EENT APEA EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
93 demented pt. tx for URI and still has nasal drainage from one
nostril. What should the NP suspect? Correct Answer Presence
of a FB; 2 cluesunilateral, and drainage even after TX
Age-Related Macular Degeneration (AMD)
Description (1)
Types (2) Correct Answer -Degeneration of the central portion
of the retina (Macula)
1. Dry (most common); macula gets thinner w/ age (No TX)
2. Wet (more severe) Abnormal blood vessels grow in the back
of the eye and damage the macula (Treatable)
Allergic Rhinitis:
Etiology Correct Answer - IgE mediated respsone from
allergens
Allergic Rhinitis:
RX (2) Correct Answer 1. Topical intranasal steroids
- MOST effective TX; Preventive!
- Drugs: Budesonide, Fluticasone, mometasone, ciclesonide
- MOA: Inhibit allergic inflammation & down regulate the
inflammatory response**
- Onset: few hours, but takes a few days for maximal effect!
ADD intranasal antihistamine if needed (<3 days)
,2. Oral Antihistamins
- Helps with itching, sneezing, rhinorrrhea (not so much nasal
congestion)
ADD
- Oral decongestant or leukotriene receptor antagonist (Do not
add INS)
Allergic Rhinitis:
SX (7) Correct Answer - Sneezing
- Rhinorrhea
- Pruritus of the face
- Post nasal drip
- Fatigue
- Cough
Allergic Rhinitis:
Description Correct Answer Inflammatory IgE-mediated
disease of the mucous membranes of the nasal tract. Produces
mucosal edema, clear discharge, sneezing, and stuffiness.
Allergic Rhinitis:
DX Correct Answer - Usually none
- CBC: eosinophilia if acute reaction
- Allergy Testing
Allergic Rhinitis:
NonRX Correct Answer - 1st line TX is avoiding the allergen
AMD:
,Incidence (1) Correct Answer Most common cause of
permanent* vision loss in older adults
AMD:
Prevention (7)
TX (3) Correct Answer Prevention
- Eye exams yearly
- Healthy diet
- Exercise
- Stop smoking
- BP control
- HLD control
- Green veggies & fish
TX
- Oral eye vitamin supplement (eg, Ocuvite, PreserVision)
- NO TX for DRY AMD
- TX for WET AMD
AMD: RF (4) Correct Answer - Age >60
- White
- Smoke
- Fx HX
AMD: SX
3 stages
Hallmark sign? Correct Answer *Loss of central vision over
the years; Central vision* needed for driving, watching TV,
Reading, ADLS
1. Early: Asymptomatic
, 2. Intermediate:
- Asymptomatic
- Mild blurriness in central vision
- Trouble seeing in low light
3. Late:
- Blurry spot in the center of vision
- Colors less bright
- Trouble seeing in low light
- Straight lines look wavy*
-*Drusen *hallmark sign Localized deposits of extracellular
materialSmall, bright-yellow objects
AOM:
3 Characteristics Correct Answer 1. Acute sx onset
2. Presence of middle ear effusion
3. SX of acute middle ear inflammation (TM bulging, loss of
bony landmarks)
AOM:
Etiology (4) Correct Answer * Respiratory viruses + bacteria
1. Streptococcus pneumoniae: 49%
2. H. influenzae: 29% (half are beta lactamase-positive)
3. Moraxella catarrhalis: 28% (most are beta lactamase-positive)
4. Group A beta-hemolytic Streptococcus: <5%
SOLUTIONS
93 demented pt. tx for URI and still has nasal drainage from one
nostril. What should the NP suspect? Correct Answer Presence
of a FB; 2 cluesunilateral, and drainage even after TX
Age-Related Macular Degeneration (AMD)
Description (1)
Types (2) Correct Answer -Degeneration of the central portion
of the retina (Macula)
1. Dry (most common); macula gets thinner w/ age (No TX)
2. Wet (more severe) Abnormal blood vessels grow in the back
of the eye and damage the macula (Treatable)
Allergic Rhinitis:
Etiology Correct Answer - IgE mediated respsone from
allergens
Allergic Rhinitis:
RX (2) Correct Answer 1. Topical intranasal steroids
- MOST effective TX; Preventive!
- Drugs: Budesonide, Fluticasone, mometasone, ciclesonide
- MOA: Inhibit allergic inflammation & down regulate the
inflammatory response**
- Onset: few hours, but takes a few days for maximal effect!
ADD intranasal antihistamine if needed (<3 days)
,2. Oral Antihistamins
- Helps with itching, sneezing, rhinorrrhea (not so much nasal
congestion)
ADD
- Oral decongestant or leukotriene receptor antagonist (Do not
add INS)
Allergic Rhinitis:
SX (7) Correct Answer - Sneezing
- Rhinorrhea
- Pruritus of the face
- Post nasal drip
- Fatigue
- Cough
Allergic Rhinitis:
Description Correct Answer Inflammatory IgE-mediated
disease of the mucous membranes of the nasal tract. Produces
mucosal edema, clear discharge, sneezing, and stuffiness.
Allergic Rhinitis:
DX Correct Answer - Usually none
- CBC: eosinophilia if acute reaction
- Allergy Testing
Allergic Rhinitis:
NonRX Correct Answer - 1st line TX is avoiding the allergen
AMD:
,Incidence (1) Correct Answer Most common cause of
permanent* vision loss in older adults
AMD:
Prevention (7)
TX (3) Correct Answer Prevention
- Eye exams yearly
- Healthy diet
- Exercise
- Stop smoking
- BP control
- HLD control
- Green veggies & fish
TX
- Oral eye vitamin supplement (eg, Ocuvite, PreserVision)
- NO TX for DRY AMD
- TX for WET AMD
AMD: RF (4) Correct Answer - Age >60
- White
- Smoke
- Fx HX
AMD: SX
3 stages
Hallmark sign? Correct Answer *Loss of central vision over
the years; Central vision* needed for driving, watching TV,
Reading, ADLS
1. Early: Asymptomatic
, 2. Intermediate:
- Asymptomatic
- Mild blurriness in central vision
- Trouble seeing in low light
3. Late:
- Blurry spot in the center of vision
- Colors less bright
- Trouble seeing in low light
- Straight lines look wavy*
-*Drusen *hallmark sign Localized deposits of extracellular
materialSmall, bright-yellow objects
AOM:
3 Characteristics Correct Answer 1. Acute sx onset
2. Presence of middle ear effusion
3. SX of acute middle ear inflammation (TM bulging, loss of
bony landmarks)
AOM:
Etiology (4) Correct Answer * Respiratory viruses + bacteria
1. Streptococcus pneumoniae: 49%
2. H. influenzae: 29% (half are beta lactamase-positive)
3. Moraxella catarrhalis: 28% (most are beta lactamase-positive)
4. Group A beta-hemolytic Streptococcus: <5%
