EENT Blueprint

Welcome to episode 33of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue tocover topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. This week we will be covering 10 topic specific EENTboard review questions. Eyes, Ears Nose and Throat accounts for 9% of your PANCE/PANRE board exam. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full EEMTreview includes over 111 EENTspecific questions andis available to all members of the PANCE and PANRE Academy. You can download and listen to past FREE episodes here,oniTunesor StitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. EENTPANCE and PANREPodcast Quiz The Audio PANCE and PANRE EENT Quiz 1 Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Question 1A 4 year-old child presents with a rapid onset of high fever and extremely sore throat. Which of the following findings are suggestive of the diagnosis of epiglottitis?ACroupy cough and droolingBThick gray, adherent exudateHint: Thick gray adherent exudate is suggestive of diphtheria.CBeefy red uvula, palatal petechiae, white exudate Hint: Beefy red uvula, palatal petechiae, and white exudate are findings suggestive of streptococcal pharyngitis.DInflammation and medial protrusion of one tonsilHint: Inflammation with medial protrusion of the tonsil is suggestive of a peritonsillar abscess.Question 1 Explanation: A croupy cough with drooling in a patient who appears very ill is consistent with epiglottitis. Examining the throat is contraindicated, unless the airway can be maintained.Question 2Which of the following are normal findings in a Weber test?AThe tympanic membrane is movable with pneumatic otoscopy.Hint: A movable tympanic membrane indicates there is no effusion, and is not the Weber test. BThe tympanic membrane is pearly gray with a sharp cone of light with apex at the umbo.Hint: The tympanic membrane is evaluated by direct observation with an otoscope, and is not the Weber test.CSound is heard equally in both ears when a vibrating tuning fork is placed on the mid forehead. DAir conduction is greater than bone conduction when a vibrating tuning fork is moved from the mastoid bone to close to the ear canal.Hint: A normal Rinne test means that tuning fork vibration is heard longer through the air than the bone.Question 2 Explanation: A normal Weber test means there is no lateralization of sound perception when a vibrating tuning fork is placed on the mid forehead.Question 3Which of the following is diagnosed by use of the cover/uncover test?AAdie's pupilHint: Adie's pupil is a sluggish pupil reaction to light and accommodation, evaluated by papillary reaction to light.BStrabismus CGlaucoma Hint: Tonometry is used to measure intraocular pressure to evaluate for glaucoma.DMyopiaHint: Myopia is evaluated by using a Snellen chart.Question 3 Explanation: The cover/uncover test is used to diagnose strabismus.Question 4A 45 year-old male complains of loss of hearing in his left ear. He also complains of ringing in the ear, and has had occasional dizziness. On exam, there is unilateral left-sided sensorineural hearing loss and a diminished corneal reflex. Neuro exam is otherwise normal. TMs are normal, and canals are clear. Neck is supple, without adenopathy. Oropharynx is normal. Of the following, the best diagnostic study to identify the cause of this patient's complaints isAauditory brainstem evoked response. Hint: See B for explanation.Bgadolinium-enhanced MRI.Cacoustic reflex testing.Hint: See B for explanation. Dvestibular testing.Hint: Vestibular testing is not a useful screening test for acoustic neuromas.Question 4 Explanation: MRI has replaced auditory brainstem evoked response and acoustic reflex testing in the evaluation of patients for acoustic neuromasQuestion 5A 23 year-old graduate student presents with sudden onset of severe dizziness, with nausea and vomiting for the past couple of hours. She denies hearing loss or tinnitus. She has had a recent cold. Which of the following is the most likely diagnosis?AMà ©nià ¨re's diseaseHint: Mà ©nià ¨re's disease is associated with hearing loss, tinnitus, and vertigo that lasts from seconds to hours.BVestibular neuronitisCBenign positional vertigoHint: Benign positional vertigo occurs with changes in position, especially rapid movements of the head. Nausea may occur, but vomiting is not significant.DVertebrobasilar insufficiencyHint: Vertebrobasilar insufficiency is usually accompanied by brain stem findings, such as diplopia, dysarthri a, or dysphagia, and is not common in this age group.Question 5 Explanation: Vestibular neuronitis or labyrinthitis presents with vertigo, nausea, and vomiting, but not hearing loss or tinnitus. It is related to viral URIs, and develops over several hours, with symptoms worse in the first day, with gradual recovery over several days.Question 6A 4 year-old boy presents with purulent, foul-smelling nasal discharge for three days. He has not had any other symptoms of respiratory illness, cough, wheeze, or fever. His activity level and appetite has been normal. On exam, he is afebrile. TM's have normal light reflex, canals are clear. Left nare is clear; there is considerable amount of purulent exudate from the right nare, and a bright reflection of light is noticed. Oropharynx is without inflammation or exudate. Neck is supple, without lymphadenopathy. Lungs are clear, with equal breath sounds and no wheezing. Heart has regular rhythm without murmurs. Which of the following is the most likely diagnosis?AViral URIHint: Viral URI does not present with foul-smelling nasal discharge.BAcute sinusitisHint: Acute sinusitis may present with purulent nasal discharge, but the observation of a bright light reflection suggests a foreign body.CAllergic rhinitisHint: Allergic rhinitis is seasonal, associated with sneezing and other allergy-related symptoms. DNasal foreign bodyQuestion 6 Explanation: Nasal foreign body is suggested by unilateral nasal obstruction or discharge.Question 7A 59 year-old male complains of "flashing lights behind my eye" followed by sudden loss of vision, stating that it was "like a curtain across my eye." He denies trauma. He takes Glucophage for his diabetes mellitus and atenolol for his hypertension. He has no other complaints. On funduscopic exam, the retina appears to be out of focus. Which of the following is the most likely diagnosis?ACentral retinal vein occlusionHint: Central retinal vein occlusion causes painless, variable loss of vision. Ex am shows retinal hemorrhages in all quadrants and edema of the optic disk.BRetinal artery occlusionHint: Retinal artery occlusion presents with sudden, painless loss of vision. Exam shows pale retina with normal macula, seen as a cherry-red spot.CRetinal detachmentDHyphemaHint: Hyphema is usually associated with trauma, and is a collection of blood in the anterior chamber.Question 7 Explanation: Patients with retinal detachment frequently complain of flashes of light or floaters that occur during traction on the retina as it detaches. This is followed by loss of vision. In small detachments, the retina may appear out of focus, but with larger detachments, a retinal fold may be identified.Question 8A 64 year-old woman complains of headache and left eye pain for about a day. She says it started yesterday as a dull ache and now is throbbing. She also complains of nausea and vomiting, which she attributes to the popcorn she ate at the movie theater yesterday afternoon. On exam, the left pupil is mid-dilated and nonreactive. The cornea is hazy. A ciliary flush is noted. Which of the following is the most likely diagnosis?AMigraine headacheHint: Migraine headache does not present with eye findings.BTemporal arteritisHint: Temporal arteritis presents with headache and systemic symptoms of fever, myalgias, anorexia, and tenderness over the temporal artery.CAcute glaucomaDRetinal artery occlusionHint: Retinal artery occlusion presents with sudden, painless, severe loss of vision. There are no systemic symptoms.Question 8 Explanation: Acute glaucoma often presents with abdominal complaints that may delay diagnosis. Findings of ciliary flush, mid-dilated and nonreactive pupil, and hazy cornea in a patient with severe eye pain are consistent with acute angle closure glaucoma.Question 9The most reliable sign of acute otitis media (AOM) isAbulging of the tympanic membrane.Hint: Bulging and air bubbles behind the TM represent OM with effusion.Bloss of tympanic membrane mobil ity.Creddening of the tympanic membrane.Hint: Reddening of the eardrum is not reliable as it may be due to crying or other vascular changes. Dair bubbles behind the tympanic membrane.Hint: See A for explanation.Question 9 Explanation: Loss of tympanic membrane mobility during pneumoinsufflation is the most reliable sign for diagnosing acute otitis media.Question 10A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis?AViral keratitisBFungal corneal ulcerHint: Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern.CAcanthamoeba keratitis Hint: Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern.DBacterial corneal ulcerHint: Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern.Question 10 Explanation: Herpes Simplex virus is a common cause of dendritic ulceration noted on fluorescein staining.Question 11Small grayish vesicles and punched-out ulcers in the posterior pharynx in a child with pharyngitis is representative of which organism?AEpstein-Barr virusHint: Epstein-Barr virus presents with enlarged tonsils with exudates and petechiae of the palate.BGroup C Streptococcus Hint: Group C Streptococcus presents with a red pharynx and enlarged tonsils with a yellow, blood tinged exudates CCoxsackievirusDGonorrheaHint: Neisseria gonorrhea of the pharynx may be asymptomaticQuestion 11 Explanation: Coxsackievirus presents with small grayish vesicles and punched-out ulcers in the posterior pharynx. There are 11 questions to complete. List Return Shaded items are complete. 1234567891011 Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Not bad!Good work!Perfect! Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joiningThe PANCE and PANRE Exam Academy. I will bereleasing new episodes every few weeks. The Academy isdiscounted, so sign up now. Resources and Show Notes: My list of recommended PANCE and PANRE review books My secretly hidden 50 Question EENT Board Review (HINT IT IS FREE) Click Here USE CODE PALIFE TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE This Podcast is also available on iTunes and Stitcher Radio for Android iTunes:The Audio PANCE AND PANRE Podcast iTunes Stitcher Radio:The Audio PANCE and PANRE Podcast Stitcher document.createElement('audio'); http://traffic.libsyn.com/pasquini/Episode_33_-_EENT_1_-_The_Audio_PANCE_and_PANRE_Board_Review_Podcast.mp3Podcast: Download () | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | Stitcher | RSS | PANCE and PANRE Podcast PlayerView all posts in this seriesThe Audio PANCE and PANRE Board Review Podcast Episode 1The Audio PANCE and PANRE Board Review Podcast Episode 3The Audio PANCE and PANRE Board Review Podcast Episode 5The Audio PANCE and PANRE Board Review Podcast Episode 7The Audio PANCE and PANRE Board Review Podcast Episode 9The Audio PANCE and PANRE Board Review Podcast Episode 11The Audio PANCE and PANRE Board Review Podcast Episode 13The Audio PANCE and PANRE Board Review Podcast Episode 15The Audio PANCE and PANRE Board Review Podcast Episode 17The Audio PANCE and PANRE Board Review Podcast Episode 19The Audio PANCE and PANRE Board Review Podcast Episode 21The Audio PANCE and PANRE Board Review Podcast Episode 23The Audio PANCE and PANRE Board Review Podca st Episode 25Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Reproductive System 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 39Episode 41: The Audio PANCE and PANRE Board Review PodcastEpisode 43: The Audio PANCE and PANRE Board Review PodcastMurmur Madness: The Audio PANCE and PANRE Episode 45Episode 47: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 49: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 51: The Au dio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 53: General Surgery End of Rotation Exam The Audio PANCE and PANRE PodcastEpisode 55: The Audio PANCE and PANRE Board Review PodcastEpisode 57: The Audio PANCE and PANRE Board Review PodcastEpisode 59: Emergency Medicine EOR The Audio PANCE and PANRE Board Review PodcastEpisode 61: The Audio PANCE and PANRE Board Review PodcastEpisode 63: The Audio PANCE and PANRE PA Board Review PodcastPodcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-CPodcast Episode 67: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 69: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 71: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 73: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 77: The Audio PANCE and PANRE Board Review Podcast You may also like -Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Welcome to episode 37of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. 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