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ENT EXAM MASTER | 215 QUESTIONS | WITH 100% COMPLETE ANSWERS, PASSED!!
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ENT EXAM MASTER | 215 QUESTIONS | WITH 100% COMPLETE ANSWERS, PASSED!!
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ENT EXAM MASTER |215 QUESTIONS |
WITH 100% COMPLETE
ANSWERS, PASSED!!
ENT
Evatee 9/24/24 ENT
,ENT EXAM MASTER | 215 QUESTIONS |
WITH 100% COMPLETE ANSWERS, PASSED!!
Question
A 66-year-old male presents to the clinic with a complaint of not being able to
hear the beeping of his microwave oven when it signals completion of it's
heating cycle. Knowing that the "beeping" is high pitched and the age of the
individual, you suspect hearing loss in this patient that is typically associated
with aging. This type of hearing loss is related to which one of the following
alterations in the ear?
Answer Choices
1 Fibrosis of the tympanic membrane
2 Hypersecretion of cerumen in the external auditory meatus
3 Ankylosis of the stapes at the oval window
4 Loss of cochlear hair cells
5 Loss of otoconia in the otolithic membrane Answer - Correct answer:
Loss of cochlear hair cells
Explanation Hearing loss may be the result of one of two basic problems.
Auditory disorders may be related to either conductive disorders, or
sensorineural disorders. Conductive disorders are those that result from the
mechanical impedance of sound waves from reaching the auditory sensory
,receptors. Sensorineural disorders are those that result from the loss of the
ability to transduce or convey the mechanical signal into the neural signal.
Fibrosis of the tympanic membrane, excessive secretion of cerumen in the
external auditory meatus or ankylosis (bone deposition) of the stapes at the
oval window are all examples of conductive disorders leading to hearing
loss.Furthermore, conductive disorders such as these would result in a clinical
situation with the loss of sound at all frequencies, rather than only a high
frequency or selected frequency. Loss of the cochlear hair cells, particularly at
the beginning of the basal turn of the cochlea, typically result in the loss of high
frequency sounds. This is due to a sensorineural disorder which results in the
loss of a specific frequency due to inability to transduce or convey the
mechanical signal to a neural signal. This selective hearing loss of high
frequency sounds, such as that of a beeping microwave oven, can be
associated with hearing disorders during the process of aging.Loss of neurons
from the spiral ganglion would be another example of a sensorineural disorder.
The loss of otoconia in the otolithic membrane would probably have little effect
on auditory responses.
A 13-month-old girl presents in the urgent care center with a history of fever,
increasing lethargy, and decreased appetite for 4 days. She has had watery
rhinorrhea, an occasional dry cough, and progressive vomiting with 6 episodes
in the prior day, but no diarrhea. Also noted are pain and difficulty when
swallowing and noisy breathing. She has no active medical problems and her
immunizations are up to date.
On examination, her temperature is 39.5°C, respiratory rate 48, apical pulse
162, and blood pressure 90/66 mm Hg. Physical examination demonstrates
decreased hydration of the oral mucosa, increased capillary refill time, and cool
extremities. Tympanic membranes are clear. Pupils are equal, round, and
reactive to light. Nasal mucosa appears mildly erythematous with some dried
crusted secretions in both nares. Nasal flaring is noted. There are no oral or
pharyngeal lesions visible; tonsils appear to be of normal s Answer - Correct
answer:
Otolaryngologist
Explanation
, The X-ray of the lateral neck demonstrates a retropharyngeal abscess.
Definitive treatment consists of surgical drainage performed by an
otolaryngologist. This is primarily a pediatric illness, rarely occurring in
adolescents and adults.
Physical examination may demonstrate nuchal rigidity and/or cervical
lymphadenopathy. An X-ray of the lateral neck may reveal the diagnosis with
findings of a widened prevertebral soft tissue shadow, the presence of air-fluid
level, foreign body, and/or loss of the normal curvature of the cervical spine.
The width of the prevertebral soft tissue should be less than or equal to the
width of the adjacent vertebral body. Radiologically, it may be difficult to
distinguish an abscess from cellulitis in the neck. A follow-up CT scan of the
neck may help. A chest X-ray should be done to determine if there is
mediastinal extension or aspiration pneumonia.
Laboratory findings reflect an acute bacterial infection. White blood cells in the
cerebrospinal fluid can result from irritation of the meninges by infection in
adjoining tissues.
Case
A 25-year-old woman presents with watery eyes and a runny nose. The
symptoms get worse after she has been outside, especially if she plays in the
grass with her 2-year-old. Allergy testing reveals that she is highly allergic to
several grass pollens. Allergy shots using grass pollens as the antigens might be
helpful.
Question Ico-delete Highlights
What mechanism describes how allergy shots help to reduce allergy
symptoms? Answer - Correct answer:
Increased production of allergy-specific IgG
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