “or” options)?
- This is a bitch of a card, I apologize…
Persistent symptoms for >10 days with no improvement
OR
Onset with severe symptoms lasting 3-4 days (high fever, purulent drainage, facial pain)
OR
Viral URI lasting 5-6 days with initial improvement then severe symptoms “double worsening”
What is the first line treatment for bacterial Rhinosinusitis (ARS) (4)? - include timing
Augmentin, Doxycycline, Levaquin (levofloxacin), Avelox (moxifloxacin) for 5-7 days
What is the second line treatment for bacterial Rhinosinusitis (ARS) (4)? - include timing
Augmentin, Doxycycline, Levaquin (levofloxacin), Avelox (moxifloxacin) for 7-10 days
What is a possible complication of bacterial Rhinosinusitis (ARS)?
Osteomyelitis of frontal bone
What condition has mucopurulent nasal drainage, nasal obstruction and congestion, facial pain/pressure/fullness, reduction/loss of sense of smell?
Chronic Rhinosinusitis
What are the 4 cardinal symptoms of Chronic Rhinosinusitis? How does this change for children?
- Mucopurulent nasal drainage
- Nasal obstruction and congestion
- Facial pain/pressure/fullness
- Reduction/loss of sense of smell)
In children, first three are the same, but loss of smell is replaced with COUGH
How is Chronic Rhinosinusitis diagnosed ( _ AND _, PLUS _ or _)?
- This is a bitch of a card, I apologize…
Presence of at least 2/4 cardinal symptoms AND infection lasting >12 weeks PLUS…
- Sinus mucosal disease with imaging (non-contrast CT) showing mucosal thickening or partial/complete opacification of sinuses
OR
- Direct visualization of mucosal inflammation, nasal polyps and/or purulent mucous/edema
What condition has hemotympanum (blood on TM) with possible TM rupture?
Barotrauma
What condition has unilateral sensorineural hearing loss and tinnitus?
Acoustic Neuroma (Vestibular Schwannoma)
What CN is associated with Acoustic Neuroma (Vestibular Schwannoma)? What type of tumor cells are present?
Schwann cell tumors that arise from CN VIII vestibular portion
What is a genetic disease considered a risk factor for Acoustic Neuroma (Vestibular Schwannoma)? How does this present differently from normal presentation?
NF Type 2 (often bilateral presentation)
What condition has a perception of buzzing, ringing, hissing, other noise in one or both ears?
Tinnitus
What etiology should be considered with pulsatile Tinnitus?
Vascular-related
What type of Allergic Rhinitis occurs at particular times of year via trees, grass, ragweed, etc.?
Seasonal Allergic Rhinitis, or “Hay Fever”
What type of Allergic Rhinitis year-round via dust mites, cockroaches, mold, animal dander, etc.?
Perennial Allergic Rhinitis
What condition has sneezing, rhinorrhea, nasal congestion with itchy eyes, nose and palate?
Allergic Rhinitis
What condition involves a peak incidence in childhood and IgE antibodies?
Allergic Rhinitis
What condition presents with “shiners”, Dennie-Morgan Lines and pale, boggy, “bluish” mucosa in nose?
Allergic Rhinitis
What condition presents with throat “cobblestoning” with post-nasal drainage in posterior pharynx
Allergic Rhinitis
What test can be used to confirm Allergic Rhinitis? What does a positive test look like?
Scratch (prick) test
- “Wheal-and-flare” >3 mm
What is the first line treatment for mild Allergic Rhinitis (4)
2nd generation oral antihistamine (Zyrtec), antihistamine nasal spray (Astepro), nasal steroid spray (Nasacort), Cromolyn nasal spray
What is the first line treatment for moderate Allergic Rhinitis? What treatment is recommended for children <2 years?
Nasal steroid spray
- For children, Cromolyn sodium nasal spray
What type of response is Non-Allergic Rhinitis (Vasomotor Rhinitis)? What are the triggers?
Abnormal autonomic response
- Triggered by perfumes, cigarette smoke, stress, sexual arousal, temperature changes
What condition has rhinorrhea, nasal congestion, postnasal drainage with NO ocular/nasal itching or sneezing?
Non-Allergic Rhinitis (Vasomotor Rhinitis)
When does Non-Allergic Rhinitis (Vasomotor Rhinitis) typically present?
Occurs later in life (>20 years)
What type of treatment for Non-Allergic Rhinitis (Vasomotor Rhinitis) should be used if rhinorrhea is the prominent symptom?
Ipratropium nasal spray
What condition is the result of regular use of Afrin (>3 days) with rebound congestion
Rhinitis Medicamentosa
What condition has non-tender, grey soft tissue growth?
Nasal Polyps
What is the first line treatment for Nasal Polyps?
Nasal steroid spray
What condition has pruritic, pale/bright erythematous, well-circumscribed raised wheals?
Urticaria (“Hives”)
How can you differentiate Urticaria (“Hives”) from Urticarial Vasculitis?
Urticaria (“Hives”) are transient
- Urticarial Vasculitis are fixed and last longer than 24 hours with residual hyperpigmentation
What is the etiology behind Urticaria (“Hives”)?
Histamine release by mast cells
What is the first line treatment for Urticaria (“Hives”)?
H1 histamine blockers (Zyrtec or Xyzal)
What is excessive tearing?
Epiphoria
What is conjunctival swelling?
Chemosis
What is leukocytic exudate in anterior chamber of eye?
Hypopyon
What is dilated conjunctival and episcleral vessels adjacent and circumferential to corneal limbus?
Ciliary flush
What is dilated conjunctival vessels?
Hyperemia
What is inflammatory condition of cornea?
Keratitis
What is eye protrusion (2 names)?
Proptosis aka Exophthalmos
What is the name for measuring intraocular pressure (IOP)? What is a normal reading?
Tonometry
- Normal is 8-21
What eye condition has chronic itching/burning/scratching in AM with NO vision changes?
Blepharitis
What eye condition has chronic itching/burning/scratching at night with +/- vision changes?
Dry Eye
What diagnostic test is used for Dry Eye?
Schirmer Test
What eye condition involves a painful nodule of the eyelid with swelling?
Hordeolum (Cyst)
What is the etiology of a Hordeolum (Cyst)?
Infected eye lash root
What eye condition involves a typically painless nodule of the eyelid?
Chalazion
What is the etiology of a Chalazion?
Clogged oil gland (MGD)
What eye condition involves lids/lashes everted?
Ectropion
What eye condition involves lids/lashes inverted?
Entropion
What eye condition has harmless clear, thin tissue covering sclera; does NOT cause vision loss?
Pinguecula
What eye condition has thickening of bulbar conjunctiva; can interfere with vision?
Pterygium
What eye condition has optic nerve unaffected, no impairment of vision or pain with ocular movement?
Preseptal Cellulitis
What eye condition involves optic nerve, +/- impair vision or impaired/painful ocular movement; often involves fever?
Orbital Cellulitis
What is the first line treatment for eye cellulitis in OUTpatient (hint: _ OR _, PLUS _ OR _)?
Clindamycin OR Bactrim DS, PLUS Augmentin OR Cefpodoxime
What is the first line treatment for eye cellulitis in INpatient (hint: _ PLUS _ PLUS _)?
Vancomycin PLUS Ceftriaxone PLUS Metronidazole
What eye condition has acute red, watery discharge (severe injection); often bilateral; preauricular lymphadenopathy?
Conjunctivitis (Viral)
What eye condition has acute thick, yellow/mucopurulent discharge; unilateral or bilateral?
Conjunctivitis (Bacterial)
What are two types of rare Conjunctivitis (Bacterial)? Which is sight-threatening?
- C. trachomatis
- N. gonorrhea (sight-threatening)
How is C. trachomatis diagnosed? How is it treated?
- Diagnosis: PCR
- Treatment: oral Erythromycin or Azithromycin
How is N. gonorrhea diagnosed? How is it treated?
- Diagnosis: Giemsa stain, gram stain, culture
- Treatment: Rocephin IM (ceftriaxone) admitted and OP consult
What eye condition has chronic symptoms bilaterally with mild injection, itching and chemosis; stringy discharge?
Conjunctivitis (Allergic)
What eye condition has acute, often spontaneous, asymptomatic bleeding in conjunctiva; vision NOT affected?
Subconjunctival Hemorrhage
What are the three subtypes of Scleritis?
- Diffuse (50%): widespread inflammation of sclera; typically, no recurrence
- Nodular (20-40%): localized area of inflammation with a distinct, visible nodule; can reoccur
- Necrotizing (rare): often due to underlying autoimmune disorder; more severe symptoms with ocular comp.
What eye condition has severe/constant eye pain worse in AM; radiates to face and worse with EOMs; hyperemia?
Anterior Scleritis
What eye condition has milder symptoms; NO hyperemia?
Posterior Scleritis
What eye condition presents with violaceous eye redness, pain with eyelid pressure; scleral edema on slit lamp exam?
Anterior Scleritis
What eye condition has abrupt onset of bright red episcleral inflammation (uni or bi); typically, no pain; vision unaffected?
Episcleritis
What eye condition has FB sensation with acute onset of pain; +/- vision affected?
Corneal Abrasion
What treatment is NOT recommended for corneal injuries (or any eye conditions really)?
NO topical anesthetic drops (can lead to corneal toxicity or Anesthetic Keratitis)
What is the first line treatment for a chemical eye injury?
IRRIGATE immediately
What might develop in the eye if there is a metal corneal foreign body?
Rust ring
What eye condition has acute onset of pain with white infiltrate +/- hypopyon?
Keratitis/Corneal Ulcer
What eye condition is associated with contact lens abuse?
Keratitis/Corneal Ulcer
What eye condition presents with appears with dendritic pattern around eye?
Keratitis (HSV)
What eye condition has blood in anterior chamber with acute onset of pain, N/V, usually vision decrease?
Hyphema
What condition presents with progressive pain; ciliary flush (ring of white around Limbus); hypopyon?
Anterior Uveitis
What condition presents with painless; floaters and blurred vision?
Posterior Uveitis
What is the preferred topical antibiotics used to treat eye conditions?
Erythromycin ointment
What is perceived flash of light in field of vision?
Photopsia
What is yellow, fatty protein/lipid deposits under retina that occurs naturally with age?
Drusen
What is an area of partial alteration in field of vision with surrounding areas of normal visual acuity?
Scotoma
What is visual defect in which linear objects look curved or rounded?
Metamorphopsia
Which two vision loss disease are considered painful?
Angle-Closure Glaucoma and Optic Neuritis
What is the Afferent Pupillary Defect? With what two conditions might it be positive?
Lesion of CN II leads to… with light on affected side, BOTH do NOT constrict, or with light on unaffected side, BOTH constrict (normal)
- Can be positive with Open-Angle Glaucoma and Retinal Detachment
What eye condition has pain; halos around lights; optic nerve damage, visual field loss; nausea/vomiting?
Angle-Closure Glaucoma
What is the etiology behind Angle-Closure Glaucoma?
Increase in intraocular pressure due to obstruction
What is the gold standard diagnostic test used for Angle-Closure Glaucoma? What two other findings on exam may be seen?
Gonioscopy
- Also mid-dilated pupil and “crescent moon” on penlight exam
What eye condition involves early, asymptomatic; later, chronic painless visual field loss?
Open-Angle Glaucoma
What is the etiology behind Open-Angle Glaucoma?
Increased intraocular pressure due to increased aqueous production and/or decreased outflow
What two findings present with Macular Degeneration?
- Metamorphopsia
- Central scotoma
What eye condition has slow, gradual vision loss in one or both eyes; drusen present?
Dry Macular Degeneration
What eye condition has rapid vision distortion commonly in one eye; neovascularization and “leaky vessels”?
Wet Macular Degeneration
What eye condition has gradual, chronic, painless loss of vision; glare from headlights with night driving?
Cataracts
What eye condition has history of myopia, “curtain-like” vision loss, floaters/photopsia?
Retinal Detachment (RD)
What eye condition involves “copper wiring”, “silver siring”, “A:V nicking”, soft exudates?
Hypertensive Retinopathy
What are the two subtypes of Diabetic Retinopathy? Which can cause traction retinal detachment?
- Non-proliferative (no neovascularization)
- Proliferative (+ neovascularization) = can cause traction retinal detachment
What eye condition has “cherry red spot” due to embolic event?
Central Retinal Artery Occlusion (CRAO)
What eye condition has “blood and thunder” due to thrombotic event?
Central Retinal Vein Occlusion (CRVO)
Which of the two eye vascular occlusion conditions involves TOTAL loss of vision?
Central Retinal Artery Occlusion (CRAO)
What eye condition has painful, worse with EOMIs; abnormal color vision?
Optic Neuritis
How does Optic Neuritis present on exam?
Inflammatory demyelination of optic nerve
What chronic condition is Optic Neuritis associated with?
Multiple Sclerosis (MS)
Which of Angela’s cats does Dwight freeze?
SPRINKLESSSSSS
Which office employee did Michael Scott hit with his car?
Meredith lmao aka Dancing With the Stars star
Who started the fire?
RYAN STARTED THE FIYAAAA
What is Michael Scott’s username for the online dating website?
Little Kid Lover <3
What vegetable does Michael Scott force feed Kevin?
Broccoli
Which type of exudate(s) seen with Diabetic Retinopathy?
Soft exudates AND hard exudates
Which type of exudate(s) seen with Hypertensive Retinopathy?
Soft exudates
