HEENT

Question 1

A mother brings in her 7 yo son to your family practice clinic with continuing pain since being hit in the eye with a stick earlier in the day. You assess some blood layering in the anterior chamber on your visual inspection. Your diagnosis should be which of the following?

Answer 1

A. Dacryocystitis
B. Orbital Cellulitis
C. Chalzion
*. D. Hyphema

Question 2

You are completing your exam and note that a 4 month old child has a white spot in their eye. On exam, these is no red reflex noted in the that eye. This is most likely?

Answer 2

• A. Retinoblastoma
  B. Periorbital ecchymoses
  C. Congenital neuroblastoma
  D. Opsocionus

Question 3

\Which of the following is a cause of sudden vision loss?

Answer 3

A. Cataracts
B. Pituitary Tumon
*. C. Central Retinal Vessel Occlusion
D. Amblyopia

Question 4

Which of the following conditions usually does not require urgent referral for ophthalmological evaluation and/or management?

Answer 4

A. Orbital Cellulitis
*. B. Minor corneal abrasion
C. Iritis/Uveitis
D. Acute angle closure glaucoma

Question 5

Malignant otitis externa

Answer 5

A. Occurs primarily in young diabetic patients
*. B. May develop cranial neuropathies
C. Do not require infectious disease or ENT consultations in immunosuppressed
D. Is primary caused by Staph aureus

Question 6

The mother brings her 18 month old female to your clinic for eye drainage.
Your exam reveals a sharply circumscribed, erythematous and edematous rt eyelid, closed with the patient unable to open, conjunctival injection seen when attempting to open the edematous lids, and mucopurulent drainage.
You think you see a sluggish pupil reaction to light, but it is difficult due to her screaming while you try to open the swollen lid.
Which of the following is most appropriate?

Answer 6

*. A. Refer pt now for CT orbit study and probable admission to hospital
B. Place on oral antibiotics to follow up with you in 1-2 days for recheck
C. Prescribe antibiotic steroid eye ointment and follow up with you in 1-2 days
D. Give Motrin al appropriate dose for weight, wait 30 minutes for effect and reassess

Question 7

Mastoiditis

Answer 7

inflammation of the mastoid process of the temporal bone. Can be a complication of AOM

Question 8

Mastoiditis causes

Answer 8

Group A strep, staph aureus, H. influenza

Question 9

Mastoiditis S/S

Answer 9

AOM, swelling of mastoid, postauricular erythema, tenderness, edema, fluctuant, lethargy, irritability, fever, poor feeding, facial weakness, lymphadenopathy, rhinorrhea

Question 10

Mastoiditis Evalulation

Answer 10

CT scan, BCX, LP

Question 11

Mastoiditis TX

Answer 11

High dose Amoxicillin or ampicillin-sulbactam( Unasyn).
IP: broad spectrum abx