H.E.E.N.T

Question 1

• Acute onset of severe eye pain, photophobia, and blurred vision in one eye.
• “Fern-like” lines in the corneal surface are a positive sign.
• Infection permanently damages corneal epithelium, which may result in corneal blindness.

Answer 1

• Herpes Keratitis

Question 2

Diagnostics for Herpes Keratitis is:

Answer 2

• Fluorescein Dye, and…

* Black lamp in a darkened room

Question 3

• An ophthalmologic emergency

* Acute onset of severe eye pain, accompanied by headache, nausea/vomiting, halos around lights, and decreased vision.

Answer 3

• Acute Angle-Closure Glaucoma

Question 4

What does the examination of “acute angle-closure” glaucoma reveal?

Answer 4

• Examination reveals a mid-dilated pupil (oval shape)
• Fundoscopic exam reveals cupping of optic nerve
• Cloudy corneas

Question 5

• Cauliflower like growth accompanied by foul-smelling ear discharge.
• Hearing loss reported on affected ear.
• Tympanic membrane ad ossicles are NOT VISIBLE.
• NON-CANCEROUS

Answer 5

• Cholesteatoma

Question 6

• Cholesteatoma is associated with

Answer 6

• History of chronic Otitis Media

Question 7

• Bilateral condition manifesting as a white ring around the cornea.
• It is a benign variant in the elderly
• It is associated with ↑ cholesterol and ↑ triglycerides in the young adult

Answer 7

• Arcus Senilis

Question 8

• Common “NON-CANCEROUS” growth of the conjunctiva.
• A yellow triangular thickening of the bulbar conjunctiva.
• Located on the “inner and outer margins of the cornea”
• May be associated with long-term sunlight

Answer 8

• Pinguecula

Question 9

• Severe sore throat and difficulty swallowing
• One-sided swelling of the peri-tonsilar area and soft palate.
• Uvula is displaced to one side
• Accompanied by fever, chills, malaise.

Answer 9

• Peri-tonsilar abscess.

* Refer to ED

Question 10

• An acute onset of a bruise behind the ear, over the mastoid process
• Normal seen after a recent trauma
• Indicates a fracture of the basilar skull

Answer 10

• Battle Sign

Question 11

If a basilar skull fracture is noted, what should the practitioner check for?

Answer 11

• Check for CSF FLUID. It can slowly leak through the fracture

Question 12

• Sore throat and “low-grade” fever
• Markedly swollen neck (bull neck)
• Hoarseness and dysphagia
• A “Pseudomembrane” is located on the pharynx, uvula, tonsils, and soft palate.

Answer 12

• Diptheria

Question 13

• A yellow triangular thickening of the conjunctiva that extends on the “nasal or temporal” side of the cornea.
• Caused by UV light damage

Answer 13

• Pterygium

Question 14

• Sore red eyes with increase tearing
• No reports of purulent discharge
• Higher risk with autoimmune disorders (RA, lupus, ankylosing spondylitis), sarcoidosis, and syphilis.

Answer 14

• Anterior Uveitis

Question 15

Part of the eye that is responsible for color and night vision

Answer 15

• Cones (also responsible for high spatial acuity)

Question 16

What is a normal result of the Rinne Test

Answer 16

• Air conduction is greater than bone conduction

Question 17

The Cover/Uncover test is used to screen for?

Answer 17

• Strasismus

Question 18

Vertical nystagmus is _______, but horizontal nystagmus after a lateral gaze is ________

Answer 18

• Vertical Nystagmus is Abnormal

* Horizontal (a few beats) is Normal

Question 19

Peripheral vision is examined with the:

Answer 19

• Visual fields of confrontation

Question 20

Legal blindness is considered when

Answer 20

• Best corrected vision is 20/200

* Visual field is less than 20 degrees

Question 21

The area of the eye that determines 20/20 vision

Answer 21

Fovea (Macula and Fovea)

Question 22

• White spots that appear on the surface and under the tongue.
• May be cancerous.
• A sign in patients with a history of chewing tobacco

Answer 22

Leukoplakia

Question 23

• Normal range of Intraocular Pressure is

Answer 23

• 10-22mm Hg

Question 24

• 1st line Pharmacological treatment for Otitis Externa is:

Answer 24

• Topical floroquinolones (Ciprodex) or,…

* Cortisporin (Neomycin and Hydrocortisone)

Question 25

* Common bacteria found in Otitis Externa is:

Answer 25

* Pseudomonas

Question 26

Over the counter treatment for Cerumenosis is:

Answer 26

* Carbamide Peroxide

Question 27

* Which medications should always be avoided in patients with Mononucleosis?

Answer 27

* Amoxicillin or Ampicillin (they may cause a generalized rash). * The rash is not an allergic reaction, just a reaction to the Epstein Barr Virus.

Question 28

* Fissures and cracks on the corners of a patients mouth. * Various oral or peri-oral infections of the mouth * Commonly associated with Malnutrition, HIV, Advanced Age, or Immunocompromised states. * Also known as Angular Stomatitis, Perleche, or Cheiliosis.

Answer 28

* Angular Cheilitis.

Question 29

* The various oral or peri-oral infections of the mouth related to "Angular Cheilitis", "Angular Stomatitis", "Perleche", or "Cheiliosis" are caused by what type of bug?

Answer 29

* Candida bugs

Question 30

* Ototoxic medications include:

Answer 30

* Aspirin * Aminoglycosides * Vancomycin * Erythromycin * Loop diuretics (Furosemide) * Anti-malarial medications * Erectile dysfunction medications

Question 31

* Nasal Congestion * Purulent Nasal Discharge * Maxillary Tooth Pain/Discomfort * Facial Pain and Pressure (Both are worse with bending forward) * **The above mentioned are indicative of***

Answer 31

* Acute Rhinosinusitis

Question 32

* A virus that causes a triad of fatigue, pharyngitis, and lymphadenopathy. * Peak ages of acute infection are between ages of 15 and 24 years of age. * After acute infection, the virus lies latent in the oropharygeal tissues.

Answer 32

* Infectious Mononucleosis.

Question 33

* Signs and Symptoms of Infectious Mononucleosis includes:

Answer 33

* Fatigue. * Pharyngitis...Sore Throat. * Lymphadenopathy..Enlarged Postcervical lymph nodes. * Splenomegaly and Hepatomegaly - may have abdominal pain.

Question 34

* The main organism found in Mononucleosis is?

Answer 34

* Epstein Barr Virus.

Question 35

* How is Mononucleosis shed/transmitted?

Answer 35

* Via saliva.