EENT Exam Master – questions with correct answers
1. A 22-year-old woman presents with a 1-year history of flaking and
scaling around her lashes, along with itching and a burning sensation. She
has also noted her lid margins are red, and some of her lashes are missing.
Her history is significant for diabetes and for seborrheic dermatitis of
the scalp, eyebrows, and external ears.
Question
What is the most likely diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign body: Blepharitis
2. A 78-year-old Caucasian man presents with unilateral painless loss of
vision in the right eye of 3 hours duration. Examination reveals an elderly
man who is anxious but in no acute distress. Visual acuity is light
perception only in the right eye and 20/30 in the left eye. Pupillary
examination is significant for an afferent pupillary defect on the right side.
Penlight examination of the eyes is otherwise unremarkable. Retinal
examination of the right eye reveals a cherry-red spot. Retinal examination
of the left eye is unremarkable.
Question
What disease process most likely accounts for the patient's presentation?
Adult-onset Tay-Sachs
disease Open-angle glaucoma
Central retinal artery occlusion
Trauma
Cataract: Central retinal artery occlusion
3. A 30-year-old Black male patient is admitted to the hospital to undergo
stapedectomy for the treatment of otosclerosis. He has experienced
increased hearing loss in the right ear for a few years. The patient's mother
had had the same condition when she was in her 40s, and she underwent a
successful operation. Assessment is performed using the Weber and Rinne
tests. Question
,What physical exam finding is expected?
Bone conduction of the affected side is greater than air conduction.
,Bone conduction of the affected side is equal to air conduction.
Air conduction of the affected side is greater than bone
conduction. Sound lateralizes to the unaffected ear.
Bone conduction of the unaffected ear is greater than air conduction.: Bone
conduction of the affected side is greater than air conduction
4. A 41-year-old woman presents to the local emergency department
with a 14-day history of nasal drainage, congestion, fever, and cheek
pain. She
was started on amoxicillin/clavulanate initially, but she was switched to lev-
ofloxacin 7 days ago due to no improvement in symptoms. After 7 days of
levofloxacin therapy, she presents again, reporting that she is no better. The
fever continues and she now has upper tooth pain. On exam, she is in mild
distress, with thick purulent rhinorrhea and halitosis.
Question
What is the next step in the care of this patient?
Admission for intravenous antibiotics
Continue current therapy for an additional 10
days Switch to a broad spectrum antibiotic
Refer to ENT for sinus aspiration
Sinus surgery: Refer to ENT for sinus aspiration
5. A 44-year-old man presents for follow-up of poorly controlled type 1 dia-
betes mellitus that was diagnosed 32 years ago. What change on his
fundus- copic examination would indicate a need for urgent referral to an
ophthalmol- ogist?
Blot hemorrhages
Cotton wool spots
Microaneurysms
Neovascularization
Flame-shaped hemorrhages: Neovascularization
6. A 42-year-old man presents with a firm painless bump on his left upper
eyelid. On examination, you note a 5 mm mass within the tarsus of the left
eye. The skin is freely movable over the mass. The remainder of the eye
exam is unremarkable.
Question
What is the most likely diagnosis?
Pterygium
Ectropion
, Hordeolum
Chalazion
Xanthelasma: Chalazion
7. A 25-year-old male patient presents with an acute otitis media with
serous otitis in the right ear. Weber and Rinne tests are performed.
Question
What results are expected?
A Weber—sound is heard louder in right ear; Rinne—bone conduction ex-
ceeds air conduction in right ear
B Weber—sound is heard louder in left ear; Rinne—bone conduction exceeds
air conduction in right ear
C Weber—sound is heard louder in right ear; Rinne—air conduction exceeds
bone conduction in right ear
D Weber—sound is heard louder in left ear; Rinne—air conduction exceeds
air conduction in right ear
E Weber—sound is equal in both ears; Rinne—bone conduction greater
than air conduction in right ear: C Weber—sound is heard louder in
right ear; Rinne—bone conduction exceeds air conduction in right ear
8. A 67-year-old woman presents; according to her, her husband says she
never listens to anything he says. The patient states that occasionally she
has to ask people to repeat themselves when sitting to her right. She denies
any dizziness, headaches, or visual disturbances. Her current medication is
furosemide. On physical examination, the Weber test reveals lateralization
to the left ear. On the left ear, air conduction lasted for 15 seconds and bone
conduction lasted 10 seconds. On the right ear, air conduction lasted for 22
seconds and bone conduction lasted 10 seconds.
Question
What is the most likely cause of this hearing loss?
Cerumen impaction
Otosclerosis
Ototoxicity
Ménière's disease
Middle ear effusion: Ototoxicity
9. A 35-year-old woman presents with a painful swelling of her left eyelid.
On physical exam, there is tenderness to palpation and erythematous
swelling present on the lid margin involving the eyelashes.
1. A 22-year-old woman presents with a 1-year history of flaking and
scaling around her lashes, along with itching and a burning sensation. She
has also noted her lid margins are red, and some of her lashes are missing.
Her history is significant for diabetes and for seborrheic dermatitis of
the scalp, eyebrows, and external ears.
Question
What is the most likely diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign body: Blepharitis
2. A 78-year-old Caucasian man presents with unilateral painless loss of
vision in the right eye of 3 hours duration. Examination reveals an elderly
man who is anxious but in no acute distress. Visual acuity is light
perception only in the right eye and 20/30 in the left eye. Pupillary
examination is significant for an afferent pupillary defect on the right side.
Penlight examination of the eyes is otherwise unremarkable. Retinal
examination of the right eye reveals a cherry-red spot. Retinal examination
of the left eye is unremarkable.
Question
What disease process most likely accounts for the patient's presentation?
Adult-onset Tay-Sachs
disease Open-angle glaucoma
Central retinal artery occlusion
Trauma
Cataract: Central retinal artery occlusion
3. A 30-year-old Black male patient is admitted to the hospital to undergo
stapedectomy for the treatment of otosclerosis. He has experienced
increased hearing loss in the right ear for a few years. The patient's mother
had had the same condition when she was in her 40s, and she underwent a
successful operation. Assessment is performed using the Weber and Rinne
tests. Question
,What physical exam finding is expected?
Bone conduction of the affected side is greater than air conduction.
,Bone conduction of the affected side is equal to air conduction.
Air conduction of the affected side is greater than bone
conduction. Sound lateralizes to the unaffected ear.
Bone conduction of the unaffected ear is greater than air conduction.: Bone
conduction of the affected side is greater than air conduction
4. A 41-year-old woman presents to the local emergency department
with a 14-day history of nasal drainage, congestion, fever, and cheek
pain. She
was started on amoxicillin/clavulanate initially, but she was switched to lev-
ofloxacin 7 days ago due to no improvement in symptoms. After 7 days of
levofloxacin therapy, she presents again, reporting that she is no better. The
fever continues and she now has upper tooth pain. On exam, she is in mild
distress, with thick purulent rhinorrhea and halitosis.
Question
What is the next step in the care of this patient?
Admission for intravenous antibiotics
Continue current therapy for an additional 10
days Switch to a broad spectrum antibiotic
Refer to ENT for sinus aspiration
Sinus surgery: Refer to ENT for sinus aspiration
5. A 44-year-old man presents for follow-up of poorly controlled type 1 dia-
betes mellitus that was diagnosed 32 years ago. What change on his
fundus- copic examination would indicate a need for urgent referral to an
ophthalmol- ogist?
Blot hemorrhages
Cotton wool spots
Microaneurysms
Neovascularization
Flame-shaped hemorrhages: Neovascularization
6. A 42-year-old man presents with a firm painless bump on his left upper
eyelid. On examination, you note a 5 mm mass within the tarsus of the left
eye. The skin is freely movable over the mass. The remainder of the eye
exam is unremarkable.
Question
What is the most likely diagnosis?
Pterygium
Ectropion
, Hordeolum
Chalazion
Xanthelasma: Chalazion
7. A 25-year-old male patient presents with an acute otitis media with
serous otitis in the right ear. Weber and Rinne tests are performed.
Question
What results are expected?
A Weber—sound is heard louder in right ear; Rinne—bone conduction ex-
ceeds air conduction in right ear
B Weber—sound is heard louder in left ear; Rinne—bone conduction exceeds
air conduction in right ear
C Weber—sound is heard louder in right ear; Rinne—air conduction exceeds
bone conduction in right ear
D Weber—sound is heard louder in left ear; Rinne—air conduction exceeds
air conduction in right ear
E Weber—sound is equal in both ears; Rinne—bone conduction greater
than air conduction in right ear: C Weber—sound is heard louder in
right ear; Rinne—bone conduction exceeds air conduction in right ear
8. A 67-year-old woman presents; according to her, her husband says she
never listens to anything he says. The patient states that occasionally she
has to ask people to repeat themselves when sitting to her right. She denies
any dizziness, headaches, or visual disturbances. Her current medication is
furosemide. On physical examination, the Weber test reveals lateralization
to the left ear. On the left ear, air conduction lasted for 15 seconds and bone
conduction lasted 10 seconds. On the right ear, air conduction lasted for 22
seconds and bone conduction lasted 10 seconds.
Question
What is the most likely cause of this hearing loss?
Cerumen impaction
Otosclerosis
Ototoxicity
Ménière's disease
Middle ear effusion: Ototoxicity
9. A 35-year-old woman presents with a painful swelling of her left eyelid.
On physical exam, there is tenderness to palpation and erythematous
swelling present on the lid margin involving the eyelashes.
