HEENT_king

Question 1

Fetal alcohol syndrome

Answer 1

mild microcephaly

Question 2

Fragile x

Answer 2

broad nasal bridge

Question 3

Hurler syndrome

Answer 3

low nasal bridge

frontal prominence

Question 4

Treacher Collins

Answer 4

downward slant of palpebral fissures
low set ears
micrognathia

Question 5

acromegaly

Answer 5

elongated head
coarsened facial features
bony overgrowth of forehead, nose, lower jaw

Question 6

Cushing’s disease

Answer 6

Moon face
reddened cheeks
hirsutism

Question 7

hypothyroidism

Answer 7

puffiness in the face

thinning and coarsening of the eyebrows and hair

Question 8

ear height

Answer 8

top of auricle should be at or above a line bw the inner canthus and most prominent protuberance of the occiput

Question 9

preauricular pit

Answer 9

developmental defect in the branchial arches
just anterior to the ear

can become infected

Question 10

keloid

Answer 10

overgrowth of collagen in scar tissue

grow beyond the corders of original injury

Question 11

cauliflower ear

Answer 11

d/t repeated blows to the ext ear in boxers and wrestlers

hematoma separates from the cartilage from the perichondrium

scar tissue fills the gap

Question 12

otitis externa

Answer 12

painful when the ear is pulled

canal remains moist, most often d/t pseudomonas

PO abx not effective, ear drops and cleaning must be used
irrigate with any sort of acid

can become malignant OE, especially in DM

Question 13

otitis media

Answer 13

bacterial infection of the middle ear

many resolve w/o tx

rarely can progress to mastoiditis, meningitis, or encephalitis….

Question 14

glue ear

Answer 14

the middle ear becomes filled with glue-like fluid after repeated bouts of OM!!!!!!!!!!!!!!
glue ear is common, unk mech
dampens vibrations of eardrum= dec auditory acuity
surgically lance and drain w/ myringotomy tube

Question 15

hemotympanum

Answer 15

collection of blood int he middle ear that is visible thru the TM
usually d/t head trauma

Question 16

TM retraction

Answer 16

sequelae of glue ear
portion of the TM is weak and retracts into middle ear d/t relative negative pressure
decreased auditory acuity

Question 17

epistaxis-anterior

Answer 17

anterior is most common, visible w/ inspection in area of Kesselbach’s plexus

arid climates, irritants, HTN, coagulopathies, cocaine

Question 18

epistaxis- posterior

Answer 18

older patients with fragile vessels d/t HTN etc….

profuse bleeding from sphenopalatine a.
Emergent! `

Question 19

basal cell carcinoma

Answer 19

most common
slow growing, exposed areas in fair-skinned individuals

over-exposure to radiation, solar, x-rays

overgrowth of tissue, does not ulcerate until later

Question 20

squamous cell carcinoma

Answer 20

more aggressive and mets early

scaley, crusting patch

Question 21

Herpes simplex of lip

Answer 21

HSV1 accounts for about 80% of cases
goes from asx–>latent stage that migrates to the DRG–>re-activated by physical or emotional stress at site of original infection

Question 22

peutz-jeghers syndrome

Answer 22

AD disease
melanin deposits of mucous membranes
multiple intestinal polys
15x increased risk of GI cancer

Question 23

thrush

Answer 23

oral infection d.t. candidia albicans
(infants, IS pts, abx therapy)

mouth irritation and altered taste

Question 24

geographic tongue

Answer 24

loss of papillae causes this appearance

may be linked to vit B deficiency

no tx necessary

Question 25

fissured tongue

Answer 25

probably genetic

often asx and noticed on routine exam

Question 26

hairy leukoplakia

Answer 26

usually an early sign of HIV
pip smoking, chewing tobacco

resembles thrush
painless and rarely undergoes malignant transformations

Question 27

tooth erosion

Answer 27

erosion of the posterior surface of the teeth

characteristic of bulimia nervosa

Question 28

oral cancers

Answer 28

highly malignant

tx delayed, often d/t poor exmainations

Question 29

tonsilar carcinomas

Answer 29

fairly rare
usually squamous cell
linked to HPV infection
often presents late in the course of the disease because there are few early sx

Question 30

torus palatinus

Answer 30

hard body growth on the hard palate
normal, body exostosis
females>30, rarely need tx

Question 31

pneumonia findings

Answer 31

auscultation: decreased breath sounds over affected ares, with bronchial sounds, rhonchi, wheezing

dullness to percussion
increased bronchophony and TF

Question 32

COPD findings

Answer 32

Auscultation
Decreased breath sounds throughout ALL lung fields
wheezing but may have rhonci

Hyperresonance

Special Tests
Bronchophony-Decreased
Tactile fremitus-Decreased

Question 33

CHF

Answer 33

Auscultation
Decreased breath sounds in dependent portions of the lung
Rales (crackles)

Percussion
May be unchanged or decreased over dependent portions of the lungs

Special Tests
Bronchophony-Usually unchanged
Tactile fremitus-Usually unchanged

Question 34

Pneumothorax

Answer 34

Auscultation
Breath sounds decreased or absent on affected side

Percussion
Marked hyperresonance

Special Tests
Bronchophony-Decreased
Tactile fremitus-Decreased

Question 35

Pleural effusion

Answer 35

Auscultation
Decreased or absent on affected side

Percussion
Dullness on affected side

Special Tests
Bronchophony-Unchanged
Tactile fremitus-Decreased

MCC is lung cancers (u/l)

Question 36

Tonsillitis

Answer 36

most common is S. Pyogenes and other G+ bacteria

treat w/ abx to avoid RF or tonsillar abscess