EENT (Eyes, Ears, Nose, Throat) exam
with answers
A patient presents with an acute infection of the parotid gland. After several trials of
antibiotics and sialogogues, the swelling has not resolved. What would you do next?
A. Culture the area
B. Observe the swelling for another month
C. Order a panoramic radiograph
D. Send to an ENT specialist for further evaluation - ** VERIFIED ANSWERS **✔✔D. Send
to an ENT specialist for further evaluation
Some cases of parotitis may require surgery if the stone does not pass. Refer the patient to an
ENT for further evaluation if this occurs. If you have already tried several courses of
antibiotics, a culture will not help at this point, since it is likely that the stone may lodge in
the salivary gland. Even if you were able to locate the stone on a radiograph, once
conservative treatment fails an ENT may have to remove the stone.
A 4-year-old boy being treated for sinusitis presents to the emergency department with a
fever and headache. The boy was seen by his primary care provider 2 days ago and given a
prescription for amoxicillin. You cannot obtain a clear history from the mother on whether
she administered the medication properly. On examination, you notice that his eyelid is
swollen, there is restricted extraocular movements, and proptosis is present. The remainder
of the examination is normal. What is the most likely diagnosis?
A. Meningitis
,B. Orbital cellulitis
C. Chronic Sinusitis
D. Mastoiditis - ** VERIFIED ANSWERS **✔✔B. Orbital Cellulitis
Orbital cellulitis can develop from a sinus infection if left untreated. A patient may have
decreased visual acuity, limited ocular motility, and chemosis. The eyelid becomes warm,
erythematous, and painful. Computed tomography (CT) scans of the orbit and sinuses
should be obtained. Treatment consists of hospital admission and intravenous therapy.
Meningitis would present with meningeal signs including a high fever, headache, and neck
pain. Resistant chronic sinusitis would not present with restricted extraocular movements.
Mastoiditis usually presents after an otitis media with pain, swelling, and erythema around
the ear in the area of the mastoid.
A 12-year-old girl was recently diagnosed clinically with a viral pharyngitis but now
presents with worsening of throat pain, fever, tender lymph nodes, and a red rash over her
shoulders only. What is the most likely diagnosis?
A. Hand, foot, and mouth disease
B. Measles
C. Roseola
D. Scarlet fever - ** VERIFIED ANSWERS **✔✔D. Scarlet fever
This patient most likely had a group A beta-hemolytic streptococci (GABHS) and is now
presenting with scarlet fever. A scarlatiniform rash or strawberry tongue is also considered
, pathognomonic of streptococcal disease. Hand, foot, and mouth disease can present with
upper respiratory symptoms, but usually the rash is isolated to the hands and feet. Oral
ulcers can occur as well. Measles can also present with upper respiratory symptoms, but
subsequently the patient develops Koplik spots in the mouth and a rash that starts at the
head and then spreads downward across the body. Roseola infantum is also referred to as
sixth disease. It starts as a high fever and once the fever resolves, a characteristic rash
appears on the trunk.
When conductive hearing loss occurs, the lesion causing the hearing deficit usually involves
which of the following structures?
A. Cochlea
B. Eighth cranial nerve
C. Central auditory pathway
D. Middle Ear - ** VERIFIED ANSWERS **✔✔D. Middle Ear
Conductive hearing loss results from lesions involving the external or middle ear.
Sensorineural hearing loss results from lesions of the cochlea, auditory division, or eighth
cranial nerve. Central hearing disorders result from lesion of the central auditory pathway.
What is the most common pathogen associated with otitis media?
A. Streptococcus pneumoniae
B. Haemophilus influenza
C. Moraxella catarrhalis
with answers
A patient presents with an acute infection of the parotid gland. After several trials of
antibiotics and sialogogues, the swelling has not resolved. What would you do next?
A. Culture the area
B. Observe the swelling for another month
C. Order a panoramic radiograph
D. Send to an ENT specialist for further evaluation - ** VERIFIED ANSWERS **✔✔D. Send
to an ENT specialist for further evaluation
Some cases of parotitis may require surgery if the stone does not pass. Refer the patient to an
ENT for further evaluation if this occurs. If you have already tried several courses of
antibiotics, a culture will not help at this point, since it is likely that the stone may lodge in
the salivary gland. Even if you were able to locate the stone on a radiograph, once
conservative treatment fails an ENT may have to remove the stone.
A 4-year-old boy being treated for sinusitis presents to the emergency department with a
fever and headache. The boy was seen by his primary care provider 2 days ago and given a
prescription for amoxicillin. You cannot obtain a clear history from the mother on whether
she administered the medication properly. On examination, you notice that his eyelid is
swollen, there is restricted extraocular movements, and proptosis is present. The remainder
of the examination is normal. What is the most likely diagnosis?
A. Meningitis
,B. Orbital cellulitis
C. Chronic Sinusitis
D. Mastoiditis - ** VERIFIED ANSWERS **✔✔B. Orbital Cellulitis
Orbital cellulitis can develop from a sinus infection if left untreated. A patient may have
decreased visual acuity, limited ocular motility, and chemosis. The eyelid becomes warm,
erythematous, and painful. Computed tomography (CT) scans of the orbit and sinuses
should be obtained. Treatment consists of hospital admission and intravenous therapy.
Meningitis would present with meningeal signs including a high fever, headache, and neck
pain. Resistant chronic sinusitis would not present with restricted extraocular movements.
Mastoiditis usually presents after an otitis media with pain, swelling, and erythema around
the ear in the area of the mastoid.
A 12-year-old girl was recently diagnosed clinically with a viral pharyngitis but now
presents with worsening of throat pain, fever, tender lymph nodes, and a red rash over her
shoulders only. What is the most likely diagnosis?
A. Hand, foot, and mouth disease
B. Measles
C. Roseola
D. Scarlet fever - ** VERIFIED ANSWERS **✔✔D. Scarlet fever
This patient most likely had a group A beta-hemolytic streptococci (GABHS) and is now
presenting with scarlet fever. A scarlatiniform rash or strawberry tongue is also considered
, pathognomonic of streptococcal disease. Hand, foot, and mouth disease can present with
upper respiratory symptoms, but usually the rash is isolated to the hands and feet. Oral
ulcers can occur as well. Measles can also present with upper respiratory symptoms, but
subsequently the patient develops Koplik spots in the mouth and a rash that starts at the
head and then spreads downward across the body. Roseola infantum is also referred to as
sixth disease. It starts as a high fever and once the fever resolves, a characteristic rash
appears on the trunk.
When conductive hearing loss occurs, the lesion causing the hearing deficit usually involves
which of the following structures?
A. Cochlea
B. Eighth cranial nerve
C. Central auditory pathway
D. Middle Ear - ** VERIFIED ANSWERS **✔✔D. Middle Ear
Conductive hearing loss results from lesions involving the external or middle ear.
Sensorineural hearing loss results from lesions of the cochlea, auditory division, or eighth
cranial nerve. Central hearing disorders result from lesion of the central auditory pathway.
What is the most common pathogen associated with otitis media?
A. Streptococcus pneumoniae
B. Haemophilus influenza
C. Moraxella catarrhalis
