Review questions for ENT

39 year old male states he was holding his baby daughter and she put her fingers in his right eye. He now presents to the ED with acute eye pain and photophobia. His right eye appears grossly normal except for increased tearing. Which of the following is the diagnostic study of choice in this patient?

When seeing a 64 year old gentleman for routine followup of hypertension and hyperlipidemia, examination of the retina shows while lesions with irregular borders. They are moderate in size. What are these lesions called?

A 5 year old child presents to your pediatric practice with her parents complaining of 2 day history of fever (101F) sore throat, and tearing/ mild erythema of both eyes. Since it is summer, she has been taking swimming lessons in a public pool. There is no cough, nasal congestion, pain or photophobia. Your examination shows a small amount of exudate in the eyes bilaterally along with a large amount of clear discharge. There are conjunctival follicles present in both eyes and follicles of the pharyngeal mucosa. There is nontender andeopathy in the preauricular area. What is the most likely diagnosis for this patient?

After a recent bount of gastroenteritis characterized by vomiting and diarrhea, a 60 year old male presents with bright red blood visible on the lateral right sclera. Blood pressure is normal as is his visual acuity. What is your treatment plan?

16 year old presents with her mother and complaints of pain, irritation, and decreased hearing in the right ear since waking this morning. Upon examining the patient with an otoscope, a moth is noted in the right external auditory canal. You are not able to completely visualize the tympanic membrane. What is the most appropriate treatment?

After being involved in an altercation the night before a 24 year old male presents to the ER with persistent double vision. His left periorbital area displays signficant ecchymosis and edema. Based on the history, what other findigns do you expect on physical examination and what diagnostic test will confirm the diagnosis?

You determine that a patient with bilateral hearing loss should undergo an audiogram for a more complete evaluation of her hearing loss. AS part of the examination, you perform Weber and Rinne Tests and find that Weber is equal in both ears and air conduction is greater than bone conduction is greater in both ears. Therefore, you suspect that her hearing loss, if any, is most likely:

36 year old female presents to the occupational health clinic with a history of a fleck of metal in the right eye obtained while working in a fabrication plant. You note a large area of subconjunctival hemorrhage and central abrasion of the sclera. How would you rule out perforation of the globe?

12 year old girl was seen a week ago with an upper respiratory infection which has failed to improve. She now presents with an elevated temperature (101.4) bilateral facial pain, congestion, and purulent nasal discharge. At this point, was is the most appropriate therapy?

17 year old female presents with sneezing, clear rhinorrhea, itchy watery nose and eyes. You examine the young woman and find clear nasal drainage and pale, boggy turbinates. What is the most likely diagnosis?

35 year old man presents with sudden marked decrease in hearing in his left ear There is no history of trauma, otorrhea, or vertigo. The physical examination appears to be normal except for tuning fork tests. The Weber test lateralizes to the better ear and the Rinne test shows that air conduction is better than bone conduction bilaterally. After confirmation findings with an audiometric evaluation, what is the most appropriate therapy?

Your patient who is a 39 year old truck driver presents stating that he has a growth for at least 8 years on his eyes. Your examination shows a fleshy triangular area of conjunctivae encroaching on the nasal aspect of the cornea bilaterally. It has begun affecting his vision. What is the best intervention at this time?

54 morbidly obese gentleman presents complaining of persistent fatigue all day long despite a full night sleep obtained with short acting sleeping pills which worsen his symptoms. His medical history is significant for poorly controlled HTN. Every morning he awakens with sore throat and headache. Which of the following is the most likely condition this patient is suffering from?

Your patient is a 39 year old second grade teacher who states that she developed acute hoarseness 3 days ago. Prior to that, she had a cold, symptoms of which are improving. Where is no history of smoking or other tobacco use. What is the most important intervention for the patient at this time?

42 year old male presents complaining of chronic nasal blockage. History reveals that he has been using 12 hour nasal spray every 6 hours for several months. He initially used the spray as directed, but with continued usage, finds that he has to use it more frequently as he cannot breathe without it. He has no clear or purulent drainage and denies epistaxis. What is your diagnosis?

Which of the following patients should undergo audiologic evaluation?

35 year old male who recently underwent restoration of teeth #28, 29, 30. He has a 24 hour history of fever, dysphagia, odynophagia, and drooling secondary to inability to swallow his own secretions. Examination of the patient shows a toxic appearing male with trismus, edema of the neck, and submandibular area along with poor dentition, foul smelling breath, and gingivitis. The tongue, which is painful for the patient to move is displaced posteriorly and a temperature of 103 is noted. What is the most likely diagnosis ?

64 year old male with 45 pack year history of tobacco use (both cigarette and smokeless tobacco). The patient complains of a 2 month history of a 2 x 0.5 cm white leasion on the right lateral ventral area of the tongue. Upon lifting the tongue with gauze, you note that the lesion is adherent to the tongue and cannot be rubbed off. What is the most likely diagnosis?

While examining a 6 year old male, you note an alarming findings suggestive of cystic fibrosis. Which of the following nasal conditions is suggestive of this disease?

70 year old woman with a history of glaucoma and diabetic retinopathy presents to the ED stating that she fell down and bumped her head earlier in the evening. She is now experiencing a sensation of flashing lights and floaters in her right eye. She has decreased visual acuity and feels there is a curtain over her visual field. Fundoscopic examination is difficult and therefore nondiagnostic. What is the next step that you should take to address her visual complaints?

35 year old female presents complaining that she experiences several minutes of vertigo-associated with turning over in bed for the past 3 days. She denies hearing loss, otalgia, tinnitus. The Dix-Hallpike maneuver shows rotary nystagmus diminishing with repeated testing. What is the most likely diagnosis?

40 year old female presents with foreign body sensation in the right eye. Over the last 3 weeks, she has had gradually increasing painless swelling around the right lower eyelid. Your examination shows a nontender discrete nodule on the right lower eyelid. There is no evidence of injection or discharge and her visual acuity is normal. What is the most likely diagnosis?

48 year old male is diagnosed with shingles involving CN V. During the examination you note the tip of his nose is involved. At this point, it is crucial to rule out involvement of:

While working in the ER, you are triaging a patient who experienced facial trauma. You note blood in the anterior chamber of the patient's left eye. What is a possible complication for this patient?

22 year old martial arts practioner presents after an injury during a match which has resulted in a fluctuant , mildly tender edematous lesion of the anterior-superior outer portion of the right pinna. Which of the following is the most appropriate treatment ?