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HEENT EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS
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HEENT EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS
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HEENT EXAM 2024/2025 WITH 100% ACCURATESOLUTIONS
A 40-year-old man presents with an acute onset of severe left eye pain
and blurry vision. He was watching a movie in the theater prior to the
onset of his symptoms. Left eye examination reveals redness, dilated
pupil, steamy cornea, and no pupillary light response. His right eye is
otherwise normal. Intraocular pressure measurement in his left eye reads
50 mm Hg. Which of the following is the most likely diagnosis?
Acute angle-closure glaucoma
Acute anterior uveitis
Acute conjunctivitis
Acute keratitis - Answer Acute angle-closure glaucoma
Acute Angle-Closure Glaucoma
Patient will be entering a dark room or movie theater
Acute unilateral painful vision loss, vomiting, and seeing halos around
lights
PE will show cloudy cornea and fixed mid-dilated pupil
Testing will show IOP ( > 21 mm Hg)
Treatment is topical beta-blockers, topical alpha-agonists, carbonic
anhydrase inhibitors, mioticsIridotomy is definitive treatment, but not
used for initial management
,A 54-year-old woman comes to the emergency department because of
vertigo for the past 20 minutes. She has a one-year history of attacks of
vertigo, left ear fullness, left ear hearing loss, and tinnitus. One month
ago, she was treated with oral steroids by another physician and her
symptoms improved. She has subsequently had three more vertigo
attacks with similar symptoms in her left ear. Physical examination
shows Rinne and Weber tests are consistent with sensorineural hearing
loss in the left ear. No nystagmus is present. Which of the following is
the most likely diagnosis?
A. Benign paroxysmal positional vertigo
B. Labyrinthitis
C. Meniere disease
D. Otitis Media
E. Vestibular Neuronitis - Answer C. Meniere disease
Think of Meniere disease when a patient presents with recurrent
episodes of rotatory vertigo associated with hearing loss,
aural fullness, and
tinnitus.
Meniere disease, also known as endolymphatic
hydrops, is an idiopathic disorder of the inner ear associated with
increased endolymphatic pressure.
___________ ___________ is visualized on
,fundoscopic crinkling of retinal tissue and changes in vessel direction. -
Answer Retinal detachment
____________ is the separation of neurosensory layer of retina from
outermost pigmented epithelium leading to vision loss. - Answer Retinal
detachment
Retinal detachment usually presents with defects in the
(central/peripheral) visual field. - Answer Peripheral
Most of the cases of retinal detachment are (rhegmatogenous/non-
rhegmatogenous). - Answer Rhegmatogenous
(Myopia/Hypermetropia) is a risk factor for the development of retinal
detachment. - Answer Myopia
The most common manifestation of posterior vitreous detachment is the
presence of _________ in the visual field. - Answer floaters
Retinal detachment is usually (unilateral/bilateral). - Answer unilateral.
A 66-year-old man comes to the emergency department because of
vision changes. About 2 hours ago, he experienced a sudden flash of
light followed by many floaters in his right eye. His visual disturbances
have since progressed to a peripheral loss of vision that is spreading to
the rest of his visual field. His past medical history is significant for type
2 diabetes mellitus and bilateral cataracts which were corrected
, surgically. External examination of the eye shows reactive pupils and
intact extra-ocular movements. Slit-lamp examination reveals the image
shown below. Which of the following is the most likely diagnosis?
A. Acute angle closure glaucoma
B. Cataracts
C. Diabetic retinopathy
D. Macular degeneration
E. Retinal detachment - Answer E. Retinal detachment
Retinal detachment occurs when the intra-ocular pressure from the
vitreous humor falls, causing the neural and pigment epithelial layers to
separate. Symptoms include a sudden flash of light at the time of the
initial detachment, great increase in the number of floats in the
visual field, and vision loss spreading like "a curtain falling." Slit-lamp
examination can show the actual
detachment. This is an opthalmologic emergency requiring immediate
treatment. If untreated, permanent vision loss may occur. Risk factors of
retinal detachment include a history of cataract surgery, human
immunodeficiency virus infection, glaucoma, and eye neoplasm.
Erythromycin eye-drops can be used as prophylaxis for
_______________ in infants at risk of infection by Chlamydia
trachomatis or Neisseria gonorrhoeae. - Answer Conjunctivitis
The hallmark of allergic conjunctivitis is the presence of ___________,
distinguishing it from viral conjunctivitis. - Answer itching
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