Rosh Review-HEENT Exam Questions and Answers Solved Correctly Rated 100%
Acute Angle Closure Glaucoma
Dx:
Labs show increased IOP >21 mmHg
Tx:
Topical ßBs: (TIMOLOL)
Carbonic anhydrase inhibitors: (Acetazolamide)
Steroids: (Prednisolone)
Miotics: (PILOCARPINE) - Answers What presents with patient entering a dark room or movie theater
complaining of acute unilateral painful vision loss, vomiting, and seeing halos around lights, with cloudy
cornea and fixed mid-dilated pupil?
Dx and Tx?
Angle-closure glaucoma - Answers What presents with painful loss of vision with physical exam revealing
circumlimbal injection, steamy cornea, fixed mid-dilated pupil, decreased visual acuity and tearing?
Patient can have colored halos around lights nausea, vomiting, diaphoresis also.
Open-angle glaucoma - Answers What most commonly presents with loss of peripheral vision with no
other complaints?
Anterior chamber is narrowed
intraocular pressure is acutely elevated >21 mmHG
,pressure builds on optic nerve leading to loss of vision - Answers What angle is closed in closed angle
glaucoma?
IMMEDIATE referral to ophthalmologist
1st line: ** Start IV ACETAZOLAMIDE (carbonic anhydrase inhibitor --> to decrease aqueous humor
production
Topical beta blocker (TIMOLOL) and LATANOPROST
USE Miotics--> Pilocarpine, Carbachol
Definitive treatment: surgical iridotomy
DO NOT use Mydriatics - Answers Treatment for closed angle glaucoma?
Optic Nerve
causes peripheral vision loss - Answers What nerve is damaged with glaucoma?
Acute closed angle closure glaucoma - Answers What presents with unilateral ocular pain,
nausea/vomiting, headache, intermittent blurry vision, halos around lights, peripheral vision loss (tunnel
vision)?
Acute narrow angle closure glaucoma - Answers What presents with erythema, steamy cornea(corneal
epithelial edema or cloudiness), mid-dilated, nonreactive pupil, and eyes feel hard to palpation?
Increased intraocular pressure >21 by Tonometry
Cupping of optic nerve - Answers What are diagnostics for acute closed angle glaucoma?
Open angle glaucoma - Answers What is slow, bilateral, peripheral vision loss?
,Open angle glaucoma - Answers What presents with tunnel vision?
Prostaglandin analogs 1st line: Latanoprost - Answers What is management of Open angle glaucoma?
Open angle - Answers What is primary glaucoma?
Open angle glaucoma - Answers What is most common form of glaucoma?
Anterior Uveitis (Iritis) - Answers What presents with unilateral ocular pain/redness/photophobia with
excessive tearing (no discharge)?
Idiopathic
Anterior: commonly follows blunt trauma
BOTH anterior and posterior can occur from SYSTEMATIC INFLAMMATORY DISEASES (HLA-B27
Spondyloathropathies, or infection diseases of CMS, toxoplasmosis, syphillis, TB) - Answers What is most
common cause of Uveitis Iritis?
Ophthamalmoscopy and slit lamp examination will reveal ciliary injection (LIMBIC FLUSH), consensual
photophobia, INFLAMMATORY CELLS AND FLARE within aqueous - Answers How do you diagnose and
treat Iritis (Uveitis)?
Posterior Uveitis (Iritis)
Tx: systemic corticosteroids - Answers What presents with blurred/decreased vision, floaters and
photophobia?
How do you treat?
Anterior: Topical steroids for anterior Iritis
Posterior: Systemic corticosteroids - Answers What is treatment for anterior and posterior Uveitis?
Acute Sinusitis - Answers What presents with purulent nasal discharge, facial pain and pressure, nasal
obstruction and fever?
Strep Pneumo, H. influenza, and less often Staph A
, Risk factors: Cigarette smoking, history of trauma and presence of foreign body - Answers What are
common organisms causing Acute Sinusitis?
What are risk factors?
Sinusitis
Tx: NSAIDS (for pain)
Saline washes, steam and oral and/or nasal decongestants; intranasal corticosteroids
1st line antibiotic: AMOXICILLIN- CLAVULANATE
PCN allergy: Macrolides, TMP-SMX, or doxycycline - Answers What presents with tenderness to
palpation over sinuses, decreased light transmission (opacification) with transillumination of sinuses?
Treatment?
Sinusitis
tx: Amoxicillin-Clavulanate, Doxycycline, Trimethoprim-Sulfamethoxazole
along with decongestants, antihistamines, mycolytics and intranasal steroids - Answers What presents
with facial pressure/pain worsened with bending down and leaning forward, headache and purulent
sputum or nasal discharge?
Treatment?
Ct scan
Acute Angle Closure Glaucoma
Dx:
Labs show increased IOP >21 mmHg
Tx:
Topical ßBs: (TIMOLOL)
Carbonic anhydrase inhibitors: (Acetazolamide)
Steroids: (Prednisolone)
Miotics: (PILOCARPINE) - Answers What presents with patient entering a dark room or movie theater
complaining of acute unilateral painful vision loss, vomiting, and seeing halos around lights, with cloudy
cornea and fixed mid-dilated pupil?
Dx and Tx?
Angle-closure glaucoma - Answers What presents with painful loss of vision with physical exam revealing
circumlimbal injection, steamy cornea, fixed mid-dilated pupil, decreased visual acuity and tearing?
Patient can have colored halos around lights nausea, vomiting, diaphoresis also.
Open-angle glaucoma - Answers What most commonly presents with loss of peripheral vision with no
other complaints?
Anterior chamber is narrowed
intraocular pressure is acutely elevated >21 mmHG
,pressure builds on optic nerve leading to loss of vision - Answers What angle is closed in closed angle
glaucoma?
IMMEDIATE referral to ophthalmologist
1st line: ** Start IV ACETAZOLAMIDE (carbonic anhydrase inhibitor --> to decrease aqueous humor
production
Topical beta blocker (TIMOLOL) and LATANOPROST
USE Miotics--> Pilocarpine, Carbachol
Definitive treatment: surgical iridotomy
DO NOT use Mydriatics - Answers Treatment for closed angle glaucoma?
Optic Nerve
causes peripheral vision loss - Answers What nerve is damaged with glaucoma?
Acute closed angle closure glaucoma - Answers What presents with unilateral ocular pain,
nausea/vomiting, headache, intermittent blurry vision, halos around lights, peripheral vision loss (tunnel
vision)?
Acute narrow angle closure glaucoma - Answers What presents with erythema, steamy cornea(corneal
epithelial edema or cloudiness), mid-dilated, nonreactive pupil, and eyes feel hard to palpation?
Increased intraocular pressure >21 by Tonometry
Cupping of optic nerve - Answers What are diagnostics for acute closed angle glaucoma?
Open angle glaucoma - Answers What is slow, bilateral, peripheral vision loss?
,Open angle glaucoma - Answers What presents with tunnel vision?
Prostaglandin analogs 1st line: Latanoprost - Answers What is management of Open angle glaucoma?
Open angle - Answers What is primary glaucoma?
Open angle glaucoma - Answers What is most common form of glaucoma?
Anterior Uveitis (Iritis) - Answers What presents with unilateral ocular pain/redness/photophobia with
excessive tearing (no discharge)?
Idiopathic
Anterior: commonly follows blunt trauma
BOTH anterior and posterior can occur from SYSTEMATIC INFLAMMATORY DISEASES (HLA-B27
Spondyloathropathies, or infection diseases of CMS, toxoplasmosis, syphillis, TB) - Answers What is most
common cause of Uveitis Iritis?
Ophthamalmoscopy and slit lamp examination will reveal ciliary injection (LIMBIC FLUSH), consensual
photophobia, INFLAMMATORY CELLS AND FLARE within aqueous - Answers How do you diagnose and
treat Iritis (Uveitis)?
Posterior Uveitis (Iritis)
Tx: systemic corticosteroids - Answers What presents with blurred/decreased vision, floaters and
photophobia?
How do you treat?
Anterior: Topical steroids for anterior Iritis
Posterior: Systemic corticosteroids - Answers What is treatment for anterior and posterior Uveitis?
Acute Sinusitis - Answers What presents with purulent nasal discharge, facial pain and pressure, nasal
obstruction and fever?
Strep Pneumo, H. influenza, and less often Staph A
, Risk factors: Cigarette smoking, history of trauma and presence of foreign body - Answers What are
common organisms causing Acute Sinusitis?
What are risk factors?
Sinusitis
Tx: NSAIDS (for pain)
Saline washes, steam and oral and/or nasal decongestants; intranasal corticosteroids
1st line antibiotic: AMOXICILLIN- CLAVULANATE
PCN allergy: Macrolides, TMP-SMX, or doxycycline - Answers What presents with tenderness to
palpation over sinuses, decreased light transmission (opacification) with transillumination of sinuses?
Treatment?
Sinusitis
tx: Amoxicillin-Clavulanate, Doxycycline, Trimethoprim-Sulfamethoxazole
along with decongestants, antihistamines, mycolytics and intranasal steroids - Answers What presents
with facial pressure/pain worsened with bending down and leaning forward, headache and purulent
sputum or nasal discharge?
Treatment?
Ct scan
