TEST 1 – EENT (OTALGIA AND NASAL SINUSES)



FINAL EXAM MATERIAL FOR EENT – CUMMULATIVE OVER TEST 1 AND 2

TEST 1 – EENT (OTALGIA AND NASAL SINUSES)

DR. DeGEER

1. Ototoxic agents

□ Can harm the function of the balance organ and hearing organ

2. The pneumatic attachment on the otoscope is used for

□ Evaluating mobility of eardrum

3. Delayed language development, limited vocabulary and short attention span may indicate

□ Hearing loss in a child

4. Nose bleed (epistaxis) is commonly caused by

□ Seeping bleeding from injured capillaries along mucosa of inferior nasal septum

5. Most common cause of acquired conductive hearing loss in children is

□ Otitis media w/ effusion

6. Positive Rinne test bilaterally signifies

□ Sensorineural hearing loss

7. Abnormal finding when performing Weber test is

□ Lateralizing to blocked ear (+) Weber

8. Pathophysiology mechanism for otitis media w/ effusion is

□ Blocked passage of air from middle ear to pharynx

9. Typical otoscopic appearance of an ear w/ OME is

□ Retracted, thin, immobile tympanic membrane w/ visible fluid

10. Two most common causes of hearing loss in adults are

□ Wax impaction and presbycusis

11. Terminal branches of arteries that provide vascular supply to nose are

□ Internal and external carotid arteries

12. Which sinuses that don’t exist in children

□ Frontal sinus

13. Protective roles of the nose are all of the following except

□ Conducting sound waves to the cochlea

14. Which of the following is not a function of the paranasal sinuses

□ Conveying chemicals to olfactory nerves

15. Which sinuses drain through the middle meatus

□ Maxillary, anterior ethmoid, and frontal sinuses

16. Orbital abscesses, seen in children, are most commonly caused by extension of sinusitis of

□ Maxillary sinuses

17. Cartilage of outer ear and nasal septum

□ Are prone to injury/deformity after hemorrhage

18. Ossicles of the ear are located in

□ Middle ear

19. Ossicle that contacts the eardrum is

□ Malleus

20. What cranial nerve traverses the middle ear

□ Facial nerve

21. Referred pain from cervical spine may cause earache by

□ Posterior roots of 2nd and 3rd cervical nerves

22. Common symptom/cause of nasal pathology is

□ Nasal obstruction

23. Another word for nasal hemorrhage is

□ Epistaxis

24. Total loss of smell is called

□ Anosmia

25. Inferior turbinate is seen well and often mimics a

□ Nasal polyp

26. Most reliable test for allergic rhinitis is

□ RAST test

27. Nasal pathology may cause referred head and neck pain via

□ Trigeminal nerve (CN 5)

28. Skin prick tests for allergies are

□ Quite unreliable

29. What is rhinnitis

□ Inflammation of the nose

30. What is the common means of managing nasal allergies

□ Avoidance of the allergen

31. Rhinnitis medicamentosa is

□ Overuse of topical vasoconstrictors

32. Most common causes of referred ear pain in adults are

□ Osteoarthritis of cervical spine and TMJ problems

33. Most common causes of otologic pain in children are

□ OME and AOM

34. Malignant otitis externa is

□ Osteomyelitis of temporal bone due to infection of ear canal (not cancer)

35. Watery ottorhea is typical of

□ Eczema of ear canal

36. Most common complication of AOM is

□ Chronic OME and perforations (Rare complication is mastoiditis)

37. Most common bacterium causing AOM is

□ Streptococcus Pneumonia (pneumococci)

38. Most common infectious organisms causing acute sinusitis are

□ Common cold virus (haemophilus influenza) and streptococcus pneumonia

39. Stiff neck, high fever and severe headaches are key symptoms of

□ Acute meningitis

40. Swimmer’s ear is also called

□ Acute Otitis externa

TEST 2 – EENT (EYES, MOUTH AND THROAT)

1. Glaucoma involves which of the following…

□ Increased intra-ocular pressure

2. Cataracts involve which of the following…

□ Clouding of the lens

3. Pseudomonas keratitis is associated w/

□ Infection of the cornea by improper handling of contact lenses

4. Reiter’s and ankylosing spondylitis are associated w/

□ Autoimmune disease of the iris (iritis) …. Or Keratic Precipitates

5. Most common cause of legal blindness in developed countries is

□ Diabetes Mellitus

6. Conjunctivitis is

□ Inflammation/irritation of the conjunctiva

7. Conjunctival injection (hyperemia) is associated w/

□ Bacterial conjunctivitis

8. Ciliary hyperemia is typical for

□ Immovable vessels encircling the iris and having purulent secretions (bacterial cause)

9. Eye pain is typical for all of the following except…

□ Cataract

10. Rapidly developing loss of vision is typical for all except…

□ Allergic Conjunctivitis

11. Strep throat is a common name for

□ Tonsillitis from streptococcus A bacteria

CASE 1 – 8 year old patient comes into your office w/ red eyes, sore throat, cough, headache and a

temperature above 100 degrees.

12. During your exam you discover movable, dilated blood vessels on the eye bulb. This indicates…

□ Conjunctival Hyperemia

13. The finding in question 12 is most likely caused by…

□ Staph infection secondary to an URI

14. The presentation in case 1 is not typical for…

□ Streptococcus Tonsillitis

15. Allergic conjunctivitis is associated w/ all of the following except…

□ Ciliary Hyperemia

16. Conservative treatment (nutrition advice, rest, antioxidants, chiropractic adjustments…) is indicated in which of the following…

□ OME – otitis media w/ effusion

17. Immune complications to group A Strep related tonsillitis include…

□ Glomerulonephritis and Rheumatic Fever

18. A loud murmur is heard over the left 5TH ICS in the midclavicular line in a recurrent case of G. A. S. This could explain…

□ Mitral valve stenosis from Strep and scarlet fever

19. What’s true in regard to ear tubes and OM…

□ The cost to insert ear tubes is astronomical

20. Conjunctivitis in neonates in the US is most commonly caused by…

□ Chlamydia Trachomatus

21. Macular degeneration mainly affects which group of people…

□ People over age of 65 yrs.

22. Macular degeneration causes…

□ Difficulty reading

23. Bacterial conjunctivitis should primarily be treated w/…

□ Washing your eyes out w/ water first and then applying a salve

24. Nutritional support for macular degeneration includes…

□ Lutein and Zinc

25. What structure in the neck should be penetrated when a secondary airway is needed…

□ Cricothyroid Membrane

26. Before doing that procedure in #25, what should you do first…

□ Heimlich maneuver

CASE 2 – A 2 year-old boy comes to our office w/ fever, severe dyspnea and inspiratory stridor.

27. In our list of differential diagnoses, what must we include as a possibility…

□ Epiglottidis

28. Haemophilus Influenza can cause…

□ All of the above (meningitis, Epiglottidis, AOM)

29. Streptococcus Pyogens (GAS) is an example of infectious bacteria of what group…

□ Gram (+) bacteria

30. Diphtheria may present w/ severe dyspnea and inspiratory stridor caused by the formation of membranes in the hypopharynx and larynx. What is this condition called…

□ Croup

31. When a person has an URI, how should they handle their contact lenses…

□ Discard them and don’t put in new ones until they are well. Bacteria on your hands could transfer to contact lenses and result in eye infections.

MATCHING:

32. Purulent secretion of the eyes --- Bacterial conjunctivitis

33. Scarlet fever associated w/ --- Strep (GAS) and mitral valve stenosis

34. Function of saliva --- protect teeth (IgA), start digestion process, taste, lubricate food, articulation

35. Function of larynx --- phonation and protection

36. Function of epiglottis and larynx --- protection of respiratory tract

37. Size of pupil due to iritis --- miosis (small pupil)

38. Size of pupil due to acute glaucoma --- mydriasis (large dilated pupil)

39. Unilateral tonsillitis is associated w/ --- cancer

40. Most common agent of tonsillitis --- viral (adults) … bacterial (younger ages)

41. Common cause of loss of sense of taste --- nasal obstruction

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